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.
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.
Authors: Michael D Jensen; Donna H Ryan; Caroline M Apovian; Jamy D Ard; Anthony G Comuzzie; Karen A Donato; Frank B Hu; Van S Hubbard; John M Jakicic; Robert F Kushner; Catherine M Loria; Barbara E Millen; Cathy A Nonas; F Xavier Pi-Sunyer; June Stevens; Victor J Stevens; Thomas A Wadden; Bruce M Wolfe; Susan Z Yanovski; Harmon S Jordan; Karima A Kendall; Linda J Lux; Roycelynn Mentor-Marcel; Laura C Morgan; Michael G Trisolini; Janusz Wnek; Jeffrey L Anderson; Jonathan L Halperin; Nancy M Albert; Biykem Bozkurt; Ralph G Brindis; Lesley H Curtis; David DeMets; Judith S Hochman; Richard J Kovacs; E Magnus Ohman; Susan J Pressler; Frank W Sellke; Win-Kuang Shen; Sidney C Smith; Gordon F Tomaselli Journal: Circulation Date: 2013-11-12 Impact factor: 29.690
Authors: Salim Yusuf; Steven Hawken; Stephanie Ounpuu; Leonelo Bautista; Maria Grazia Franzosi; Patrick Commerford; Chim C Lang; Zvonko Rumboldt; Churchill L Onen; Liu Lisheng; Supachai Tanomsup; Paul Wangai; Fahad Razak; Arya M Sharma; Sonia S Anand Journal: Lancet Date: 2005-11-05 Impact factor: 79.321
Authors: James R Cerhan; Steven C Moore; Eric J Jacobs; Cari M Kitahara; Philip S Rosenberg; Hans-Olov Adami; Jon O Ebbert; Dallas R English; Susan M Gapstur; Graham G Giles; Pamela L Horn-Ross; Yikyung Park; Alpa V Patel; Kim Robien; Elisabete Weiderpass; Walter C Willett; Alicja Wolk; Anne Zeleniuch-Jacquotte; Patricia Hartge; Leslie Bernstein; Amy Berrington de Gonzalez Journal: Mayo Clin Proc Date: 2014-03 Impact factor: 7.616
Authors: Abel Romero-Corral; Virend K Somers; Justo Sierra-Johnson; Yoel Korenfeld; Simona Boarin; Josef Korinek; Michael D Jensen; Gianfranco Parati; Francisco Lopez-Jimenez Journal: Eur Heart J Date: 2009-11-20 Impact factor: 29.983
Authors: Yong-Moon Mark Park; Alexandra J White; Hazel B Nichols; Katie M O'Brien; Clarice R Weinberg; Dale P Sandler Journal: Int J Cancer Date: 2017-03-28 Impact factor: 7.396
Authors: Elizabeth M Cespedes Feliciano; Wendy Y Chen; Patrick T Bradshaw; Carla M Prado; Stacey Alexeeff; Kathleen B Albers; Adrienne L Castillo; Bette J Caan Journal: J Clin Oncol Date: 2019-08-01 Impact factor: 44.544
Authors: T da Silva Alexandre; S Scholes; J L Ferreira Santos; Y A de Oliveira Duarte; C de Oliveira Journal: J Nutr Health Aging Date: 2018 Impact factor: 4.075
Authors: Cesare Russo; Fusako Sera; Zhezhen Jin; Vittorio Palmieri; Shunichi Homma; Tatjana Rundek; Mitchell S V Elkind; Ralph L Sacco; Marco R Di Tullio Journal: Eur J Heart Fail Date: 2016-04-24 Impact factor: 15.534
Authors: D J Cuthbertson; T Steele; J P Wilding; J C Halford; J A Harrold; M Hamer; F Karpe Journal: Int J Obes (Lond) Date: 2017-01-12 Impact factor: 5.095
Authors: Naima Covassin; Fatima H Sert-Kuniyoshi; Prachi Singh; Abel Romero-Corral; Diane E Davison; Francisco Lopez-Jimenez; Michael D Jensen; Virend K Somers Journal: Mayo Clin Proc Date: 2018-05 Impact factor: 7.616