{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:26:53Z","timestamp":1783700813700,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T00:00:00Z","timestamp":1605484800000},"content-version":"vor","delay-in-days":534,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate prospectively the association of body fat percentage (BF%) estimates using various equations from bioelectrical impedance analysis (BIA) with cardiovascular events, compared with body mass index (BMI) and waist circumference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We used data of 34 BIA-BF%-equations that were used for estimation of BF% in 6486 (men\u2009=\u20093194, women\u2009=\u20093294) subjects. During a median follow-up of 8.3 years, 510 (7.9%) cardiovascular events (363 in men; 147 in women) occurred. In men, the crude hazard ratio (95% confidence interval) for BF% from the best predicting BIA-BF%-equation was 3.97 (3.30\u20134.78) against 2.13 (1.85\u20132.45) for BF% from the BIA device's BIA-BF%-equation, 1.34 (1.20\u20131.49) for BMI and 1.49 (1.40\u20131.73) for waist circumference per log-1-SD increase of all. In women, the hazard ratios for best predicting BIA-BF%-equation, BIA device estimation, BMI and waist circumference were 3.80 (2.85\u20134.99), 1.89 (1.57\u20132.28), 1.35 (1.21\u20131.51) and 1.52 (1.31\u20131.75), respectively. After adjustments for age, Framingham cardiovascular disease risk score and creatinine excretion \u2013 a marker of muscle mass \u2013 BF%s and BMI remained independently associated with cardiovascular events in both men and women, while waist circumference was independently associated with cardiovascular events in men, but not in women. According to discrimination ability (C-index) and additive predictive value (net reclassification index and integrated discrimination index) on obesity measures to the Framingham cardiovascular disease risk score, BF% was superior to BMI and waist circumference in both men and women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BF% was independently associated with future cardiovascular events. Body fat estimates from the best-predicting BIA-BF%-equations can be a more predictive measurement in cardiovascular risk assessment than BMI or waist circumference.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2047487319833283","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T01:39:14Z","timestamp":1550799554000},"page":"905-916","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["Body fat estimates from bioelectrical impedance equations in cardiovascular risk assessment: The PREVEND cohort study"],"prefix":"10.1093","volume":"26","author":[{"given":"Oyuntugs","family":"Byambasukh","sequence":"first","affiliation":[{"name":"Department of Epidemiology , University Medical Centre Groningen, University of Groningen, The Netherlands"},{"name":"Department of Internal Medicine , Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele F","family":"Eisenga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , University Medical Centre Groningen, University of Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron T","family":"Gansevoort","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , University Medical Centre Groningen, University of Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan JL","family":"Bakker","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , University Medical Centre Groningen, University of Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Corpeleijn","sequence":"additional","affiliation":[{"name":"Department of Epidemiology , University Medical Centre Groningen, University of Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,29]]},"reference":[{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1161\/CIRCULATIONAHA.105.548206","article-title":"Prediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age","volume":"113","author":"Lloyd-Jones","year":"2006","journal-title":"Circulation"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1161\/CIRCRESAHA.116.307547","article-title":"Cardiovascular disease in women: Clinical perspectives","volume":"118","author":"Garcia","year":"2016","journal-title":"Circ Res"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1177\/2047487317751291","article-title":"Obesity and sudden cardiac death in the young: Clinical and pathological insights from a large national registry","volume":"25","author":"Finocchiaro","year":"2018","journal-title":"Eur J Prev Cardiol"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.nut.2009.05.019","article-title":"Visceral adipose tissue and body fat mass: Predictive values for and role of gender in cardiometabolic risk among Turks","volume":"26","author":"Onat","year":"2010","journal-title":"Nutrition"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1080\/14034940600595621","article-title":"Effects of body fatness and physical activity on cardiovascular risk: Risk prediction using the bioelectrical impedance method","volume":"34","author":"Calling","year":"2006","journal-title":"Scand J Public Health"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"NP1","DOI":"10.1177\/2047487316653709","article-title":"2016 European Guidelines on cardiovascular disease prevention in clinical practice","volume":"23","author":"Piepoli","year":"2016","journal-title":"Eur J Prev Cardiol"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/S0899-9007(00)00471-8","article-title":"Limits of body mass index to detect obesity and predict body