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A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity : results from a large European cohort

Christakoudi, Sofia ; Tsilidis, Konstantinos K. ; Muller, David C. ; Freisling, Heinz ; Weiderpass, Elisabete ; Overvad, Kim ; Söderberg, Stefan ; Häggström, Christel ; Pischon, Tobias and Dahm, Christina C. , et al. (2020) In Scientific Reports 10(1).
Abstract

Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while... (More)

Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI < 18.5 kg/m2) or obese (BMI ≥ 30 kg/m2) categories, while the highest quartile of ABSI separated 18–39% of the individuals within each BMI category, which had 22–55% higher risk of death. In conclusion, only a waist index independent of BMI by design, such as ABSI, complements BMI and enables efficient risk stratification, which could facilitate personalisation of screening, treatment and monitoring.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
10
issue
1
article number
14541
publisher
Nature Publishing Group
external identifiers
  • pmid:32883969
  • scopus:85090137097
ISSN
2045-2322
DOI
10.1038/s41598-020-71302-5
language
English
LU publication?
yes
id
25e72780-c9f0-45bc-bed8-d404f61594be
date added to LUP
2020-09-14 13:37:32
date last changed
2024-04-17 15:52:05
@article{25e72780-c9f0-45bc-bed8-d404f61594be,
  abstract     = {{<p>Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI &lt; 18.5 kg/m<sup>2</sup>) or obese (BMI ≥ 30 kg/m<sup>2</sup>) categories, while the highest quartile of ABSI separated 18–39% of the individuals within each BMI category, which had 22–55% higher risk of death. In conclusion, only a waist index independent of BMI by design, such as ABSI, complements BMI and enables efficient risk stratification, which could facilitate personalisation of screening, treatment and monitoring.</p>}},
  author       = {{Christakoudi, Sofia and Tsilidis, Konstantinos K. and Muller, David C. and Freisling, Heinz and Weiderpass, Elisabete and Overvad, Kim and Söderberg, Stefan and Häggström, Christel and Pischon, Tobias and Dahm, Christina C. and Zhang, Jie and Tjønneland, Anne and Halkjær, Jytte and MacDonald, Conor and Boutron-Ruault, Marie Christine and Mancini, Francesca Romana and Kühn, Tilman and Kaaks, Rudolf and Schulze, Matthias B. and Trichopoulou, Antonia and Karakatsani, Anna and Peppa, Eleni and Masala, Giovanna and Pala, Valeria and Panico, Salvatore and Tumino, Rosario and Sacerdote, Carlotta and Quirós, J. Ramón and Agudo, Antonio and Sánchez, Maria Jose and Cirera, Lluís and Barricarte-Gurrea, Aurelio and Amiano, Pilar and Memarian, Ensieh and Sonestedt, Emily and Bueno-de-Mesquita, Bas and May, Anne M. and Khaw, Kay Tee and Wareham, Nicholas J. and Tong, Tammy Y.N. and Huybrechts, Inge and Noh, Hwayoung and Aglago, Elom K. and Ellingjord-Dale, Merete and Ward, Heather A. and Aune, Dagfinn and Riboli, Elio}},
  issn         = {{2045-2322}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity : results from a large European cohort}},
  url          = {{http://dx.doi.org/10.1038/s41598-020-71302-5}},
  doi          = {{10.1038/s41598-020-71302-5}},
  volume       = {{10}},
  year         = {{2020}},
}