Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality.
Body mass index
Cardiovascular
Hip circumference
Mortality
Obesity
Waist circumference
Journal
Archives of Iranian medicine
ISSN: 1735-3947
Titre abrégé: Arch Iran Med
Pays: Iran
ID NLM: 100889644
Informations de publication
Date de publication:
01 06 2019
01 06 2019
Historique:
received:
26
03
2019
accepted:
16
04
2019
entrez:
30
7
2019
pubmed:
30
7
2019
medline:
23
9
2020
Statut:
epublish
Résumé
It is unclear which anthropometric obesity indicator best predicts adverse health outcomes. This study aimed to investigate the association of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and hip-adjusted WC with all-cause and cardiovascular mortality. 50045 people aged 40-75 (58% women, median BMI: 26.3 kg /m2 ) participated in the population-based Golestan Cohort Study. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) for the association of obesity indicators with mortality. We also examined the association of these indicators with intermediate outcomes, including hypertension, blood glucose, dyslipidemia, carotid atherosclerosis, nonalcoholic fatty liver, and visceral abdominal fat. After a median follow-up of 10.9 years (success rate: 99.1%), 6651 deaths (2778 cardiovascular) occurred. Comparing 5th to the 1st quintile, HRs (95% CIs) for all-cause and cardiovascular mortality were 1.12 (1.02-1.22) and 1.59 (1.39-1.83) for BMI, 1.16 (1.07-1.27) and 1.66 (1.44-1.90) for WC, 1.28 (1.17-1.40) and 1.88 (1.63-2.18) for WHtR, 1.44 (1.32-1.58) and 2.04 (1.76-2.36) for WHR, and 1.84 (1.62-2.09) and 2.72 (2.23-3.32) for hip-adjusted WC, respectively. Hip-adjusted WC had the strongest associations with the intermediate outcomes. Indicators of visceral adiposity (e.g., hip-adjusted WC) were much stronger predictors of overall and cardiovascular mortality than were indicators of general adiposity (e.g., BMI). The full-strength effect of visceral adiposity becomes apparent only when both WC, as a risk factor, and hip circumference, as a protective factor, are individually and simultaneously taken into consideration.
Sections du résumé
BACKGROUND
It is unclear which anthropometric obesity indicator best predicts adverse health outcomes. This study aimed to investigate the association of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and hip-adjusted WC with all-cause and cardiovascular mortality.
METHODS
50045 people aged 40-75 (58% women, median BMI: 26.3 kg /m2 ) participated in the population-based Golestan Cohort Study. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) for the association of obesity indicators with mortality. We also examined the association of these indicators with intermediate outcomes, including hypertension, blood glucose, dyslipidemia, carotid atherosclerosis, nonalcoholic fatty liver, and visceral abdominal fat.
RESULTS
After a median follow-up of 10.9 years (success rate: 99.1%), 6651 deaths (2778 cardiovascular) occurred. Comparing 5th to the 1st quintile, HRs (95% CIs) for all-cause and cardiovascular mortality were 1.12 (1.02-1.22) and 1.59 (1.39-1.83) for BMI, 1.16 (1.07-1.27) and 1.66 (1.44-1.90) for WC, 1.28 (1.17-1.40) and 1.88 (1.63-2.18) for WHtR, 1.44 (1.32-1.58) and 2.04 (1.76-2.36) for WHR, and 1.84 (1.62-2.09) and 2.72 (2.23-3.32) for hip-adjusted WC, respectively. Hip-adjusted WC had the strongest associations with the intermediate outcomes.
CONCLUSION
Indicators of visceral adiposity (e.g., hip-adjusted WC) were much stronger predictors of overall and cardiovascular mortality than were indicators of general adiposity (e.g., BMI). The full-strength effect of visceral adiposity becomes apparent only when both WC, as a risk factor, and hip circumference, as a protective factor, are individually and simultaneously taken into consideration.
Identifiants
pubmed: 31356096
pii: S1029-2977-22(06)301-0
pmc: PMC8843234
mid: NIHMS1776897
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
301-309Subventions
Organisme : NIGMS NIH HHS
ID : UL1 GM118973
Pays : United States
Organisme : Intramural NIH HHS
ID : Z99 CA999999
Pays : United States
Informations de copyright
© 2019 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Références
Eur J Clin Invest. 2017 Jun;47(6):415-421
pubmed: 28380255
Epidemiology. 2012 Jul;23(4):565-73
pubmed: 22517300
Lancet. 2005 Nov 5;366(9497):1640-9
pubmed: 16271645
Curr Opin Cardiol. 2008 Nov;23(6):591-8
pubmed: 18830075
Am J Gastroenterol. 2007 Dec;102(12):2708-15
pubmed: 17894848
Adv Physiol Educ. 2013 Sep;37(3):213-9
pubmed: 24022766
Circulation. 2015 Aug 4;132(5):457-72
pubmed: 26149446
Ann Hepatol. 2015 Sep-Oct;14(5):702-9
pubmed: 26256899
Circulation. 2007 Dec 18;116(25):2933-43
pubmed: 18071080
Obes Rev. 2013 Jan;14(1):86-94
pubmed: 23072327
Circulation. 2011 Nov 1;124(18):1996-2019
pubmed: 21947291
N Engl J Med. 2004 Jun 17;350(25):2549-57
pubmed: 15201411
PLoS One. 2010 Jun 17;5(6):e11183
pubmed: 20567597
Lancet Diabetes Endocrinol. 2017 Mar;5(3):196-213
pubmed: 28126460
Int J Epidemiol. 2012 Apr;41(2):484-94
pubmed: 22266094
Am J Clin Nutr. 2004 Apr;79(4):593-9
pubmed: 15051602
Circulation. 2014 Jun 24;129(25 Suppl 2):S102-38
pubmed: 24222017
Lancet. 2008 Mar 15;371(9616):923-31
pubmed: 18342687
Lancet. 2016 Aug 20;388(10046):776-86
pubmed: 27423262
Int J Epidemiol. 2010 Feb;39(1):52-9
pubmed: 19332502
Int J Obes Relat Metab Disord. 1995 Sep;19(9):644-52
pubmed: 8574275
PLoS One. 2011;6(10):e26621
pubmed: 22028926
BMJ. 2018 Jul 3;362:k2575
pubmed: 29970408
Cardiovasc Res. 2017 Jul 1;113(9):1074-1086
pubmed: 28549096
Am J Epidemiol. 2018 Jan 1;187(1):125-134
pubmed: 29309516
Am J Clin Nutr. 2007 Jun;85(6):1540-4
pubmed: 17556690
Lancet Glob Health. 2018 Jul;6(7):e712-e713
pubmed: 29903366
Obes Rev. 2011 Jun;12(6):478-81
pubmed: 20663064
Int J Epidemiol. 2009 Aug;38(4):978-88
pubmed: 19416955
Circulation. 2018 Mar 13;137(11):1143-1157
pubmed: 29142011
Eur Heart J. 2007 Apr;28(7):850-6
pubmed: 17403720
Int J Obes Relat Metab Disord. 2004 Jun;28(6):741-7
pubmed: 15052280
Obes Rev. 2008 Jul;9(4):312-25
pubmed: 17956544
Stroke. 1999 Apr;30(4):841-50
pubmed: 10187889
Jpn J Radiol. 2016 Jun;34(6):414-22
pubmed: 27015838