The influence of hip circumference on the relationship between abdominal obesity and mortality

Cameron, Adrian J., Magliano, Dianna J., Shaw, Jonathan E., Zimmet, Paul Z., Carstensen, Bendix, Alberti, K George M. M., Tuomilehto, Jaakko, Barr, Elizabeth L. M., Pauvaday, Vassen K., Kowlessur, Sudhirsen and Soderberg, Stefan 2012, The influence of hip circumference on the relationship between abdominal obesity and mortality, International journal of epidemiology, vol. 41, no. 2, pp. 484-494.

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Title The influence of hip circumference on the relationship between abdominal obesity and mortality
Author(s) Cameron, Adrian J.
Magliano, Dianna J.
Shaw, Jonathan E.
Zimmet, Paul Z.
Carstensen, Bendix
Alberti, K George M. M.
Tuomilehto, Jaakko
Barr, Elizabeth L. M.
Pauvaday, Vassen K.
Kowlessur, Sudhirsen
Soderberg, Stefan
Journal name International journal of epidemiology
Volume number 41
Issue number 2
Start page 484
End page 494
Total pages 11
Publisher Oxford University Press
Place of publication Oxford, England
Publication date 2012
ISSN 0300-5771
1464-3685
Keyword(s) Waist circumference
African
South Asian
mortality
obesity
hip circumference
Summary Background Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction.

Methods
In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of >25% and a decrease of >20% after waist and hip circumference were added to the model was calculated.

Results Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by >25% for 23.7% of those who died and 15.7% of those censored. Cumulative mortality decreased by >20% for 4.5% of those who died and 14.8% of those censored.

Conclusions
The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models.
Language eng
Field of Research 111199 Nutrition and Dietetics not elsewhere classified
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2012, Oxford University Press
Persistent URL http://hdl.handle.net/10536/DRO/DU:30046268

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Created: Thu, 26 Jul 2012, 15:12:57 EST by Jane Moschetti

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