The relation of CUN-BAE index and BMI with body fat, cardiovascular events and diabetes during a 6-year follow-up: The hordaland health study

Objective: We compared Clínica Universidad de Navarra-Body Adiposity Estimator (CUNBAE) and body mass index (BMI) as correlates of body fat percent (BF%) and the association with future risk of cardiovascular disease (CVD) and type 2 diabetes in a Caucasian population. Methods: We used data from 6796 individuals (born 1925-27 and 1950-52) from the Hordaland Health Study, a prospective cohort study in Norway. The study was conducted in 1992-1993 and 1997-1999. Cross-sectional analyses were conducted with data from 1997/99, including BF% measured by dual-energy X-ray absorptiometry. Longitudinal analyses included BMI and CUN-BAE calculated in 1992/93, and self-reported information on CVD events and diabetes in 1997/99. Results: The correlation between CUN-BAE and BF% (r=0.88) was stronger than between BMI and BF% (r=0.56). In sex-stratified analyses, CUN-BAE and BMI correlated similarly with BF% in men (r=0.77 and r=0.76, respectively) and women (r=0.82 and r=0.81, respectively). In longitudinal analyses, the odds ratio (per 1 SD increase) of CVD and type 2 diabetes was higher for BMI (ORCVD =1.23 [95% CI: 1.11-1.36]; ORdiabetes =2.11 [1.82-2.45]) than for CUN-BAE (ORCVD =1.15 [1.04-1.27]; ORdiabetes =2.06 [1.72-2.47]) in the total population. In sex-stratified analyses, CUN-BAE showed higher CVD and diabetes risk than BMI: in men BMI ORCVD =1.22 (1.04-1.44), ORdiabetes =2.13 (1.64-2.83); CUN-BAE ORCVD =1.93 (1.54-2.43), ORdiabetes =4.33 (2.80-6.71); and in women BMI ORCVD =1.22 (1.07-1.39), ORdiabetes =2.11 (1.76-2.53); CUN-BAE ORCVD =2.06 (1.69-2.51), ORdiabetes =5.45 (3.87-7.67). Conclusion: CUN-BAE is more strongly associated with future risk of type 2 diabetes and CVD compared with BMI in analysis stratified by sex. As a measure of adiposity in men and women separately, CUN-BAE has no advantage over BMI, except when the value of estimated BF% itself is of interest.