General and Abdominal Adiposity and Risk of Death in Europe
(2008) In New England Journal of Medicine 359(20). p.2105-2120- Abstract
- BACKGROUND Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. METHODS We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking... (More)
- BACKGROUND Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. METHODS We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height. RESULTS During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women. After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death. Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively. BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P<0.001). CONCLUSIONS These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-tohip ratio in addition to BMI in assessing the risk of death. (Less)
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- organization
- publishing date
- 2008
- type
- Contribution to journal
- publication status
- published
- subject
- in
- New England Journal of Medicine
- volume
- 359
- issue
- 20
- pages
- 2105 - 2120
- publisher
- Massachusetts Medical Society
- external identifiers
-
- wos:000260823900009
- scopus:56249131806
- ISSN
- 0028-4793
- language
- English
- LU publication?
- yes
- id
- b53ffc37-8f2e-4e31-aaa6-7b93aefab55a (old id 1283795)
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- http://content.nejm.org/cgi/reprint/359/20/2105.pdf
- date added to LUP
- 2016-04-01 12:17:20
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@article{b53ffc37-8f2e-4e31-aaa6-7b93aefab55a,
abstract = {{BACKGROUND Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. METHODS We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height. RESULTS During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women. After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death. Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively. BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P<0.001). CONCLUSIONS These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-tohip ratio in addition to BMI in assessing the risk of death.}},
author = {{Pischon, T. and Boeing, H. and Hoffmann, K. and Bergmann, M. and Schulze, M. B. and Overvad, K. and van der Schouw, Y. T. and Spencer, E. and Moons, K. G. M. and Tjonneland, A. and Halkjaer, J. and Jensen, M. K. and Stegger, J. and Clavel-Chapelon, F. and Boutron-Ruault, M. -C. and Chajes, V. and Linseisen, J. and Kaaks, R. and Trichopoulou, A. and Trichopoulos, D. and Bamia, C. and Sieri, S. and Palli, D. and Tumino, R. and Vineis, P. and Panico, S. and Peeters, P. H. M. and May, A. M. and Bueno-de-Mesquita, H. B. and van Duijnhoven, F. J. B. and Hallmans, G. and Weinehall, L. and Manjer, Jonas and Hedblad, Bo and Lund, E. and Agudo, A. and Arriola, L. and Barricarte, A. and Navarro, C. and Martinez, C. and Quiros, J. R. and Key, T. and Bingham, S. and Khaw, K. T. and Boffetta, P. and Jenab, M. and Ferrari, P. and Riboli, E.}},
issn = {{0028-4793}},
language = {{eng}},
number = {{20}},
pages = {{2105--2120}},
publisher = {{Massachusetts Medical Society}},
series = {{New England Journal of Medicine}},
title = {{General and Abdominal Adiposity and Risk of Death in Europe}},
url = {{http://content.nejm.org/cgi/reprint/359/20/2105.pdf}},
volume = {{359}},
year = {{2008}},
}