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

The relationship between central obesity and survival in community-dwelling adults with normal body mass index (BMI) is not well-known. To examine total and cardiovascular mortality risks associated with central obesity and normal BMI. Stratified multistage probability design. NHANES III (Third Nati...

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Vydáno v:	Annals of internal medicine Ročník 163; číslo 11; s. 827 - 835
Hlavní autoři:	Sahakyan, Karine R, Somers, Virend K, Rodriguez-Escudero, Juan P, Hodge, David O, Carter, Rickey E, Sochor, Ondrej, Coutinho, Thais, Jensen, Michael D, Roger, Véronique L, Singh, Prachi, Lopez-Jimenez, Francisco
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States 01.12.2015
Témata:	Adolescent Adult Aged Body Mass Index Body Weight Cardiovascular Diseases - mortality Cause of Death Comorbidity Cross-Sectional Studies Female Humans Male Middle Aged Nutrition Surveys Obesity, Abdominal - complications Proportional Hazards Models Risk Factors United States - epidemiology Waist-Hip Ratio Young Adult United States
ISSN:	1539-3704
On-line přístup:	Zjistit podrobnosti o přístupu
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Abstract	The relationship between central obesity and survival in community-dwelling adults with normal body mass index (BMI) is not well-known. To examine total and cardiovascular mortality risks associated with central obesity and normal BMI. Stratified multistage probability design. NHANES III (Third National Health and Nutrition Examination Survey). 15,184 adults (52.3% women) aged 18 to 90 years. 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. 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. Body fat distribution was assessed based on anthropometric indicators alone. Information on comorbidities was collected by self-report. Normal-weight central obesity defined by WHR is associated with higher mortality than BMI-defined obesity, particularly in the absence of central fat distribution. National Institutes of Health, American Heart Association, European Regional Development Fund, and Czech Ministry of Health.
AbstractList	BACKGROUNDThe relationship between central obesity and survival in community-dwelling adults with normal body mass index (BMI) is not well-known.OBJECTIVETo examine total and cardiovascular mortality risks associated with central obesity and normal BMI.DESIGNStratified multistage probability design.SETTINGNHANES III (Third National Health and Nutrition Examination Survey).PARTICIPANTS15,184 adults (52.3% women) aged 18 to 90 years.MEASUREMENTSMultivariable 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.RESULTSPersons 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.LIMITATIONSBody fat distribution was assessed based on anthropometric indicators alone. Information on comorbidities was collected by self-report.CONCLUSIONNormal-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 SOURCENational Institutes of Health, American Heart Association, European Regional Development Fund, and Czech Ministry of Health. The relationship between central obesity and survival in community-dwelling adults with normal body mass index (BMI) is not well-known. To examine total and cardiovascular mortality risks associated with central obesity and normal BMI. Stratified multistage probability design. NHANES III (Third National Health and Nutrition Examination Survey). 15,184 adults (52.3% women) aged 18 to 90 years. 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. 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. Body fat distribution was assessed based on anthropometric indicators alone. Information on comorbidities was collected by self-report. Normal-weight central obesity defined by WHR is associated with higher mortality than BMI-defined obesity, particularly in the absence of central fat distribution. National Institutes of Health, American Heart Association, European Regional Development Fund, and Czech Ministry of Health.
Author	Somers, Virend K Lopez-Jimenez, Francisco Jensen, Michael D Sahakyan, Karine R Sochor, Ondrej Roger, Véronique L Rodriguez-Escudero, Juan P Carter, Rickey E Singh, Prachi Hodge, David O Coutinho, Thais
Author_xml	– sequence: 1 givenname: Karine R surname: Sahakyan fullname: Sahakyan, Karine R – sequence: 2 givenname: Virend K surname: Somers fullname: Somers, Virend K – sequence: 3 givenname: Juan P surname: Rodriguez-Escudero fullname: Rodriguez-Escudero, Juan P – sequence: 4 givenname: David O surname: Hodge fullname: Hodge, David O – sequence: 5 givenname: Rickey E surname: Carter fullname: Carter, Rickey E – sequence: 6 givenname: Ondrej surname: Sochor fullname: Sochor, Ondrej – sequence: 7 givenname: Thais surname: Coutinho fullname: Coutinho, Thais – sequence: 8 givenname: Michael D surname: Jensen fullname: Jensen, Michael D – sequence: 9 givenname: Véronique L surname: Roger fullname: Roger, Véronique L – sequence: 10 givenname: Prachi surname: Singh fullname: Singh, Prachi – sequence: 11 givenname: Francisco surname: Lopez-Jimenez fullname: Lopez-Jimenez, Francisco
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/26551006$$D View this record in MEDLINE/PubMed
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Snippet	The relationship between central obesity and survival in community-dwelling adults with normal body mass index (BMI) is not well-known. To examine total and... BACKGROUNDThe relationship between central obesity and survival in community-dwelling adults with normal body mass index (BMI) is not well-known.OBJECTIVETo...
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SubjectTerms	Adolescent Adult Aged Body Mass Index Body Weight Cardiovascular Diseases - mortality Cause of Death Comorbidity Cross-Sectional Studies Female Humans Male Middle Aged Nutrition Surveys Obesity, Abdominal - complications Proportional Hazards Models Risk Factors United States - epidemiology Waist-Hip Ratio Young Adult
Title	Normal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality
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