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. 2025 Aug 8:11:30495334251361319.
doi: 10.1177/30495334251361319. eCollection 2025 Jan-Dec.

A Comparative Assessment of Body Shape and Size Index (BSSI), Body Mass Index (BMI), and Body Surface Area (BSA) in Predicting Diabetes Prevalence Among Pakistani Adults

Farrukh Shehzad  1 , Waqas Ghulam Hussain  1 , Atif Akbar  2
Affiliations

A Comparative Assessment of Body Shape and Size Index (BSSI), Body Mass Index (BMI), and Body Surface Area (BSA) in Predicting Diabetes Prevalence Among Pakistani Adults

Farrukh Shehzad et al. Sage Open Aging. .

Abstract

This study evaluates the impact of the recently developed BSSI on diabetic adults in Pakistan. A comparative analysis was conducted between BSSI, body mass index (BMI), and body surface area (BSA) to assess the performance of BSSI and identify ideal measures that can accurately predict the incidence of diabetes in Pakistani adults. The research is based on a cross-sectional dataset collected from 1,928 individuals in Pakistan over 2-years. Pregnant women were excluded from the study, and all participants aged 20 years or older, including both males and females, were included and provided required information. Quantile regression curve analyses were employed to investigate the projecting influence of baseline BSSI, BSA, and BMI on the development of Type-2 diabetes. The findings revealed that during the follow-up period, 511 new cases of Type-2 diabetes emerged. The results suggest that BSSI is the most effective measure for predicting Type-2 diabetes in males, as evidenced by quantile regression curve analyses. In contrast, for women, the predictive abilities of BSSI and BMI are similar and superior to those of BSA. For both sex, BSA was found to be the weakest factor. Notably, BSSI and BMI emerged as the best predictors of Type-2 diabetes, while BSA was identified as the weakest measure for assessing diabetes in adults.

Keywords: body mass index; body shape and size index; body surface area; diabetes; integrated obesity measures; quantile regression.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

This pie chart illustrates the diabetes status among male respondents, with 75% reported as diabetic and the remaining 25% as not-diabetic. This indicates a significant portion of the population has diabetes mellitus.
Figure 1.
Diabetes status in male respondents.
This pie chart represents 100% distribution of female respondents into diabetic and not-diabetic categories, with 27% not-diabetic and 73% diabetic.
Figure 2.
Diabetes status in female respondents.
A person is shown to have an optimal weight.
Figure 3.
Standardized quantile curves for BMI, BSA and BSSI for the prediction of diabetes type 2 for complete data.
generate a comparison in 20 words
Figure 4.
Standardized quantile curves for BMI, BSA and BSSI for the prediction of diabetes type 2 for male.
Standardized quantile curves for BMI, BSA and BSSI for the prediction of diabetes type 2 for female.
Figure 5.
Standardized quantile curves for BMI, BSA and BSSI for the prediction of diabetes type 2 for female.
See this image and copyright information in PMC

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