SAT-668 - A Body Shape Index and Body Roundness Index in Predicting Mortality and Cardiovascular Risks in Koreans

Obesity significantly affects mortality, and research on obesity indices continues to evolve. The recently introduced A Body Shape Index (ABSI) has demonstrated superiority over traditional obesity indices in predicting mortality; however, studies specifically targeting East Asian populations are limited. This study aimed to evaluate the predictive value of ABSI by analyzing data from a large Korean cohort. This study included adults aged 20 years and older from the Korean National Health Insurance Service-National Cohort database. Participants were stratified into quartiles based on ABSI values, and statistical analyses were performed to compare participant characteristics and assess the combined effects and impact on mortality outcomes. Among 576,573 participants, 31,943 deaths and 18,635 major adverse cardiac and cerebrovascular events (MACCE) occurred during follow-up. Across increasing ABSI quartiles, mean age increased while the proportion of women decreased. Although body mass index (BMI) remained relatively constant across quartiles, waist circumference (WC) and body roundness index (BRI) increased progressively, as did smoking history and alcohol consumption. The prevalence of metabolic diseases, cardiovascular disease, and chronic kidney disease increased with higher ABSI values. Correlation analysis revealed an inverse relationship between ABSI and BMI, and a positive correlation with WC as well as BRI. In multivariable Cox regression analysis, participants in the highest ABSI quartile demonstrated increased all-cause mortality, whereas BRI showed inverse association. Restricted cubic spline analysis revealed a J-shaped relationship between ABSI and all-cause mortality, whereas other indices approximated reverse J-shaped curves. Kaplan-Meier survival analysis and Cox proportional hazard models stratified by subgroups showed that individuals with elevated ABSI was associated with increased risks of both all-cause mortality and MACCE even within same BMI group, suggesting the potential of combining ABSI and BMI for more refined risk stratification. In conclusion, this large-scale Korean cohort analysis demonstrated that ABSI has superior predictive ability for mortality compared to other obesity indices. These findings support the clinical utility of ABSI alongside BMI in mortality and cardiovascular risk assessment, and warrant further in-depth longitudinal studies utilizing this index.

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