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Novel and established anthropometric measures and the prediction of incident cardiovascular disease: a cohort study

Carlsson, A. C.; Riserus, U.; Engström, Gunnar LU ; Arnlov, J.; Melander, O. LU ; Leander, K.; Gigante, B.; Hellenius, M-L and de Faire, U. (2013) In International Journal of Obesity 37(12). p.1579-1585
Abstract
OBJECTIVES: The aim of this study was to compare novel and established anthropometrical measures in their ability to predict cardiovascular disease (CVD), and to determine whether they improve risk prediction beyond classical risk factors in a cohort study of 60-year-old men and women. We also stratified the results according to gender to identify possible differences between men and women. Furthermore, we aimed to replicate our findings in a large independent cohort (The Malmo Diet and Cancer study-cardiovascular cohort). METHODS: This was a population-based study of 1751 men and 1990 women, aged 60 years and without CVD at baseline, with 375 incident cases of CVD during 11 years of follow-up. Weight, height, waist circumference (WC), hip... (More)
OBJECTIVES: The aim of this study was to compare novel and established anthropometrical measures in their ability to predict cardiovascular disease (CVD), and to determine whether they improve risk prediction beyond classical risk factors in a cohort study of 60-year-old men and women. We also stratified the results according to gender to identify possible differences between men and women. Furthermore, we aimed to replicate our findings in a large independent cohort (The Malmo Diet and Cancer study-cardiovascular cohort). METHODS: This was a population-based study of 1751 men and 1990 women, aged 60 years and without CVD at baseline, with 375 incident cases of CVD during 11 years of follow-up. Weight, height, waist circumference (WC), hip circumference and sagittal abdominal diameter (SAD) were measured at baseline. Body mass index (BMI), waist-hip ratio (WHR), waist-hip-height ratio (WHHR), WC-to-height ratio (WCHR) and SAD-to-height ratio (SADHR) were calculated. RESULTS: All anthropometric measures predicted CVD in unadjusted Cox regression models per s.d. increment (hazard ratios, 95% confidence interval), while significant associations after adjustments for established risk CVD factors were noted for WHHR 1.20 (1.08-1.33), WHR 1.14 (1.02-1.28), SAD 1.13 (1.02-1.25) and SADHR 1.17 (1.06-1.28). WHHR had higher increases in C-statistics, and model improvements (likelihood ratio tests (P<0.001)). In the replication study (MDC-CC, n = 5180), WHHR was the only measure that improved Cox regression models in men (P = 0.01). CONCLUSION: WHHR, a new measure reflecting body fat distribution, showed the highest risk estimates after adjustments for established CVD risk factors. These findings were verified in men but not women in an independent cohort. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
waist circumference, sagittal abdominal diameter, waist-hip ratio, waist-hip-height ratio, WC-to-height ratio, SAD-to-height ratio
in
International Journal of Obesity
volume
37
issue
12
pages
1579 - 1585
publisher
Nature Publishing Group
external identifiers
  • wos:000328456200010
  • scopus:84892577277
ISSN
1476-5497
DOI
10.1038/ijo.2013.46
language
English
LU publication?
yes
id
becd736e-a5d6-4600-94e9-d7b24668432c (old id 4269089)
date added to LUP
2014-02-10 12:17:22
date last changed
2019-10-20 03:05:50
@article{becd736e-a5d6-4600-94e9-d7b24668432c,
  abstract     = {OBJECTIVES: The aim of this study was to compare novel and established anthropometrical measures in their ability to predict cardiovascular disease (CVD), and to determine whether they improve risk prediction beyond classical risk factors in a cohort study of 60-year-old men and women. We also stratified the results according to gender to identify possible differences between men and women. Furthermore, we aimed to replicate our findings in a large independent cohort (The Malmo Diet and Cancer study-cardiovascular cohort). METHODS: This was a population-based study of 1751 men and 1990 women, aged 60 years and without CVD at baseline, with 375 incident cases of CVD during 11 years of follow-up. Weight, height, waist circumference (WC), hip circumference and sagittal abdominal diameter (SAD) were measured at baseline. Body mass index (BMI), waist-hip ratio (WHR), waist-hip-height ratio (WHHR), WC-to-height ratio (WCHR) and SAD-to-height ratio (SADHR) were calculated. RESULTS: All anthropometric measures predicted CVD in unadjusted Cox regression models per s.d. increment (hazard ratios, 95% confidence interval), while significant associations after adjustments for established risk CVD factors were noted for WHHR 1.20 (1.08-1.33), WHR 1.14 (1.02-1.28), SAD 1.13 (1.02-1.25) and SADHR 1.17 (1.06-1.28). WHHR had higher increases in C-statistics, and model improvements (likelihood ratio tests (P&lt;0.001)). In the replication study (MDC-CC, n = 5180), WHHR was the only measure that improved Cox regression models in men (P = 0.01). CONCLUSION: WHHR, a new measure reflecting body fat distribution, showed the highest risk estimates after adjustments for established CVD risk factors. These findings were verified in men but not women in an independent cohort.},
  author       = {Carlsson, A. C. and Riserus, U. and Engström, Gunnar and Arnlov, J. and Melander, O. and Leander, K. and Gigante, B. and Hellenius, M-L and de Faire, U.},
  issn         = {1476-5497},
  keyword      = {waist circumference,sagittal abdominal diameter,waist-hip ratio,waist-hip-height ratio,WC-to-height ratio,SAD-to-height ratio},
  language     = {eng},
  number       = {12},
  pages        = {1579--1585},
  publisher    = {Nature Publishing Group},
  series       = {International Journal of Obesity},
  title        = {Novel and established anthropometric measures and the prediction of incident cardiovascular disease: a cohort study},
  url          = {http://dx.doi.org/10.1038/ijo.2013.46},
  volume       = {37},
  year         = {2013},
}