Net contribution and predictive ability of the CUN-BAE body fatness index in relation to cardiometabolic conditions

Eur J Nutr. 2019 Aug;58(5):1853-1861. doi: 10.1007/s00394-018-1743-9. Epub 2018 Jun 11.


Background: The CUN-BAE (Clínica Universidad de Navarra-Body adiposity estimator) index is an anthropometric index based on age, sex and body mass index (BMI) for a refined prediction of body fatness in adults. CUN-BAE may help detect metabolically unhealthy individuals with otherwise normal weight according to BMI or waist circumference (WC). The aim of this study was to evaluate whether CUN-BAE, independent of its components (BMI, age and sex), was associated with cardiometabolic conditions including arterial hypertension, diabetes mellitus and metabolic syndrome (MetS).

Methods: The ENRICA study was based on a cross-sectional sample of non-institutionalized men and women representative of the adult Spanish population. Body weight, height, and WC were measured in all participants. The residual of CUN-BAE (rCUN-BAE), i.e. the part of the index not explained by its components, was calculated. The associations of CUN-BAE, rCUN-BAE, BMI and WC with hypertension, diabetes and MetS were analysed by multivariate logistic regression, and the Akaike information criterion (AIC) was calculated.

Results: The sample included 12,122 individuals. rCUN-BAE was associated with hypertension (OR 1.14, 95% CI 1.07-1.21) and MetS (OR 1.48, 1.37-1.60), but not with diabetes (OR 1.05, 0.94-1.16). In subjects with a BMI < 25 kg/m2, CUN-BAE was significantly associated with all three outcome variables. CUN-BAE was more strongly associated with the cardiometabolic conditions than BMI and WC and fit similar AICs.

Conclusions: The CUN-BAE index for body fatness was positively associated with hypertension, diabetes and MetS in adults independent of BMI or WC. CUN-BAE may help to identify individuals with cardiometabolic conditions beyond BMI, but this needs to be confirmed in prospective settings.

Keywords: BMI; Body fatness; CUN-BAE; Diabetes; Hypertension; Metabolic syndrome.

MeSH terms

  • Adipose Tissue*
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Cross-Sectional Studies
  • Diabetes Mellitus / diagnosis*
  • Female
  • Humans
  • Hypertension / diagnosis*
  • Male
  • Metabolic Syndrome / diagnosis*
  • Middle Aged
  • Risk Factors
  • Sex Factors
  • Spain
  • Young Adult