Obesity is one of the most important metabolic diseases around the world

Obesity is one of the most important metabolic diseases around the world. The prevalence of obesity is increasing not only in adults but also in children and adolescents 1. Obesity is a phenomenon that arises from the interaction of factors such as genetics and behavioral components. Behavioral components, in turn, include physical activity and diet 2. Obesity in the world has doubled since 1980 3. The number of obese people worldwide is expected to reach 1.2 billion and the number of overweight people will reach 16.2 billion until 2030 4, 5. The prevalence of overweight and obesity in Iran is 60.5% and 20-30%, respectively 3. Obesity is a mild inflammation in which adipocyte hypertrophy enhances the production of pro-inflammatory cytokines such as IL6, TNF?, and CRP 6. This inflammatory condition and inflammatory markers contribute to the progression of insulin resistance, cardio-metabolic diseases, and complications associated with obesity 7. Obesity is associated with an increased risk of atherosclerotic vascular disease, coronary artery disease, diabetes, bile duct disease, colon cancer, high blood lipids, high blood pressure, and higher mortality rates 1, 8. According to the World Health Organization, obesity and overweight after high blood pressure, high blood sugar, smoking and inactivity are the fifth cause of death risk 9.
Obesity is often accompanied by metabolic disorders, but in all people who are obese, the risk of cardiovascular and metabolic diseases is not high. Many studies also suggest that obesity phenotypes are not always associated with metabolic abnormalities such as dyslipidemia and high blood pressure and insulin resistance 10-12. In general, obese people are divided into two healthy and unhealthy groups based on the metabolic status. Metabolically Healthy Obese (MHO) is called obese people whose BMI is higher than 30, but their Insulin sensitivity, lipid profiles and inflammatory profiles are favorable, and there are no signs of hypertension and cardio-metabolic diseases 11-13. They account for about 10 to 34 percent of the obese population. Various indicators and definitions are used to determine the healthy metabolic status and unhealthy metabolic status 10, 11. One of these indicators is the Karelis criterion that measures TG, LDL cholesterol, HDL cholesterol, CRP, HOMA-IR, and if at least four of these are in the optimal range, the person is considered to be MHO 10-13.
Different parameters are now used to evaluate obesity, Including body mass index, waist circumference, hip circumference, waist to hip ratio, and waist to height ratio 14-16, But BMI does not have the ability to detect fat mass from muscle mass, while increased fat mass is associated with increased risk of premature death 17. Also, BMI cannot detect the location of fat distribution if the accumulation of central or abdominal fat is a serious health hazard 18-20. In fact, BMI is strengthened along with other scales, such as wrist circumference and other scales that are derived from waist is a marker for identifying abdominal obesity 21-24.
A Body Shape Index (ABSI) is a marker for identifying abdominal obesity that is derived from weight, height and waist circumference that was first introduced by Nir Y. Krakauer in 2012. The calculation of ABSI is 9: ABSI = WC/??BMI ?^(2/3) hight?^(1/2) . Several studies have reported ABSI communication with diabetes 25, metabolic syndrome 26, and hypertension 27, 28. ABSI is associated with several pathophysiologic markers such as visceral adiposity, sarcopenia and Carotid artery hardness 29. In several studies, ABSI was associated with a higher mortality rate, and the risk of mortality with ABSI was more than BMI and waist circumference 9, 29, 30. In this paper, we want to investigate the relationship between ABSI and other anthropometric indices for predicting unhealthy phenotypes of obesity in a population sample.