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Comparison of overall obesity and body fat distribution in predicting risk of mortality.

Abstract

Results of studies comparing overall obesity and abdominal adiposity or body fat distribution with risk of mortality have varied considerably. We compared the relative importance and joint association of overall obesity and body fat distribution in predicting risk of mortality. Participants included 5,799 men and 6,429 women aged 30-102 years enrolled in the third National Health and Nutrition Examination Survey who completed a baseline health examination during 1988-1994. During a 12-year follow-up (102,172 person-years), 1,188 men and 925 women died. In multivariable-adjusted analyses, waist-to-thigh ratio (WTR) in both sexes (Ptrend<0.01 for both) and waist-to-hip ratio (WHR) in women (Ptrend 0.001) were positively associated with mortality in middle-aged adults (30-64 years), while BMI and waist circumference (WC) exhibited U- or J-shaped associations. Risk of mortality increased with a higher WHR and WTR among normal weight (BMI 18.5-24.9 kg/m2) and obese (BMI>or=30.0 kg/m2) adults. In older adults (65-102 years), a higher BMI in both sexes (Ptrend<0.05) and WC in men (Ptrend 0.001) were associated with increased survival, while remaining measures of body fat distribution exhibited either no association or an inverse relation with mortality. In conclusion, ratio measures of body fat distribution are strongly and positively associated with mortality and offer additional prognostic information beyond BMI and WC in middle-aged adults. A higher BMI in both sexes and WC in men were associated with increased survival in older adults, while a higher WHR or WTR either decreased or did not influence risk of death.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. jreis@jhsph.edu

    , , , ,

    Source

    Obesity (Silver Spring, Md.) 17:6 2009 Jun pg 1232-9

    MeSH

    Abdominal Fat
    Adiposity
    Adult
    Age Factors
    Aged
    Aged, 80 and over
    Body Mass Index
    Cardiovascular Diseases
    Female
    Health Surveys
    Humans
    Male
    Middle Aged
    Obesity
    Overweight
    Predictive Value of Tests
    Proportional Hazards Models
    Prospective Studies
    Risk Assessment
    Risk Factors
    Sex Factors
    Time Factors
    United States
    Waist Circumference
    Waist-Hip Ratio

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    19197258

    Citation

    Reis, Jared P., et al. "Comparison of Overall Obesity and Body Fat Distribution in Predicting Risk of Mortality." Obesity (Silver Spring, Md.), vol. 17, no. 6, 2009, pp. 1232-9.
    Reis JP, Macera CA, Araneta MR, et al. Comparison of overall obesity and body fat distribution in predicting risk of mortality. Obesity (Silver Spring). 2009;17(6):1232-9.
    Reis, J. P., Macera, C. A., Araneta, M. R., Lindsay, S. P., Marshall, S. J., & Wingard, D. L. (2009). Comparison of overall obesity and body fat distribution in predicting risk of mortality. Obesity (Silver Spring, Md.), 17(6), pp. 1232-9. doi:10.1038/oby.2008.664.
    Reis JP, et al. Comparison of Overall Obesity and Body Fat Distribution in Predicting Risk of Mortality. Obesity (Silver Spring). 2009;17(6):1232-9. PubMed PMID: 19197258.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Comparison of overall obesity and body fat distribution in predicting risk of mortality. AU - Reis,Jared P, AU - Macera,Caroline A, AU - Araneta,Maria R, AU - Lindsay,Suzanne P, AU - Marshall,Simon J, AU - Wingard,Deborah L, Y1 - 2009/02/05/ PY - 2009/2/7/entrez PY - 2009/2/7/pubmed PY - 2009/7/25/medline SP - 1232 EP - 9 JF - Obesity (Silver Spring, Md.) JO - Obesity (Silver Spring) VL - 17 IS - 6 N2 - Results of studies comparing overall obesity and abdominal adiposity or body fat distribution with risk of mortality have varied considerably. We compared the relative importance and joint association of overall obesity and body fat distribution in predicting risk of mortality. Participants included 5,799 men and 6,429 women aged 30-102 years enrolled in the third National Health and Nutrition Examination Survey who completed a baseline health examination during 1988-1994. During a 12-year follow-up (102,172 person-years), 1,188 men and 925 women died. In multivariable-adjusted analyses, waist-to-thigh ratio (WTR) in both sexes (Ptrend<0.01 for both) and waist-to-hip ratio (WHR) in women (Ptrend 0.001) were positively associated with mortality in middle-aged adults (30-64 years), while BMI and waist circumference (WC) exhibited U- or J-shaped associations. Risk of mortality increased with a higher WHR and WTR among normal weight (BMI 18.5-24.9 kg/m2) and obese (BMI>or=30.0 kg/m2) adults. In older adults (65-102 years), a higher BMI in both sexes (Ptrend<0.05) and WC in men (Ptrend 0.001) were associated with increased survival, while remaining measures of body fat distribution exhibited either no association or an inverse relation with mortality. In conclusion, ratio measures of body fat distribution are strongly and positively associated with mortality and offer additional prognostic information beyond BMI and WC in middle-aged adults. A higher BMI in both sexes and WC in men were associated with increased survival in older adults, while a higher WHR or WTR either decreased or did not influence risk of death. SN - 1930-7381 UR - https://www.unboundmedicine.com/medline/citation/19197258/Comparison_of_overall_obesity_and_body_fat_distribution_in_predicting_risk_of_mortality_ L2 - https://doi.org/10.1038/oby.2008.664 DB - PRIME DP - Unbound Medicine ER -