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Normal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality

Karine SahakyanFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaVirend K. SomersFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaJuan P. Rodriguez-EscuderoFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaDavid O. HodgeFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaRickey E. CarterFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaOndřej SochorFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaThais CoutinhoFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaMichael Dam JensenFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaVéronique L. RogerFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaPrachi SinghFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, CanadaFrancisco López-JiménezFrom the Mayo Clinic, Rochester, Minnesota; St. Anne's University Hospital Brno, Brno, Czech Republic; and University of Ottawa Heart Institute, Ottawa, Ontario, Canada

2015en

ABI

Annotatsiya

BACKGROUND: The relationship between central obesity and survival in community-dwelling adults with normal body mass index (BMI) is not well-known. OBJECTIVE: To examine total and cardiovascular mortality risks associated with central obesity and normal BMI. DESIGN: Stratified multistage probability design. SETTING: NHANES III (Third National Health and Nutrition Examination Survey). PARTICIPANTS: 15,184 adults (52.3% women) aged 18 to 90 years. MEASUREMENTS: Multivariable Cox proportional hazards models were used to evaluate the relationship of obesity patterns defined by BMI and waist-to-hip ratio (WHR) and total and cardiovascular mortality risk after adjustment for confounding factors. RESULTS: Persons with normal-weight central obesity had the worst long-term survival. For example, a man with a normal BMI (22 kg/m2) and central obesity had greater total mortality risk than one with similar BMI but no central obesity (hazard ratio [HR], 1.87 [95% CI, 1.53 to 2.29]), and this man had twice the mortality risk of participants who were overweight or obese according to BMI only (HR, 2.24 [CI, 1.52 to 3.32] and 2.42 [CI, 1.30 to 4.53], respectively). Women with normal-weight central obesity also had a higher mortality risk than those with similar BMI but no central obesity (HR, 1.48 [CI, 1.35 to 1.62]) and those who were obese according to BMI only (HR, 1.32 [CI, 1.15 to 1.51]). Expected survival estimates were consistently lower for those with central obesity when age and BMI were controlled for. LIMITATIONS: Body fat distribution was assessed based on anthropometric indicators alone. Information on comorbidities was collected by self-report. CONCLUSION: Normal-weight central obesity defined by WHR is associated with higher mortality than BMI-defined obesity, particularly in the absence of central fat distribution. PRIMARY FUNDING SOURCE: National Institutes of Health, American Heart Association, European Regional Development Fund, and Czech Ministry of Health.

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Identifikatorlar

DOI: 10.7326/m14-2525

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