{
  "abstract": "Background: Whether differences in adiposity–outcome associations translate into better prediction remains uncertain. We primarily compared the strength and patterns of associations of 12 adiposity-related indices with cardiovascular and mortality outcomes, and secondarily evaluated their discriminatory and incremental predictive performance.\n\nMethods: We analysed a complete-case sample of 278,695 UK Biobank participants without baseline coronary heart disease (CHD) or stroke. Multivariable Cox models, restricted cubic splines, and time-varying analyses associations. The primary outcome was incident cardiovascular disease (CVD; CHD or stroke); component outcomes and all-cause and broadly defined CVD mortality were also examined. Discrimination was compared using five-fold cross-validated integrated time-dependent areas under the curve (iAUCs) over 1–17 years, with alternative indices evaluated in place of body mass index (BMI) within a common covariate framework. Incremental prediction was assessed using 10-year truncated Harrell’s C-index, integrated discrimination improvement (IDI), and continuous net reclassification improvement (NRI) after adding non-BMI indices to a Framingham risk-factor benchmark containing BMI and conventional cardiovascular risk factors.\n\nResults: During a median 15.6 years, 27,947 incident CVD events and 24,464 deaths occurred. Waist-to-hip ratio (WHR) was positively associated with CVD, CHD, and stroke, with adjusted hazard ratios per standard deviation of 1.11 (95% CI 1.09–1.13), 1.12 (1.10–1.14), and 1.07 (1.03–1.10), respectively. Association patterns varied by outcome, and several CVD and CHD associations attenuated over follow-up. The highest observed iAUC gains over BMI ranged from 0.0001 to 0.0025 across outcomes. Weight-adjusted waist index yielded the highest observed total NRI for CVD and CHD, WHR for broadly defined CVD mortality, and A Body Shape Index for all-cause mortality. For CVD, adding weight-adjusted waist index yielded an NRI of 0.077 (95% CI 0.063–0.093), primarily attributable to the non-event component, with small changes in C-index (0.00076) and IDI (0.000455).\n\nConclusions: Association differences did not consistently translate into substantial discrimination gains, and no index was uniformly superior across outcomes. Selected non-BMI indices provided modest, outcome-specific incremental information, based on apparent performance within this cohort. External validation and assessment of calibration and clinical utility are needed before these findings can support clinical recommendations.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "Jinyan Liu"
    },
    {
      "name": "Guangxiang Jiang"
    },
    {
      "name": "Hanyun Qu"
    },
    {
      "name": "Wenyu Hao"
    },
    {
      "name": "Yixing Liu",
      "orcid": "0000-0001-5992-8450"
    },
    {
      "name": "Dongran Han"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/24ej4y13z4rvx.bib",
  "cited_by": 0,
  "doi": "10.1186/s12889-026-29871-z",
  "fulltext_url": null,
  "id": "24ej4y13z4rvx",
  "issns": [
    "1471-2458"
  ],
  "landing_url": "https://link.springer.com/article/10.1186/s12889-026-29871-z",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Cardiovascular Disease and Adiposity"
    ]
  ],
  "openalex": "W7223050203",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-21",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/24ej4y13z4rvx.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:54Z",
      "native_id": "10.1186/s12889-026-29871-z",
      "source": "crossref",
      "url": "https://link.springer.com/article/10.1186/s12889-026-29871-z"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiovascular Disease and Adiposity",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Comparative prognostic value of simple, formula-derived, and biomarker-based adiposity indices for cardiovascular disease and mortality: a UK Biobank cohort study",
  "title_text": "Comparative prognostic value of simple, formula-derived, and biomarker-based adiposity indices for cardiovascular disease and mortality: a UK Biobank cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:54Z",
  "url": "https://research.draconitic.com/paper/24ej4y13z4rvx",
  "venue": "BMC Public Health",
  "versions": []
}