Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity in Europeans

for the DECODE Study Group

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Background and aims: Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity is still controversial. Methods and results: Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), A Body Shape Index (ABSI) and waist-to-hip-to-height ratio (WHHR) were measured at baseline in a cohort of 46,651 European men and women aged 24-99 years. The relationship between anthropometric measures of obesity and mortality was evaluated by the Cox proportional hazards model with age as a time-scale and with threshold detected by a piecewise regression model. Over a median follow-up of 7.9 years, 2381 men and 1055 women died, 1071 men (45.0%) and 339 women (32.1%) from cardiovascular disease (CVD). BMI had a J-shaped relationship with CVD mortality, whereas anthropometric measures of abdominal obesity had positive linear relationships. BMI, WC and WHtR showed J-shaped associations with all-cause mortality, whereas WHR, ABSI and WHHR demonstrated positive linear relationships. Accordingly, a threshold value was detected at 29.29 and 30.98kg/m2 for BMI, 96.4 and 93.3cm for WC, 0.57 and 0.60 for WHtR, 0.0848 and 0.0813m11/6kg-2/3 for ABSI with CVD mortality in men and women, respectively; 29.88 and 29.50kg/m2 for BMI, 104.3 and 105.6 for WC, 0.61 and 0.67 for WHtR, 0.95 and 0.86 for WHR, 0.0807 and 0.0765 for ABSI in men and women, respectively, and 0.52 for WHHR in women with all-cause mortality. Conclusion: All anthropometric measures of abdominal obesity had positive linear associations with CVD mortality, whereas some showed linear and the others J-shaped relationships with all-cause mortality. BMI had a J-shaped relationship with either CVD or all-cause mortality. Thresholds detected based on mortality may help with clinical definition of obesity in relation to mortality.

Original languageEnglish
Pages (from-to)295-304
Number of pages10
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume25
Issue number3
DOIs
Publication statusPublished - 2015

Fingerprint

Obesity
Mortality
Body Mass Index
Waist Circumference
Cardiovascular Diseases
Waist-Hip Ratio
Hip
Abdominal Obesity
Proportional Hazards Models
Waist-Height Ratio

Keywords

  • Abdominal obesity
  • All-cause mortality
  • Cardiovascular mortality

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity in Europeans. / for the DECODE Study Group.

In: Nutrition, Metabolism and Cardiovascular Diseases, Vol. 25, No. 3, 2015, p. 295-304.

Research output: Contribution to journalArticle

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title = "Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity in Europeans",
abstract = "Background and aims: Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity is still controversial. Methods and results: Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), A Body Shape Index (ABSI) and waist-to-hip-to-height ratio (WHHR) were measured at baseline in a cohort of 46,651 European men and women aged 24-99 years. The relationship between anthropometric measures of obesity and mortality was evaluated by the Cox proportional hazards model with age as a time-scale and with threshold detected by a piecewise regression model. Over a median follow-up of 7.9 years, 2381 men and 1055 women died, 1071 men (45.0{\%}) and 339 women (32.1{\%}) from cardiovascular disease (CVD). BMI had a J-shaped relationship with CVD mortality, whereas anthropometric measures of abdominal obesity had positive linear relationships. BMI, WC and WHtR showed J-shaped associations with all-cause mortality, whereas WHR, ABSI and WHHR demonstrated positive linear relationships. Accordingly, a threshold value was detected at 29.29 and 30.98kg/m2 for BMI, 96.4 and 93.3cm for WC, 0.57 and 0.60 for WHtR, 0.0848 and 0.0813m11/6kg-2/3 for ABSI with CVD mortality in men and women, respectively; 29.88 and 29.50kg/m2 for BMI, 104.3 and 105.6 for WC, 0.61 and 0.67 for WHtR, 0.95 and 0.86 for WHR, 0.0807 and 0.0765 for ABSI in men and women, respectively, and 0.52 for WHHR in women with all-cause mortality. Conclusion: All anthropometric measures of abdominal obesity had positive linear associations with CVD mortality, whereas some showed linear and the others J-shaped relationships with all-cause mortality. BMI had a J-shaped relationship with either CVD or all-cause mortality. Thresholds detected based on mortality may help with clinical definition of obesity in relation to mortality.",
keywords = "Abdominal obesity, All-cause mortality, Cardiovascular mortality",
author = "{for the DECODE Study Group} and X. Song and P. Jousilahti and Stehouwer, {C. D A} and S. S{\"o}derberg and A. Onat and T. Laatikainen and Yudkin, {J. S.} and R. Dankner and R. Morris and J. Tuomilehto and Q. Qiao and P. Jousilahti and J. Lindstr{\"o}m and T. Laatikainen and M. Peltonen and J. Lindstr{\"o}m and S. S{\"o}derberg and M. Eliasson and B. Zethelius and A. Onat and A. Tab{\'a}k and Tab{\'a}k, {A. G.} and M. Kivim{\"a}ki and Brunner, {E. J.} and Witte, {D. R.}",
year = "2015",
doi = "10.1016/j.numecd.2014.09.004",
language = "English",
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journal = "Nutrition, Metabolism and Cardiovascular Diseases",
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T1 - Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity in Europeans

AU - for the DECODE Study Group

AU - Song, X.

