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Anthropometric markers of obesity and mortality in white and African American adults: the pennington center longitudinal study.

ABSTRACT: The purpose of this study was to determine the association between anthropometric measures of obesity and all-cause mortality in white and African American men and women.The sample included 14,343 adults 18-89 years of age. Height, weight, and waist and hip circumferences were measured, and the BMI (kg m(-2) ), body adiposity index (BAI = ([hip circumference in centimeters]/[height in meters])(1.5) - 18), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) were computed. Vital status of the participants was determined from linkage with the National Death Index through 2009. Cox regression was used to assess the association between anthropometry and all-cause mortality, adjusting for age, sex, year of baseline examination, study code, smoking status, alcohol consumption and physical activity. Hazard ratios (HR) are expressed per standard deviation of each variable.A total of 438 deaths occurred during 120,637 person-years of follow-up. All anthropometric markers demonstrated significant associations with all-cause mortality in white subjects. In multivariable-adjusted models, BMI (HR 1.34; 95% CI: 1.19-1.50), waist circumference (1.41; 1.25-1.60), BAI (1.34; 1.17-1.53), WHtR (1.46; 1.28-1.65), and WHR (1.40; 1.23-1.61) all demonstrated significant relationships with mortality in white participants, but not in African Americans. In categorical analyses, there was a significant association between BMI status and mortality in whites but not African Americans. However, the risk associated with elevated waist circumference was similar in whites (1.49; 1.15-1.94) and African Americans (1.60; 1.06-2.40).In summary, this study has demonstrated race differences in the association between anthropometry and all-cause mortality.

SUBMITTER: Katzmarzyk PT

PROVIDER: S-EPMC3695407 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Anthropometric markers of obesity and mortality in white and African American adults: the pennington center longitudinal study.

Katzmarzyk Peter T PT Mire Emily E Bray George A GA Greenway Frank L FL Heymsfield Steven B SB Bouchard Claude C

Obesity (Silver Spring, Md.) 20130501 5

<h4>Objective</h4>The purpose of this study was to determine the association between anthropometric measures of obesity and all-cause mortality in white and African American men and women.<h4>Design and methods</h4>The sample included 14,343 adults 18-89 years of age. Height, weight, and waist and hip circumferences were measured, and the BMI (kg m(-2) ), body adiposity index (BAI = ([hip circumference in centimeters]/[height in meters])(1.5) - 18), waist-to-height ratio (WHtR) and waist-to-hip ...[more]

PMID: 23784912

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Project description:BackgroundAfrican Americans (AA) have more favorable bone density and microarchitecture compared to Whites (W), which may explain their observed lower fracture rates. Obesity has deleterious effects on bone microarchitecture and strength estimates and is associated with an increase in fracture risk. Adolescence and young adulthood are periods of active bone accrual and also periods characterized by an increasing prevalence of obesity. The effect of obesity on the relationship between race and bone parameters remains unclear, particularly in youth.ObjectiveTo assess differences in BMD, bone microarchitecture and strength estimates in AA and W adolescents and young adults with moderate to severe obesity. We hypothesized that racial differences in bone endpoints in lean youth would also be noted in youth with moderate to severe obesity.MethodsWe evaluated 24 AA and 48 W adolescent and young adults with a mean age of 18.2 ± 2.4 years and a median body mass index (BMI) of 44.8 (40.5-49.4) kg/m2 who underwent dual energy X-ray absorptiometry (DXA), high resolution peripheral quantitative computed tomography (HRpQCT), extended cortical analysis (ECA) and micro-finite element analysis (FEA) to obtain measures of volumetric bone mineral density (vBMD), bone geometry, microarchitecture, and strength estimates at the distal radius and tibia.ResultsWe found no differences between AA and W for total fat and lean mass, and areal BMD Z-scores (p > 0.05 for all). At the distal radius, no significant differences were detected in vBMD, bone geometry or microarchitecture (p > 0.05 for all); however, stiffness and failure load were higher in the AA group (p = 0.031 and 0.047 respectively). At the distal tibia, cortical vBMD was higher in AA vs. W (p = 0.012), while trabecular number was higher and trabecular separation lower in W vs. AA (p ≤ 0.028). Stiffness and failure load trended higher in AA vs. W (p = 0.052 and p = 0.048, respectively). Groups did not differ for any other bone parameter (p > 0.05).ConclusionRacial differences in bone endpoints appear to be less marked in those with moderate to severe obesity, suggesting that effects of obesity may blunt the effect of race on bone endpoints.

Dataset Information

Anthropometric markers of obesity and mortality in white and African American adults: the pennington center longitudinal study.

Publications

Anthropometric markers of obesity and mortality in white and African American adults: the pennington center longitudinal study.

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