Normal-Weight Central Obesity and Mortality Risk in Older Adults With Coronary Artery Disease

To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR...

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Vydané v:	Mayo Clinic proceedings Ročník 91; číslo 3; s. 343 - 351
Hlavní autori:	Sharma, Saurabh, Batsis, John A., Coutinho, Thais, Somers, Virend K., Hodge, David O., Carter, Rickey E., Sochor, Ondrej, Kragelund, Charlotte, Kanaya, Alka M., Zeller, Marianne, Park, Jong-Seon, Køber, Lars, Torp-Pedersen, Christian, Lopez-Jimenez, Francisco
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	England Elsevier Inc 01.03.2016 Frontline Medical Communications Inc Elsevier Limited Elsevier
Predmet:	Age Factors Aged Aged, 80 and over Analysis Body Mass Index Care and treatment Cause of Death Cohort Studies Complications and side effects Coronary Artery Disease - epidemiology Coronary Artery Disease - mortality Coronary heart disease Denmark - epidemiology Female France - epidemiology Health aspects Human health and pathology Humans Internal Medicine Life Sciences Male Obesity Obesity, Abdominal - epidemiology Obesity, Abdominal - mortality Proportional Hazards Models Risk Factors Sex Factors United States - epidemiology Denmark France United States WHR NWCO CV CAD HR WC BMI coronary artery disease waist-hip ratio waist circumference body mass index cardiovascular hazard ratio normal-weight central obesity Acute Myocardial-Infarction Body-Mass Index Cardiorespiratory Fitness Sarcopenic Obesity 3rd National-Health Cardiovascular-Disease Nutrition Examination Survey Waist-Hip Ratio Heart-Disease All-Cause Mortality
ISSN:	0025-6196, 1942-5546, 1942-5546
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Abstract	To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24). In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment.
AbstractList	To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD).OBJECTIVETo study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD).We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality.PATIENTS AND METHODSWe identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality.Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24).RESULTSPatients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24).In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment.CONCLUSIONIn older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment. OBJECTIVE:To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD).PATIENTS AND METHODS:We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality.RESULTS:Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24).CONCLUSION:In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment.Copyright © 2016. Published by Elsevier Inc. To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24). In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment. To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24). In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment. Objective: To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). Patients and Methods: We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Results: Patients' mean age was 73.0 plus or minus 6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24). Conclusion: In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment. Abstract Objective To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). Patients and Methods We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Results Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24). Conclusion In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment.
Audience	Academic
Author	Sharma, Saurabh Sochor, Ondrej Somers, Virend K. Kanaya, Alka M. Coutinho, Thais Torp-Pedersen, Christian Park, Jong-Seon Carter, Rickey E. Hodge, David O. Lopez-Jimenez, Francisco Batsis, John A. Zeller, Marianne Køber, Lars Kragelund, Charlotte
Author_xml	– sequence: 1 givenname: Saurabh surname: Sharma fullname: Sharma, Saurabh organization: Division of Cardiovascular Diseases, Einstein Heart and Vascular Institute, Einstein Medical Center, Philadelphia, PA – sequence: 2 givenname: John A. surname: Batsis fullname: Batsis, John A. organization: Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH – sequence: 3 givenname: Thais surname: Coutinho fullname: Coutinho, Thais organization: Division of Cardiology, University of Ottawa Heart Institute, Ontario, Canada – sequence: 4 givenname: Virend K. surname: Somers fullname: Somers, Virend K. organization: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN – sequence: 5 givenname: David O. surname: Hodge fullname: Hodge, David O. organization: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN – sequence: 6 givenname: Rickey E. surname: Carter fullname: Carter, Rickey E. organization: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN – sequence: 7 givenname: Ondrej surname: Sochor fullname: Sochor, Ondrej organization: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN – sequence: 8 givenname: Charlotte surname: Kragelund fullname: Kragelund, Charlotte organization: Department of Cardiology, Herlev University Hospital of Copenhagen, Denmark – sequence: 9 givenname: Alka M. surname: Kanaya fullname: Kanaya, Alka M. organization: Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA – sequence: 10 givenname: Marianne surname: Zeller fullname: Zeller, Marianne organization: Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Bourgogne-Franche-Comté, Dijon, France – sequence: 11 givenname: Jong-Seon surname: Park fullname: Park, Jong-Seon organization: Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea – sequence: 12 givenname: Lars surname: Køber fullname: Køber, Lars organization: Department of Cardiology, Rigshospitalet, Copenhagen, Denmark – sequence: 13 givenname: Christian surname: Torp-Pedersen fullname: Torp-Pedersen, Christian organization: Department of Health, Science and Technology, Aalborg University, Denmark – sequence: 14 givenname: Francisco surname: Lopez-Jimenez fullname: Lopez-Jimenez, Francisco email: Lopez@mayo.edu organization: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/26860580$$D View this record in MEDLINE/PubMed https://ube.hal.science/hal-01579094$$DView record in HAL
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ContentType	Journal Article
Copyright	2016 Copyright © 2016. Published by Elsevier Inc. COPYRIGHT 2016 Frontline Medical Communications Inc. Copyright Mayo Foundation for Medical Education and Research Mar 2016 licence_http://creativecommons.org/publicdomain/zero
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Snippet	To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). We identified... Abstract Objective To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease... To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD).OBJECTIVETo... Objective: To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD).... OBJECTIVE:To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease...
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SubjectTerms	Age Factors Aged Aged, 80 and over Analysis Body Mass Index Care and treatment Cause of Death Cohort Studies Complications and side effects Coronary Artery Disease - epidemiology Coronary Artery Disease - mortality Coronary heart disease Denmark - epidemiology Female France - epidemiology Health aspects Human health and pathology Humans Internal Medicine Life Sciences Male Obesity Obesity, Abdominal - epidemiology Obesity, Abdominal - mortality Proportional Hazards Models Risk Factors Sex Factors United States - epidemiology
Title	Normal-Weight Central Obesity and Mortality Risk in Older Adults With Coronary Artery Disease
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