AU - Jousilahti, P.

AU - Stehouwer, C. D A

AU - Söderberg, S.

AU - Onat, A.

AU - Laatikainen, T.

AU - Yudkin, J. S.

AU - Dankner, R.

AU - Morris, R.

AU - Tuomilehto, J.

AU - Qiao, Q.

AU - Jousilahti, P.

AU - Lindström, J.

AU - Laatikainen, T.

AU - Peltonen, M.

AU - Lindström, J.

AU - Söderberg, S.

AU - Eliasson, M.

AU - Zethelius, B.

AU - Onat, A.

AU - Tabák, A.

AU - Tabák, A. G.

AU - Kivimäki, M.

AU - Brunner, E. J.

AU - Witte, D. R.

PY - 2015

Y1 - 2015

N2 - Background and aims: Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity is still controversial. Methods and results: Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), A Body Shape Index (ABSI) and waist-to-hip-to-height ratio (WHHR) were measured at baseline in a cohort of 46,651 European men and women aged 24-99 years. The relationship between anthropometric measures of obesity and mortality was evaluated by the Cox proportional hazards model with age as a time-scale and with threshold detected by a piecewise regression model. Over a median follow-up of 7.9 years, 2381 men and 1055 women died, 1071 men (45.0%) and 339 women (32.1%) from cardiovascular disease (CVD). BMI had a J-shaped relationship with CVD mortality, whereas anthropometric measures of abdominal obesity had positive linear relationships. BMI, WC and WHtR showed J-shaped associations with all-cause mortality, whereas WHR, ABSI and WHHR demonstrated positive linear relationships. Accordingly, a threshold value was detected at 29.29 and 30.98kg/m2 for BMI, 96.4 and 93.3cm for WC, 0.57 and 0.60 for WHtR, 0.0848 and 0.0813m11/6kg-2/3 for ABSI with CVD mortality in men and women, respectively; 29.88 and 29.50kg/m2 for BMI, 104.3 and 105.6 for WC, 0.61 and 0.67 for WHtR, 0.95 and 0.86 for WHR, 0.0807 and 0.0765 for ABSI in men and women, respectively, and 0.52 for WHHR in women with all-cause mortality. Conclusion: All anthropometric measures of abdominal obesity had positive linear associations with CVD mortality, whereas some showed linear and the others J-shaped relationships with all-cause mortality. BMI had a J-shaped relationship with either CVD or all-cause mortality. Thresholds detected based on mortality may help with clinical definition of obesity in relation to mortality.

AB - Background and aims: Cardiovascular and all-cause mortality in relation to various anthropometric measures of obesity is still controversial. Methods and results: Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), A Body Shape Index (ABSI) and waist-to-hip-to-height ratio (WHHR) were measured at baseline in a cohort of 46,651 European men and women aged 24-99 years. The relationship between anthropometric measures of obesity and mortality was evaluated by the Cox proportional hazards model with age as a time-scale and with threshold detected by a piecewise regression model. Over a median follow-up of 7.9 years, 2381 men and 1055 women died, 1071 men (45.0%) and 339 women (32.1%) from cardiovascular disease (CVD). BMI had a J-shaped relationship with CVD mortality, whereas anthropometric measures of abdominal obesity had positive linear relationships. BMI, WC and WHtR showed J-shaped associations with all-cause mortality, whereas WHR, ABSI and WHHR demonstrated positive linear relationships. Accordingly, a threshold value was detected at 29.29 and 30.98kg/m2 for BMI, 96.4 and 93.3cm for WC, 0.57 and 0.60 for WHtR, 0.0848 and 0.0813m11/6kg-2/3 for ABSI with CVD mortality in men and women, respectively; 29.88 and 29.50kg/m2 for BMI, 104.3 and 105.6 for WC, 0.61 and 0.67 for WHtR, 0.95 and 0.86 for WHR, 0.0807 and 0.0765 for ABSI in men and women, respectively, and 0.52 for WHHR in women with all-cause mortality. Conclusion: All anthropometric measures of abdominal obesity had positive linear associations with CVD mortality, whereas some showed linear and the others J-shaped relationships with all-cause mortality. BMI had a J-shaped relationship with either CVD or all-cause mortality. Thresholds detected based on mortality may help with clinical definition of obesity in relation to mortality.

KW - Abdominal obesity

KW - All-cause mortality

KW - Cardiovascular mortality

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DO - 10.1016/j.numecd.2014.09.004

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VL - 25

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JO - Nutrition, Metabolism and Cardiovascular Diseases

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