Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality - Sixteen years of follow-up in US women

被引:655
作者
Zhang, Cuilin [1 ]
Rexrode, Kathryn M. [2 ,3 ]
van Dam, Rob M. [4 ,5 ,6 ]
Li, Tricia Y. [6 ]
Hu, Frank B. [4 ,5 ,6 ,7 ]
机构
[1] NICHHD, Div Epidemiol Stat & Prevent Res, Epidemiol Branch, Bethesda, MD 20892 USA
[2] Harvard Univ, Sch Med, Dept Med, Div Prevent Med, Boston, MA 02115 USA
[3] Brigham & Womens Hosp, Dept Med, Div Prevent Med, Boston, MA 02115 USA
[4] Brigham & Womens Hosp, Dept Med, Channing Lab, Boston, MA 02115 USA
[5] Harvard Univ, Sch Med, Dept Med, Channing Lab, Boston, MA 02115 USA
[6] Harvard Sch Publ Hlth, Dept Nutr, Boston, MA USA
[7] Harvard Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
关键词
adiposity; cancer; cardiovascular diseases; mortality; obesity; waist-hip ratio;
D O I
10.1161/CIRCULATIONAHA.107.739714
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background - Accumulating evidence indicates that abdominal adiposity is positively related to cardiovascular disease (CVD) risk and some other diseases independently of overall adiposity. However, the association of premature death resulting from these diseases with abdominal adiposity has not been widely studied, and findings are inconsistent. Methods and Results - In a prospective cohort study of 44 636 women in the Nurses' Health Study, associations of abdominal adiposity with all-cause and cause-specific mortality were examined. During 16 years of follow-up, 3507 deaths were identified, including 751 cardiovascular deaths and 1748 cancer deaths. After adjustment for body mass index and potential confounders, the relative risks across the lowest to the highest waist circumference quintiles were 1.00, 1.11, 1.17, 1.31, and 1.79 (95% confidence interval [CI], 1.47 to 1.98) for all-cause mortality; 1.00, 1.04, 1.04, 1.28, and 1.99 (95% CI, 1.44 to 2.73) for CVD mortality; and 1.00, 1.18, 1.20, 1.34, and 1.63 (95% CI, 1.32 to 2.01) for cancer mortality (all P < 0.001 for trend). Among normal-weight women (body mass index, 18.5 to <25 kg/m(2)), abdominal obesity was significantly associated with elevated CVD mortality: Relative risk associated with waist circumference >= 88 cm was 3.02 (95% CI, 1.31 to 6.99) and for waist-to-hip ratio >0.88 was 3.45 (95% CI, 2.02 to 6.92). After adjustment for waist circumference, hip circumference was significantly and inversely associated with CVD mortality. Conclusions - Anthropometric measures of abdominal adiposity were strongly and positively associated with all-cause, CVD, and cancer mortality independently of body mass index. Elevated waist circumference was associated with significantly increased CVD mortality even among normal-weight women.
引用
收藏
页码:1658 / 1667
页数:10
相关论文
共 33 条
[1]   Adipose tissue, inflammation, and cardiovascular disease [J].
Berg, AH ;
Scherer, PE .
CIRCULATION RESEARCH, 2005, 96 (09) :939-949
[2]   Waist circumference and body composition in relation to all-cause mortality in middle-aged men and women [J].
Bigaard, J ;
Frederiksen, K ;
Tjonneland, A ;
Thomsen, BL ;
Overvad, K ;
Heitmann, BL ;
Sorensen, TIA .
INTERNATIONAL JOURNAL OF OBESITY, 2005, 29 (07) :778-784
[3]   Overweight, obesity and cancer: Epidemiological evidence and proposed mechanisms [J].
Calle, EE ;
Kaaks, R .
NATURE REVIEWS CANCER, 2004, 4 (08) :579-591
[4]   VALIDATION OF QUESTIONNAIRE INFORMATION ON RISK-FACTORS AND DISEASE OUTCOMES IN A PROSPECTIVE COHORT STUDY OF WOMEN [J].
COLDITZ, GA ;
MARTIN, P ;
STAMPFER, MJ ;
WILLETT, WC ;
SAMPSON, L ;
ROSNER, B ;
HENNEKENS, CH ;
SPEIZER, FE .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1986, 123 (05) :894-900
[5]  
Cox DR O, 1987, ANAL SURVIVAL DATA
[6]   Associations of general and abdominal obesity with multiple health outcomes in older women -: The Iowa women's health study [J].
Folsom, AR ;
Kushi, LH ;
Anderson, KE ;
Mink, PJ ;
Olson, JE ;
Hong, CP ;
Sellers, TA ;
Lazovich, D ;
Prineas, R .
ARCHIVES OF INTERNAL MEDICINE, 2000, 160 (14) :2117-2128
[7]   Adipose tissue as a buffer for daily lipid flux [J].
Frayn, KN .
DIABETOLOGIA, 2002, 45 (09) :1201-1210
[8]  
GIOVANNUCCI E, 1991, AM J EPIDEMIOL, V133, P810
[9]   DOSE-RESPONSE AND TREND ANALYSIS IN EPIDEMIOLOGY - ALTERNATIVES TO CATEGORICAL ANALYSIS [J].
GREENLAND, S .
EPIDEMIOLOGY, 1995, 6 (04) :356-365
[10]   Waist height ratio as a simple and useful predictor of coronary heart disease risk factors in women [J].
Hsieh, SD ;
Yoshinaga, H .
INTERNAL MEDICINE, 1995, 34 (12) :1147-1152