cameron-theinfluenceof-2012.pdf (2.04 MB)
The influence of hip circumference on the relationship between abdominal obesity and mortality
journal contribution
posted on 2012-01-01, 00:00 authored by Adrian CameronAdrian Cameron, D Magliano, J Shaw, P Zimmet, B Carstensen, K Alberti, J Tuomilehto, E Barr, V Pauvaday, S Kowlessur, S SoderbergBackground 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.
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.
History
Journal
International journal of epidemiologyVolume
41Issue
2Pagination
484 - 494Publisher
Oxford University PressLocation
Oxford, EnglandPublisher DOI
ISSN
0300-5771eISSN
1464-3685Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2012, Oxford University PressUsage metrics
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Keywords
Waist circumferenceAfricanSouth Asianmortalityobesityhip circumferenceScience & TechnologyLife Sciences & BiomedicinePublic, Environmental & Occupational HealthBODY-MASS INDEXCORONARY-HEART-DISEASEIMPAIRED GLUCOSE-TOLERANCEALL-CAUSE MORTALITYCARDIOVASCULAR RISKPRIMARY PREVENTIONMETABOLIC SYNDROMEPROSPECTIVE COHORTDIABETES-MELLITUSETHNIC-GROUPSStatistics
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