A Pooled Analysis of Waist Circumference and Mortality in 650,000 Adults

被引：335

作者：

Cerhan, James R. ^{[1
]}

Moore, Steven C. ^{[3
]}

Jacobs, Eric J. ^{[4
]}

Kitahara, Cari M. ^{[3
]}

Rosenberg, Philip S. ^{[3
]}

Adami, Hans-Olov ^{[5
,7
]}

Ebbert, Jon O. ^{[2
]}

English, Dallas R. ^{[9
]}

Gapstur, Susan M. ^{[4
]}

Giles, Graham G. ^{[10
]}

Horn-Ross, Pamela L. ^{[11
]}

Park, Yikyung ^{[3
]}

Patel, Alpa V. ^{[4
]}

Robien, Kim ^{[12
]}

Weiderpass, Elisabete ^{[5
,13
,14
,15
]}

Willett, Walter C. ^{[8
]}

Wolk, Alicja ^{[6
]}

Zeleniuch-Jacquotte, Anne ^{[16
]}

Hartge, Patricia ^{[3
]}

Bernstein, Leslie ^{[17
]}

de Gonzalez, Amy Berrington ^{[3
]}

机构：

[1] Mayo Clin, Div Epidemiol, Rochester, MN USA

[2] Mayo Clin, Div Primary Care Internal Med, Rochester, MN USA

[3] NCI, Div Canc Epidemiol & Genet, Bethesda, MD 20892 USA

[4] Amer Canc Soc, Res Program, Atlanta, GA 30329 USA

[5] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden

[6] Karolinska Inst, Natl Inst Environm Med, Div Nutr Epidemiol, Stockholm, Sweden

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

[8] Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA

[9] Univ Melbourne, MEGA Epidemiol, Melbourne, Vic, Australia

[10] Canc Council Victoria, Canc Epidemiol Ctr, Melbourne, Vic, Australia

[11] Canc Prevent Inst Calif, Fremont, CA 94538 USA

[12] Univ Minnesota, Sch Publ Hlth, Minneapolis, MN USA

[13] Univ Tromso, Fac Hlth Sci, Dept Community Med, Tromso, Norway

[14] Canc Register Norway, Oslo, Norway

[15] Samfundet Folkhalsan, Helsinki, Finland

[16] NYU, Sch Med, Dept Populat Hlth, New York, NY USA

[17] City Hope Natl Med Ctr, Duarte, CA USA

来源：

MAYO CLINIC PROCEEDINGS | 2014年 / 89卷 / 03期

基金：

瑞典研究理事会; 英国医学研究理事会; 美国国家卫生研究院;

关键词：

BODY-MASS INDEX; ALL-CAUSE MORTALITY; ABDOMINAL OBESITY; METABOLIC SYNDROME; BREAST-CANCER; RISK; ADIPOSITY; OVERWEIGHT; ACCURACY; ASSOCIATIONS;

D O I：

10.1016/j.mayocp.2013.11.011

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objectives: To assess the independent effect of waist circumference on mortality across the entire body mass index (BMI) range and to estimate the loss in life expectancy related to a higher waist circumference. Patients and Methods: We pooled data from 11 prospective cohort studies with 650,386 white adults aged 20 to 83 years and enrolled from January 1, 1986, through December 31, 2000. We used proportional hazards regression to estimate hazard ratios (HRs) and 95% CIs for the association of waist circumference with mortality. Results: During a median follow-up of 9 years (maximum, 21 years), 78,268 participants died. After accounting for age, study, BMI, smoking status, alcohol consumption, and physical activity, a strong positive linear association of waist circumference with all-cause mortality was observed for men (HR, 1.52 for waist circumferences of >= 110 vs < 90 cm; 95% CI, 1.45-1.59; HR, 1.07 per 5-cm increment in waist circumference; 95% CI, 1.06-1.08) and women (HR, 1.80 for waist circumferences of >= 95 vs < 70 cm; 95% CI, 1.70-1.89; HR, 1.09 per 5-cm increment in waist circumference; 95% CI, 1.08-1.09). The estimated decrease in life expectancy for highest vs lowest waist circumference was approximately 3 years for men and approximately 5 years for women. The HR per 5-cm increment in waist circumference was similar for both sexes at all BMI levels from 20 to 50 kg/m(2), but it was higher at younger ages, higher for longer follow-up, and lower among male current smokers. The associations were stronger for heart and respiratory disease mortality than for cancer. Conclusions: In white adults, higher waist circumference was positively associated with higher mortality at all levels of BMI from 20 to 50 kg/m(2). Waist circumference should be assessed in combination with BMI, even for those in the normal BMI range, as part of risk assessment for obesity-related premature mortality. (C) 2014 Mayo Foundation for Medical Education and Research

