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Preferred clinical measures of central obesity for predicting mortality.
Eur J Clin Nutr 2007; 61(12):1373-9EJ

Abstract

OBJECTIVE

To define the clinical measures of obesity that best predict all cause mortality and cardiovascular disease (CVD) mortality.

DESIGN AND SETTING

Eleven-year mortality follow-up of an Australian urban population sample of 9309 adults aged 20-69 years in 1989. Baseline measures of obesity included body mass index (BMI), waist circumference (WC), waist-to-stature ratio and the waist-to-hip ratio. The age-standardized hazard ratios for mortality were calculated for 1 s.d. above the mean for each measure of obesity using Cox regression analysis. We constructed receiver operator characteristic (ROC) curves to assess sensitivity and specificity of the measures and to identify approximate cut-points for the prediction of risk.

RESULTS

Waist-to-hip ratio was superior by magnitude and significance in predicting all cause mortality (male hazard ratio 1.25, P=0.003, female hazard ratio 1.24, P=0.003) and CVD mortality (male hazard ratio 1.62, P<0.001, female hazard ratio 1.59, P<0.001). Waist-to-stature ratio and WC were highly significant but less powerful predictors for CVD mortality. ROC analysis showed higher 'area under the curve' values for waist-related measures in males, with similar less marked trends in females. The ROC cut-points yielded values that corresponded to current promulgated criteria.

CONCLUSIONS

The waist-to-hip ratio is the preferred clinical measure of obesity for predicting all cause and CVD mortality. WC is a practical alternative. Waist-to-stature ratio is not more useful than WC alone.

Authors+Show Affiliations

Department of Medicine, University of Western Australia, Australia. carolyn.bond@health.wa.gov.auNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17299478

Citation

Welborn, T A., and S S. Dhaliwal. "Preferred Clinical Measures of Central Obesity for Predicting Mortality." European Journal of Clinical Nutrition, vol. 61, no. 12, 2007, pp. 1373-9.
Welborn TA, Dhaliwal SS. Preferred clinical measures of central obesity for predicting mortality. Eur J Clin Nutr. 2007;61(12):1373-9.
Welborn, T. A., & Dhaliwal, S. S. (2007). Preferred clinical measures of central obesity for predicting mortality. European Journal of Clinical Nutrition, 61(12), pp. 1373-9.
Welborn TA, Dhaliwal SS. Preferred Clinical Measures of Central Obesity for Predicting Mortality. Eur J Clin Nutr. 2007;61(12):1373-9. PubMed PMID: 17299478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preferred clinical measures of central obesity for predicting mortality. AU - Welborn,T A, AU - Dhaliwal,S S, Y1 - 2007/02/14/ PY - 2007/2/15/pubmed PY - 2008/2/20/medline PY - 2007/2/15/entrez SP - 1373 EP - 9 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 61 IS - 12 N2 - OBJECTIVE: To define the clinical measures of obesity that best predict all cause mortality and cardiovascular disease (CVD) mortality. DESIGN AND SETTING: Eleven-year mortality follow-up of an Australian urban population sample of 9309 adults aged 20-69 years in 1989. Baseline measures of obesity included body mass index (BMI), waist circumference (WC), waist-to-stature ratio and the waist-to-hip ratio. The age-standardized hazard ratios for mortality were calculated for 1 s.d. above the mean for each measure of obesity using Cox regression analysis. We constructed receiver operator characteristic (ROC) curves to assess sensitivity and specificity of the measures and to identify approximate cut-points for the prediction of risk. RESULTS: Waist-to-hip ratio was superior by magnitude and significance in predicting all cause mortality (male hazard ratio 1.25, P=0.003, female hazard ratio 1.24, P=0.003) and CVD mortality (male hazard ratio 1.62, P<0.001, female hazard ratio 1.59, P<0.001). Waist-to-stature ratio and WC were highly significant but less powerful predictors for CVD mortality. ROC analysis showed higher 'area under the curve' values for waist-related measures in males, with similar less marked trends in females. The ROC cut-points yielded values that corresponded to current promulgated criteria. CONCLUSIONS: The waist-to-hip ratio is the preferred clinical measure of obesity for predicting all cause and CVD mortality. WC is a practical alternative. Waist-to-stature ratio is not more useful than WC alone. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/17299478/Preferred_clinical_measures_of_central_obesity_for_predicting_mortality_ L2 - http://dx.doi.org/10.1038/sj.ejcn.1602656 DB - PRIME DP - Unbound Medicine ER -