Beyond Body Mass Index: Using Anthropometric Measures and Body Composition Indicators to Assess Odds of an Endometriosis Diagnosis

Uba Backonja, Mary L Hediger, Zhen Chen, Diane Lauver, Diane R Lauver, Liping Sun, C Matthew Peterson, Germaine M Buck Louis
Journal of women's health (2002) · 2017 · vol. 26(9) , pp. 941–950 · doi:10.1089/jwh.2016.6128 · PMID:28537460 · PMC5646748 · W2619561108
article OA: green CC0 ⤵ 29 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Endometriosis diagnosis was inversely associated with weight, subscapular skinfold thickness, waist and hip circumferences, upper arm muscle areas, and BMI in a surgical cohort, with no significant moderation by physical activity.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This multicenter ENDO Study analyzed 473 women scheduled for surgical evaluation of pelvic conditions, measuring anthropometry, skinfolds, and derived body composition indicators (including BMI, fat distribution ratios, and muscle/fat area estimates) and assessing physical activity and sedentariness via IPAQ-SF prior to laparoscopy/laparotomy. Using cross-sectional logistic regression with adjustments for age, site, smoking history, and income, the authors found inverse associations between an endometriosis diagnosis and several indicators of lower body mass/adiposity, including standardized weight, BMI, certain skinfolds, waist/hip circumferences, and upper arm muscle area. They reported no evidence that physical activity or sedentariness moderated these associations, and a key limitation was the cross-sectional design in a surgical cohort, alongside substantial missingness for physical activity that was handled via mode imputation. This paper is centrally about endometriosis — it tests how detailed anthropometric and body composition measures relate to odds of an endometriosis diagnosis assessed at surgery.

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Abstract

Background: Body mass index (BMI) and endometriosis have been inversely associated. To address gaps in this research, we examined associations among body composition, endometriosis, and physical activity. Materials and Methods: Women from 14 clinical sites in the Salt Lake City, Utah and San Francisco, California areas and scheduled for laparoscopy/laparotomy were recruited during 2007–2009. Participants (N = 473) underwent standardized anthropometric assessments to estimate body composition before surgery. Using a cross-sectional design, odds of an endometriosis diagnosis (adjusted odds ratio [aOR]; 95% confidence interval [CI]) were calculated for anthropometric and body composition measures (weight in kg; height in cm; mid upper arm, waist, hip, and chest circumferences in cm; subscapular, suprailiac, and triceps skinfold thicknesses in mm; arm muscle and fat areas in cm2; centripetal fat, chest-to-waist, chest-to-hip, waist-to-hip, and waist-to-height ratios; arm fat index; and BMI in kg/m2). Physical activity (metabolic equivalent of task-minutes/week) and sedentariness (average minutes sitting on a weekday) were assessed using the International Physical Activity Questionnaire-Short Form. Measures were modeled continuously and in quartiles based on sample estimates. Adjusted models were controlled for age (years, continuous), site (Utah/California), smoking history (never, former, or current smoker), and income (below, within 180%, and above of the poverty line). Findings were standardized by dividing variables by their respective standard deviations. We used adjusted models to examine whether odds of an endometriosis diagnosis were moderated by physical activity or sedentariness. Results: Inverse relationships were observed between endometriosis and standardized: weight (aOR = 0.71, 95% CI 0.57–0.88); subscapular skinfold thickness (aOR = 0.79, 95% CI 0.65–0.98); waist and hip circumferences (aOR = 0.79, 95% CI 0.64–0.98 and aOR = 0.76, 95% CI 0.61–0.94, respectively); total upper arm and upper arm muscle areas (aOR = 0.76, 95% CI 0.61–0.94 and aOR = 0.74, 95% CI 0.59–0.93, respectively); and BMI (aOR = 0.75, 95% CI 0.60–0.93), despite similar heights. Women in the highest versus lowest quartile had lower adjusted odds of an endometriosis diagnosis for: weight; mid-upper arm, hip, and waist circumferences; total upper arm and upper arm muscle areas; BMI; and centripetal fat ratio. There was no evidence of a main effect or moderation of physical activity or sedentariness. Conclusion: In a surgical cohort, endometriosis was inversely associated with anthropometric measures and body composition indicators.

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Condition tags

endometriosis

MeSH descriptors

Anthropometry Body Composition Body Mass Index Endometriosis Waist Circumference Adult Body Composition California California Cross-Sectional Studies Endometriosis Endometriosis Female Humans Utah Utah Waist-Hip Ratio

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