CONTEXT: To date, it is unclear which measure of obesity is the most appropriate for risk stratification. OBJECTIVE: The aim of the study was to compare the associations of various measures of obesity with incident cardiovascular events and mortality. DESIGN AND SETTING: We analyzed two German cohort studies, the DETECT study and SHIP, including primary care and general population. PARTICIPANTS: A total of 6355 (mean follow-up, 3.3 yr) and 4297 (mean follow-up, 8.5 yr) individuals participated in DETECT and SHIP, respectively. INTERVENTIONS: We measured body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) and assessed cardiovascular and all-cause mortality and the composite endpoint of incident stroke, myocardial infarction, or cardiovascular death. RESULTS: In both studies, we found a positive association of the composite endpoint with WHtR but not with BMI. There was no heterogeneity among studies. The relative risks in the highest versus the lowest sex- and age-specific quartile of WHtR, WC, WHR, and BMI after adjustment for multiple confounders were as follows in the pooled data: cardiovascular mortality, 2.75 (95% confidence interval, 1.31-5.77), 1.74 (0.84-3.6), 1.71 (0.91-3.22), and 0.74 (0.35-1.57), respectively; all-cause mortality, 1.86 (1.25-2.76), 1.62 (1.22-2.38), 1.36 (0.93-1.69), and 0.77 (0.53-1.13), respectively; and composite endpoint, 2.16 (1.39-3.35), 1.59 (1.04-2.44), 1.49 (1.07-2.07), and 0.57 (0.37-0.89), respectively. Separate analyses of sex and age groups yielded comparable results. Receiver operating characteristics analysis yielded the highest areas under the curve for WHtR for predicting these endpoints. CONCLUSIONS: WHtR represents the best predictor of cardiovascular risk and mortality, followed by WC and WHR. Our results discourage the use of the BMI.
CONTEXT: To date, it is unclear which measure of obesity is the most appropriate for risk stratification. OBJECTIVE: The aim of the study was to compare the associations of various measures of obesity with incident cardiovascular events and mortality. DESIGN AND SETTING: We analyzed two German cohort studies, the DETECT study and SHIP, including primary care and general population. PARTICIPANTS: A total of 6355 (mean follow-up, 3.3 yr) and 4297 (mean follow-up, 8.5 yr) individuals participated in DETECT and SHIP, respectively. INTERVENTIONS: We measured body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) and assessed cardiovascular and all-cause mortality and the composite endpoint of incident stroke, myocardial infarction, or cardiovascular death. RESULTS: In both studies, we found a positive association of the composite endpoint with WHtR but not with BMI. There was no heterogeneity among studies. The relative risks in the highest versus the lowest sex- and age-specific quartile of WHtR, WC, WHR, and BMI after adjustment for multiple confounders were as follows in the pooled data: cardiovascular mortality, 2.75 (95% confidence interval, 1.31-5.77), 1.74 (0.84-3.6), 1.71 (0.91-3.22), and 0.74 (0.35-1.57), respectively; all-cause mortality, 1.86 (1.25-2.76), 1.62 (1.22-2.38), 1.36 (0.93-1.69), and 0.77 (0.53-1.13), respectively; and composite endpoint, 2.16 (1.39-3.35), 1.59 (1.04-2.44), 1.49 (1.07-2.07), and 0.57 (0.37-0.89), respectively. Separate analyses of sex and age groups yielded comparable results. Receiver operating characteristics analysis yielded the highest areas under the curve for WHtR for predicting these endpoints. CONCLUSIONS: WHtR represents the best predictor of cardiovascular risk and mortality, followed by WC and WHR. Our results discourage the use of the BMI.
Authors: Mengyuan Kan; Paul L Auer; Gao T Wang; Kristine L Bucasas; Stanley Hooker; Alejandra Rodriguez; Biao Li; Jaclyn Ellis; L Adrienne Cupples; Yii-Der Ida Chen; Josée Dupuis; Caroline S Fox; Myron D Gross; Joshua D Smith; Nancy Heard-Costa; James B Meigs; James S Pankow; Jerome I Rotter; David Siscovick; James G Wilson; Jay Shendure; Rebecca Jackson; Ulrike Peters; Hua Zhong; Danyu Lin; Li Hsu; Nora Franceschini; Chris Carlson; Goncalo Abecasis; Stacey Gabriel; Michael J Bamshad; David Altshuler; Deborah A Nickerson; Kari E North; Leslie A Lange; Alexander P Reiner; Suzanne M Leal Journal: Eur J Hum Genet Date: 2016-01-13 Impact factor: 4.246
Authors: Robyn E Karlage; Carmen L Wilson; Nan Zhang; Sue Kaste; Daniel M Green; Gregory T Armstrong; Leslie L Robison; Wassim Chemaitilly; Deo Kumar Srivastava; Melissa M Hudson; Kirsten K Ness Journal: Cancer Date: 2015-02-27 Impact factor: 6.860
Authors: Lisa A Beck; Jeffry L Lamb; Elizabeth J Atkinson; Lisa-Ann Wuermser; Shreyasee Amin Journal: J Spinal Cord Med Date: 2013-11-26 Impact factor: 1.985