General and Abdominal Adiposity and Risk of Death in Europe

被引：1553

作者：

Pischon, T. ^{[1
]}

Boeing, H. ^{[1
]}

Hoffmann, K. ^{[1
]}

Bergmann, M. ^{[1
]}

Schulze, M. B. ^{[1
]}

Overvad, K. ^{[2
,3
]}

van der Schouw, Y. T. ^{[4
]}

Spencer, E. ^{[5
]}

Moons, K. G. M. ^{[4
]}

Tjonneland, A. ^{[6
]}

Halkjaer, J. ^{[6
]}

Jensen, M. K. ^{[2
]}

Stegger, J. ^{[3
]}

Clavel-Chapelon, F. ^{[7
,8
]}

Boutron-Ruault, M. -C. ^{[7
,8
]}

Chajes, V. ^{[7
,8
]}

Linseisen, J. ^{[9
]}

Kaaks, R. ^{[9
]}

Trichopoulou, A. ^{[10
]}

Trichopoulos, D. ^{[11
,12
]}

Bamia, C. ^{[10
]}

Sieri, S. ^{[13
]}

Palli, D. ^{[14
]}

Tumino, R. ^{[15
]}

Vineis, P. ^{[16
,17
]}

Panico, S. ^{[18
]}

Peeters, P. H. M. ^{[4
]}

May, A. M. ^{[4
]}

Bueno-de-Mesquita, H. B. ^{[19
]}

van Duijnhoven, F. J. B. ^{[19
]}

Hallmans, G. ^{[20
]}

Weinehall, L. ^{[20
]}

Manjer, J. ^{[21
]}

Hedblad, B. ^{[22
]}

Lund, E. ^{[23
]}

Agudo, A. ^{[24
]}

Arriola, L. ^{[25
]}

Barricarte, A. ^{[26
]}

Navarro, C. ^{[27
,28
]}

Martinez, C. ^{[29
]}

Quiros, J. R. ^{[30
]}

Key, T. ^{[5
]}

Bingham, S. ^{[31
]}

Khaw, K. T. ^{[32
]}

Boffetta, P. ^{[33
]}

Jenab, M. ^{[33
]}

Ferrari, P. ^{[33
]}

Riboli, E. ^{[16
]}

机构：

[1] German Inst Human Nutr, Dept Epidemiol, D-14558 Potsdam, Germany

[2] Aalborg Hosp, Aarhus Univ Hosp Syst, Dept Clin Epidemiol, Aalborg, Denmark

[3] Aalborg Hosp, Aarhus Univ Hosp Syst, Dept Cardiol, Aalborg, Denmark

[4] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[5] Univ Oxford, Canc Res UK Epidemiol Unit, Oxford, England

[6] Inst Canc Epidemiol, Danish Canc Soc, Copenhagen, Denmark

[7] INSERM, ERI 20, EA 4045, Villejuif, France

[8] Inst Gustave Roussy, Villejuif, France

[9] German Canc Res Ctr, Div Clin Epidemiol, D-6900 Heidelberg, Germany

[10] Univ Athens, Sch Med, Dept Hyg & Epidemiol, GR-11527 Athens, Greece

[11] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA

[12] Hellen Hlth Fdn, Athens, Greece

[13] Natl Canc Inst, Nutr Epidemiol Unit, I-20133 Milan, Italy

[14] Canc Res & Prevent Inst, Mol & Nutr Epidemiol Unit, Florence, Italy

[15] Azienda Osped Civile MP Arezzo, Canc Registry, Ragusa, Italy

[16] Univ London Imperial Coll Sci Technol & Med, Dept Epidemiol & Publ Hlth, London, England

[17] Univ Turin, Turin, Italy

[18] Univ Naples Federico 2, Naples, Italy

[19] Natl Inst Publ Hlth & Environm RIVM, Ctr Nutr & Hlth, NL-3720 BA Bilthoven, Netherlands