composition","volume":"17","author":"Frankenfield","year":"2001","journal-title":"Nutrition"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.atherosclerosis.2009.05.010","article-title":"Urinary creatinine excretion, an indirect measure of muscle mass, is an independent predictor of cardiovascular disease and mortality in the general population","volume":"207","author":"Oterdoom","year":"2009","journal-title":"Atherosclerosis"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/ajcn\/77.2.379","article-title":"Comparisons of waist circumferences measured at 4 sites","volume":"77","author":"Wang","year":"2003","journal-title":"Am J Clin Nutr"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"436S","DOI":"10.1093\/ajcn\/64.3.436S","article-title":"Why bioelectrical impedance analysis should be used for estimating adiposity","volume":"64","author":"Houtkooper","year":"1996","journal-title":"Am J Clin Nutr"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.1038\/ejcn.2012.168","article-title":"The use of bioelectrical impedance analysis for body composition in epidemiological studies","volume":"67","author":"B\u00f6hm","year":"2013","journal-title":"Eur J Clin Nutr"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/j.clnu.2004.06.004","article-title":"Bioelectrical impedance analysis \u2013 Part I: Review of principles and methods","volume":"23","author":"Kyle","year":"2004","journal-title":"Clin Nutr"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1038\/oby.2006.63","article-title":"Comparison of bioelectrical impedance and BMI in predicting obesity-related medical conditions","volume":"14","author":"Willett","year":"2006","journal-title":"Obesity"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.numecd.2008.10.001","article-title":"Obesity markers and estimated 10-year fatal cardiovascular risk in Switzerland","volume":"19","author":"Marques-Vidal","year":"2009","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1038\/oby.2007.593","article-title":"Measures of adiposity and cardiovascular disease risk factors","volume":"15","author":"Menke","year":"2007","journal-title":"Obesity"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1001\/jama.2009.565","article-title":"Microalbuminuria and risk of venous thromboembolism","volume":"301","author":"Mahmoodi","year":"2009","journal-title":"JAMA"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1161\/CIRCULATIONAHA.107.699579","article-title":"General cardiovascular risk profile for use in primary care: The Framingham heart study","volume":"117","author":"D'Agostino","year":"2008","journal-title":"Circulation"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1038\/ejcn.2013.125","article-title":"Development and validation of bioelectrical impedance analysis equations for predicting total body water and fat-free mass in North-African adults","volume":"67","author":"Aglago","year":"2013","journal-title":"Eur J Clin Nutr"},{"key":"2023040618235022600_","volume-title":"Basic statistical analysis","author":"Sprinthall","year":"1999"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4","article-title":"Multivariable prognostic models: Issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors","volume":"15","author":"Harrell","year":"1996","journal-title":"Stat Med"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1002\/sim.5647","article-title":"A unified inference procedure for a class of measures to assess improvement in risk prediction systems with survival data","volume":"32","author":"Uno","year":"2013","journal-title":"Stat Med"},{"key":"2023040618235022600_","volume-title":"Prevention of cardiovascular disease: Guideline for assessment and management of cardiovascular risk","author":"Shah","year":"2007"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/j.numecd.2014.04.005","article-title":"Evidence of inappropriate cardiovascular risk assessment in middle-age women based on recommended cut-points for waist circumference","volume":"24","author":"Florath","year":"2014","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1177\/2047487318806672","article-title":"Improving risk prediction is not easy","volume":"25","author":"Smulders","year":"2018","journal-title":"Eur J Prev Cardiol"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1177\/2047487318770297","article-title":"Prevention of cardiovascular disease: Much more is needed","volume":"25","author":"De Backer","year":"2018","journal-title":"Eur J Prev Cardiol"},{"key":"2023040618235022600_","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/j.amjcard.2016.01.033","article-title":"Relation of muscle mass and fat mass to cardiovascular disease mortality","volume":"117","author":"Srikanthan","year":"2016","journal-title":"Am J Cardiol"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2047487319833283","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2047487319833283","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/26\/9\/905\/49790027\/eurjpc0905.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/26\/9\/905\/49790027\/eurjpc0905.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T21:28:39Z","timestamp":1694640519000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/26\/9\/905\/5926017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,1]]},"references-count":26,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,8,29]]},"published-print":{"date-parts":[[2019,6,1]]}},"URL":"https:\/\/doi.org\/10.1177\/2047487319833283","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,6,1]]},"published":{"date-parts":[[2019,6,1]]}}}