Waist Circumference and Mortality

Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD 20892, USA.
American journal of epidemiology (Impact Factor: 5.23). 06/2008; 167(12):1465-75. DOI: 10.1093/aje/kwn079
Source: PubMed


The authors examined the association between waist circumference and mortality among 154,776 men and 90,757 women aged 51-72 years at baseline (1996-1997) in the NIH-AARP Diet and Health Study. Additionally, the combined effects of waist circumference and body mass index (BMI; weight (kg)/height (m)(2)) were examined. All-cause mortality was assessed over 9 years of follow-up (1996-2005). After adjustment for BMI and other covariates, a large waist circumference (fifth quintile vs. second) was associated with an approximately 25% increased mortality risk (men: hazard ratio (HR) = 1.22, 95% confidence interval (CI): 1.15, 1.29; women: HR = 1.28, 95% CI: 1.16, 1.41). The waist circumference-mortality association was found in persons with and without prevalent disease, in smokers and nonsmokers, and across different racial/ethnic groups (non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and Asians). Compared with subjects with a combination of normal BMI (18.5-<25) and normal waist circumference, those in the normal-BMI group with a large waist circumference (men: > or =102 cm; women: > or =88 cm) had an approximately 20% higher mortality risk (men: HR = 1.23, 95% CI: 1.08, 1.39; women: HR = 1.22, 95% CI: 1.09, 1.36). The finding that persons with a normal BMI but a large waist circumference had a higher mortality risk in this study suggests that increased waist circumference should be considered a risk factor for mortality, in addition to BMI.

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Available from: Annemarie Koster
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    • "The correlation between the waist circumference and mortality was found in both, men and women, no matter what race they belong to and whether they were smokers or nonsmokers (Koster et al., 2008). Among the people who have a normal BMI but increased waist circumference (men, over 102 cm and women, over 88 cm) the risk of mortality was 20% higher (Koster et al., 2008) than in patients who have a normal BMI and waist circumference . This indicates how important it is to include all the anthropometric parameters in order to gain a complete picture of the health status of the elderly and ther risk because certain parameters may conceal the true situation. "
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    ABSTRACT: The aim of this study was to determine the basic anthropometric characteristics and body composition of elderly persons between 60 and 80 years of age on the basis of data collection and analyzed papers published between the years 1990 and 2011. Literature search was conducted using the following bases: MEDLINE, Google Scholar, Kobson and DOAJ. The selection was based on criteria related to age which participants belong (60-80 years), than that study was related to body composition and anthropometric parameters, and that it was not conducted on a participants with chronic disease. The study included 28 research studies which met all the criteria for selection. Body composition in elderly people between 60 and 80 years could be influenced by the genetic potential, early growth and development, differences in socio-economic status, health status, as well as by geographic region and ethnic group affiliation. Aging is associated with a higher percentage of body fat and body fat redistribution. Redistribution of fat, predominantly from lower-body to subcutaneous fat in the abdominal and visceral part is the most frequent in the elderly despite an apparent decrease of BMI. This phenomenon mainly occurs due to changes in total adiposity and changes in body weight.
    Full-text · Article · Jan 2011
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    • "These results were confirmed when WC was used as a continuous variable: the significant relationship between WC and mortality disappeared after taking into account all other risk factors. Indeed, this result failed to confirm the independent effect of WC on mortality observed in other populations [12] [13] [14]. In the present study population , of the subjects with a large WC, 26% had no ARF and represented 8% of the population. "
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    ABSTRACT: This study was designed to evaluate the risks of all-cause and cardiovascular mortality in subjects with large waist circumferences, with or without associated risk factors, and to determine whether or not waist circumference might identify high-risk subjects. The population included 55,800 men (aged 52.1 ± 8.2 years) and 28,937 women (aged 54.2 ± 9.1 years) who had undergone a health checkup at the Preventive and Clinical Investigations Centre between January 1999 and December 2004 with a mean follow-up of 4.7 ± 1.7 years. An increased waist circumference was defined as those in the last quintile of distribution. Mortality risk for each waist-circumference quintile, with or without associated risk factors (hypertension, diabetes, elevated LDL cholesterol), was evaluated using Cox's regression models, including age, gender, tobacco and alcohol consumption, and physical activity. The percentage of subjects with hypertension, diabetes and raised LDL cholesterol levels increased from the first waist-circumference quintile to the last. After adjusting for variables, all-cause mortality risk did not increase significantly with large waist circumference only (HR: 1.19 [0.84-1.68]), but was significantly higher when an increased waist circumference was associated with at least one risk factor (HR=1.58 [1.26-1.98]; 3.70 [2.05-6.68] for three risk factors). Similar results were observed for cardiovascular mortality (HR: 0.85 [0.19-3.68] with only large waist circumference and 3.56 [2.05-6.57] when waist circumference was associated with at least one risk factor). In a population with low-to-moderate mortality risk, waist circumference alone did not identify high-risk subjects, thus suggesting that a more global approach is necessary.
    Full-text · Article · Oct 2010 · Diabetes & Metabolism
    • "There are data to suggest that waist circumference and/or WHR may predict health problems independently of BMI, as in diabetes mellitus[14] and cardiovascular disease.[15] Furthermore, there is accumulating evidence for a role of waist circumference[1617] and WHR[1819] in predicting mortality independently of BMI in men. In 1997, by analyzing about 135,000 men, Andersson et al. found that the risk of death from prostate cancer was statistically significant above the reference category in all BMI categories.[20] "
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    ABSTRACT: The association of central obesity, hyperinsulinemia, and dyslipidemia with higher grade advanced prostate cancer as determined by Gleason grading is not well understood. We evaluated the effect of central obesity waist hip ratio (WHR ≥ 0.9) and biochemical parameters associated with central obesity on Gleason grading in North Indian patients of prostate cancer presenting at advanced stages. A cross-sectional study was conducted among 50 nondiabetic patients having clinical stages III and IV prostate cancer. Gleason grading on core biopsy samples by histopathology was done and patients were divided in two groups-group1, Gleason score ≥8; group 2, Gleason score <8. WHR along with serum levels of prostate-specific antigen (PSA), testosterone, insulin, and lipid profile was done in each patient. The two groups are similar in Age (67.54 years); range (50-80 years). Group 1 men had statistically higher mean WHR (0.96 vs 0.90; P ≤ 0.001), higher mean triglyceride level (201.34 vs 150.52 mg/dL; P=0.0006), higher mean very low-density lipoprotein (VLDL) (40.27 vs 30.10 mg/dL; P =0.0006), higher mean insulin (19.49 vs 15.04 μIU/mL; P = 0.0024), and lower mean high-density lipoprotein (HDL) levels (32.39 vs 36.82 mg/dL; P = 0.034) than men in group 2. Serum levels of cholesterol, LDL, and testosterone did not show statistically significant differences between the two groups. This pilot study involving small number of patients indicates that central obesity, dyslipidemia, and hyperinsulinemia could be associated with high-grade prostate cancer.
    No preview · Article · Oct 2010 · Indian Journal of Urology
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