[20] Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden

[21] Malmo Univ Hosp, Dept Surg, Malmo, Sweden

[22] Malmo Univ Hosp, Dept Clin Sci, Malmo, Sweden

[23] Univ Tromso, Inst Community Med, Tromso, Norway

[24] Catalan Inst Oncol, Canc Epidemiol Res Program, Unit Nutr Environm & Canc, Barcelona, Spain

[25] Publ Hlth Dept Gipuzkoa, San Sebastian, Spain

[26] Publ Hlth Inst Navarra, Pamplona, Spain

[27] Murcia Hlth Council, Dept Epidemiol, Murcia, Spain

[28] CIBER Epidemiol & Salud Publ, Barcelona, Spain

[29] Escuela Andaluza Salud Publ, Granada, Spain

[30] Publ Hlth & Hlth Planning Directorate, Hlth Informat Unit, Asturias, Spain

[31] Univ Cambridge, Ctr Nutr & Canc, Cambridge, England

[32] Univ Cambridge, Clin Gerontol Unit, Cambridge, England

[33] WHO, Int Agcy Res Canc, Lyon, France

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2008年 / 359卷 / 20期

基金：

英国惠康基金; 英国医学研究理事会;

关键词：

D O I：

10.1056/NEJMoa0801891

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：2105 / 2120

页数：16

共 41 条

[1] Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old [J].

Adams, Kenneth F. ;

Schatzkin, Arthur ;

Harris, Tamara B. ;

Kipnis, Victor ;

Mouw, Traci ;

Ballard-Barbash, Rachel ;

Hollenbeck, Albert ;

Leitzmann, Michael F. .

NEW ENGLAND JOURNAL OF MEDICINE, 2006, 355 (08) :763-778

[2] Adiposity and mortality in men [J].

Baik, I ;

Ascherio, A ;

Rimm, EB ;

Giovannucci, E ;

Spiegelman, D ;

Stampfer, MJ ;

Willett, WC .

AMERICAN JOURNAL OF EPIDEMIOLOGY, 2000, 152 (03) :264-271

[3] CIGARETTE-SMOKING AND INCREASED CENTRAL ADIPOSITY [J].

BARRETTCONNOR, E ;

KHAW, KT .

ANNALS OF INTERNAL MEDICINE, 1989, 111 (10) :783-787

[4] Waist circumference, BMI, smoking, and mortality in middle-aged men and women [J].

Bigaard, J ;

Tjonneland, A ;

Thomsen, BL ;

Overvad, K ;

Heitmann, BL ;

Sorensen, TIA .

OBESITY RESEARCH, 2003, 11 (07) :895-903

[5] COMPARISON OF DIETARY ASSESSMENT METHODS IN NUTRITIONAL EPIDEMIOLOGY - WEIGHED RECORDS V 24-H RECALLS, FOOD-FREQUENCY QUESTIONNAIRES AND ESTIMATED-DIET RECORDS [J].

BINGHAM, SA ;

GILL, C ;

WELCH, A ;

DAY, K ;

CASSIDY, A ;

KHAW, KT ;

SNEYD, MJ ;

KEY, TJA ;

ROE, L ;

DAY, NE .

BRITISH JOURNAL OF NUTRITION, 1994, 72 (04) :619-643

[6] Body-mass index and mortality in a prospective cohort of US adults [J].

Calle, EE ;

Thun, MJ ;

Petrelli, JM ;

Rodriguez, C ;

Heath, CW .

NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (15) :1097-1105

[7] Use and misuse of the receiver operating characteristic curve in risk prediction [J].

Cook, Nancy R. .

CIRCULATION, 2007, 115 (07) :928-935

[8]

Donato KA, 1998, ARCH INTERN MED, V158, P1855, DOI 10.1001/archinte.158.17.1855

[9] FLEXIBLE REGRESSION-MODELS WITH CUBIC-SPLINES [J].

DURRLEMAN, S ;

SIMON, R .

STATISTICS IN MEDICINE, 1989, 8 (05) :551-561

[10]

FOLSOM AR, 1993, JAMA-J AM MED ASSOC, V269, P1254

← 1 2 3 4 5 →