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Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study.

Abstract

BACKGROUND

Recent clinical guidelines on the health risks of obesity use body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and waist circumference, but the waist-hip ratio may provide independent information.

METHODS

To assess the joint and relative associations of BMI, waist circumference, and waist-hip ratio with multiple disease end points, we conducted a prospective cohort study of 31,702 Iowa women, aged 55 to 69 years and free of cancer, heart disease, and diabetes, assembled by random sampling and mail survey in 1986. Study end points were total and cause-specific mortality and incidence of site-specific cancers and self-reported diabetes, hypertension, and hip fracture over 11 to 12 years.

RESULTS

The waist-hip ratio was the best anthropometric predictor of total mortality, with the multivariable-adjusted relative risk for quintile 5 vs 1 of 1.2 (95% confidence interval, 1.1-1.4), compared with 0.91 (95% confidence interval, 0.8-1.0) for BMI and 1.1 (95% confidence interval, 1.0-1. 3) for waist circumference. The waist-hip ratio was also associated positively with mortality from coronary heart disease, other cardiovascular diseases, cancer, and other causes. The waist-hip ratio was associated less consistently than BMI or waist circumference with cancer incidence. All anthropometric indexes were associated with incidence of diabetes and hypertension. For example, women simultaneously in the highest quintiles of BMI and waist-hip ratio had a relative risk of diabetes of 29 (95% confidence interval, 18-46) vs. women in the lowest combined quintiles.

CONCLUSION

The waist-hip ratio offers additional prognostic information beyond BMI and waist circumference.

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  • Authors+Show Affiliations

    ,

    Division of Epidemiology, School of Public Health, University of Minnesota, 1300 S Second St, Suite 300, Minneapolis, MN 55454-1015, USA. folsom@epi.umn.edu

    , , , , , , ,

    Source

    Archives of internal medicine 160:14 2000 Jul 24 pg 2117-28

    MeSH

    Abdomen
    Aged
    Body Constitution
    Body Mass Index
    Cause of Death
    Coronary Disease
    Diabetes Mellitus
    Female
    Hip Fractures
    Humans
    Incidence
    Iowa
    Middle Aged
    Neoplasms
    Obesity
    Outcome Assessment (Health Care)
    Prognosis
    Prospective Studies
    Risk Factors
    Surveys and Questionnaires
    Survival Rate
    Women's Health

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    10904454

    Citation

    Folsom, A R., et al. "Associations of General and Abdominal Obesity With Multiple Health Outcomes in Older Women: the Iowa Women's Health Study." Archives of Internal Medicine, vol. 160, no. 14, 2000, pp. 2117-28.
    Folsom AR, Kushi LH, Anderson KE, et al. Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study. Arch Intern Med. 2000;160(14):2117-28.
    Folsom, A. R., Kushi, L. H., Anderson, K. E., Mink, P. J., Olson, J. E., Hong, C. P., ... Prineas, R. J. (2000). Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study. Archives of Internal Medicine, 160(14), pp. 2117-28.
    Folsom AR, et al. Associations of General and Abdominal Obesity With Multiple Health Outcomes in Older Women: the Iowa Women's Health Study. Arch Intern Med. 2000 Jul 24;160(14):2117-28. PubMed PMID: 10904454.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study. AU - Folsom,A R, AU - Kushi,L H, AU - Anderson,K E, AU - Mink,P J, AU - Olson,J E, AU - Hong,C P, AU - Sellers,T A, AU - Lazovich,D, AU - Prineas,R J, PY - 2000/7/25/pubmed PY - 2000/8/12/medline PY - 2000/7/25/entrez SP - 2117 EP - 28 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 160 IS - 14 N2 - BACKGROUND: Recent clinical guidelines on the health risks of obesity use body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and waist circumference, but the waist-hip ratio may provide independent information. METHODS: To assess the joint and relative associations of BMI, waist circumference, and waist-hip ratio with multiple disease end points, we conducted a prospective cohort study of 31,702 Iowa women, aged 55 to 69 years and free of cancer, heart disease, and diabetes, assembled by random sampling and mail survey in 1986. Study end points were total and cause-specific mortality and incidence of site-specific cancers and self-reported diabetes, hypertension, and hip fracture over 11 to 12 years. RESULTS: The waist-hip ratio was the best anthropometric predictor of total mortality, with the multivariable-adjusted relative risk for quintile 5 vs 1 of 1.2 (95% confidence interval, 1.1-1.4), compared with 0.91 (95% confidence interval, 0.8-1.0) for BMI and 1.1 (95% confidence interval, 1.0-1. 3) for waist circumference. The waist-hip ratio was also associated positively with mortality from coronary heart disease, other cardiovascular diseases, cancer, and other causes. The waist-hip ratio was associated less consistently than BMI or waist circumference with cancer incidence. All anthropometric indexes were associated with incidence of diabetes and hypertension. For example, women simultaneously in the highest quintiles of BMI and waist-hip ratio had a relative risk of diabetes of 29 (95% confidence interval, 18-46) vs. women in the lowest combined quintiles. CONCLUSION: The waist-hip ratio offers additional prognostic information beyond BMI and waist circumference. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/10904454/Associations_of_general_and_abdominal_obesity_with_multiple_health_outcomes_in_older_women:_the_Iowa_Women's_Health_Study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/160/pg/2117 DB - PRIME DP - Unbound Medicine ER -