引用

页码：335 / 345

页数：11

共 42 条

[1]

[Anonymous], ANN INTERN MED, DOI DOI 10.7326/0003-4819-157-3-201208070-00462

[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]

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

[4]

Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults [J].

Calle, EE ;

Rodriguez, C ;

Walker-Thurmond, K ;

Thun, MJ .

NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (17) :1625-1638

[5]

Body size and the risk of postmenopausal breast cancer subtypes in the California Teachers Study cohort [J].

Canchola, Alison J. ;

Anton-Culver, Hoda ;

Bernstein, Leslie ;

Clarke, Christina A. ;

Henderson, Katherine ;

Ma, Huiyan ;

Ursin, Giske ;

Horn-Ross, Pamela L. .

CANCER CAUSES & CONTROL, 2012, 23 (03) :473-485

[6]

Body-Mass Index and Mortality among 1.46 Million White Adults. [J].

de Gonzalez, Amy Berrington ;

Hartge, Patricia ;

Cerhan, James R. ;

Flint, Alan J. ;

Hannan, Lindsay ;

MacInnis, Robert J. ;

Moore, Steven C. ;

Tobias, Geoffrey S. ;

Anton-Culver, Hoda ;

Freeman, Laura Beane ;

Beeson, W. Lawrence ;

Clipp, Sandra L. ;

English, Dallas R. ;

Folsom, Aaron R. ;

Freedman, D. Michal ;

Giles, Graham ;

Hakansson, Niclas ;

Henderson, Katherine D. ;

Hoffman-Bolton, Judith ;

Hoppin, Jane A. ;

Koenig, Karen L. ;

Lee, I-Min ;

Linet, Martha S. ;

Park, Yikyung ;

Pocobelli, Gaia ;

Schatzkin, Arthur ;

Sesso, Howard D. ;

Weiderpass, Elisabete ;

Willcox, Bradley J. ;

Wolk, Alicja ;

Zeleniuch-Jacquotte, Anne ;

Willett, Walter C. ;

Thun, Michael J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (23) :2211-2219

[7]

Obesity paradox and the heart: which indicator of obesity best describes this complex relationship? [J].

De Schutter, Alban ;

Lavie, Carl J. ;

Patel, Dharmendrakumar A. ;

Milani, Richard V. .

CURRENT OPINION IN CLINICAL NUTRITION AND METABOLIC CARE, 2013, 16 (05) :517-524

[8]

Abdominal obesity and the metabolic syndrome:: Contribution to global cardiometabolic risk [J].

Despres, Jean-Pierre ;

Lemieux, Isabelle ;

Bergeron, Jean ;

Pibarot, Philippe ;

Mathieu, Patrick ;

Larose, Eric ;

Rodes-Cabau, Josep ;

Bertrand, Olivier F. ;

Poirier, Paul .

ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2008, 28 (06) :1039-1049

[9]

Cause-specific excess deaths associated with underweight, overweight, and obesity [J].

Flegal, Katherine M. ;

Graubard, Barry I. ;

Williamson, David F. ;

Gail, Mitchell H. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 298 (17) :2028-2037

[10]

Estimates of excess deaths associated with body mass index and other anthropometric variables [J].

Flegal, Katherine M. ;

Graubard, Barry I. .

AMERICAN JOURNAL OF CLINICAL NUTRITION, 2009, 89 (04) :1213-1219

← 1 2 3 4 5 →