Dataset Information

Comparison of the associations between non-traditional and traditional indices of adiposity and cardiovascular mortality: an observational study of one million person-years of follow-up.

ABSTRACT:

Background/objective

The most widely used adiposity index, body mass index (BMI), is not optimal to evaluate cardiovascular (CV) risk associated with overweight and obesity. We aimed to explore the association between traditional and non-traditional adiposity indices and CV mortality, and compare their discriminative ability for CV death.

Methods

We studied participants (age 19-79 years, BMI ?18.5?kg/m²) from the population-based Norwegian Nord-Trøndelag Health Study 2 (HUNT 2). Traditional indices explored were BMI, waist circumference (WC) and waist- to-hip ratio, whereas non-traditional were estimated total body fat (eTBF), which is a sex-specific fat%-index, index of central obesity (WC/height) and a body shape index (ABSI) [WC/(BMI^2/3?×??height)]. Associations between the traditional and non-traditional indices and CV death, obtained from the Norwegian Cause of Death Registry, were explored by Cox proportional hazard regression, and the indices' discriminative ability by Harrell's C statistics.

Results

Baseline assessments were done from 1995 to 1997 and the population (n?=?61,016, 52% women) was observed for 17.7?±?4.2 years (until 2016), yielding 1,080,473.6 person-years of follow-up. Thirteen thousand one hundred and ninety five (21.6%) subjects died, of whom 4908 (37.2%) died from CV causes. Across genders, eTBF had the strongest association to CV death (unadjusted hazard ratios [HRs] 4th vs. 1st quartile in women and men 13.38 [95% confidence interval (CI): 11.05-16.22] and 9.32 [8.03-10.81], respectively), together with index of central obesity in women and ABSI in men. The other indices showed weaker associations, in particular BMI in men: 1.73 [1.56-1.93]. Age adjustment attenuated the associations, but the pattern remained. In concordance with this, C-statistics was C?=?0.725 [0.713-0.737] in women and 0.711 [0.701-0.721] in men for eTBF, and C?=?0.622 [0.610-0.634] in women and 0.551 [0.541-0.562] in men for BMI.

Conclusion

eTBF, a sex-specific total body fat index, was more strongly associated with CV death than other adiposity indices and may be a suitable clinical tool for assessment of obesity-associated CV risk.

SUBMITTER: Ofstad AP

PROVIDER: S-EPMC6760583 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Comparison of the associations between non-traditional and traditional indices of adiposity and cardiovascular mortality: an observational study of one million person-years of follow-up.

Ofstad Anne Pernille AP Sommer Christine C Birkeland Kåre I KI Bjørgaas Marit Rokne MR Gran Jon Michael JM Gulseth Hanne Løvdal HL Johansen Odd Erik OE

International journal of obesity (2005) 20190329 5

<h4>Background/objective</h4>The most widely used adiposity index, body mass index (BMI), is not optimal to evaluate cardiovascular (CV) risk associated with overweight and obesity. We aimed to explore the association between traditional and non-traditional adiposity indices and CV mortality, and compare their discriminative ability for CV death.<h4>Methods</h4>We studied participants (age 19-79 years, BMI ≥18.5 kg/m<sup>2</sup>) from the population-based Norwegian Nord-Trøndelag Health Study 2 ...[more]

PMID: 30926954

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Project description:Background:To date, the best adiposity index that predicts or associates strongly with hypertension remains controversial. Therefore, we aimed to compare the performance of different adiposity indices [BMI (body mass index), WC (waist circumference), WHtR (waist-to-height ratio), ABSI (a body shape index), VAI (visceral adipose index), BFP (body fat percentage)] as associates and potential predictors of risk of hypertension among Chinese population.Methods:A cross-sectional survey was conducted in Jiangxi province, China from 2013 to 2014. A total of 14,573 participants were included in the study. The physical measurements included body height, weight, WC, BFP and VAI. Multivariate logistic regression analysis was performed to assess the associations between different adiposity indices and the prevalence of hypertension. Receiver operating characteristic (ROC) analysis was also performed.Results:All adiposity indices were independently and positively associated with the prevalence of hypertension in a dose response fashion. The area under the curves (AUCs) for WHtR, BFP and VAI were significantly larger than those for other adiposity indices in both males and females (all P?<?0.01). For males, no statistically significant difference was found in AUCs among WHtR and BFP (0.653 vs. 0.647, P?=?0.4774). The AUC of WHtR was significantly higher than VAI (0.653 vs. 0.636, P?<?0.01). For females, the AUCs demonstrated that WHtR was significantly more powerful than BFP and VAI (both P?<?0.05) for predicting hypertension [WHtR, 0.689 (0.677-0.702); BFP, 0.677 (0.664-0.690); VAI, 0.668 (0.655-0.680)]. Whereas no significant differences were found in AUCs for hypertension among BFP and VAI in both sexes (all P?>?0.1). The AUCs for hypertension associated with each adiposity index declined with age in both males and females. For subjects aged <?65?years, WHtR still had the largest AUC. However, for participants aged ?65?years, BMI had the largest AUC.Conclusion:The findings indicated that WHtR was the best for predicting hypertension, followed by BFP and VAI, especially in younger population.

Project description:Background and aimsObesity, especially abdominal obesity, has been considered a risk factor for diabetic complications. Many abdominal obesity indices have been established, including neck circumference (NC), waist-to-hip ratio (WHR), lipid accumulation product (LAP), visceral adiposity index (VAI) and the Chinese visceral adiposity index (CVAI). However, studies investigating the associations between these indices and diabetic complications are limited. The objective of this study was to investigate the associations of the abdominal obesity indices with cardiovascular and cerebrovascular disease (CVD), diabetic kidney disease (DKD) and diabetic retinopathy (DR).MethodsA total of 4658 diabetic participants were enrolled from seven communities in Shanghai, China, in 2018. Participants completed questionnaires and underwent blood pressure, glucose, lipid profile, and urine albumin/creatinine ratio measurements; fundus photographs; and anthropometric parameters, including height, weight, waist circumference (WC), NC and hip circumference (HC).ResultsIn men, a one standard deviation (SD) increase in CVAI level was significantly associated with a greater prevalence of CVD (OR 1.35; 95% CI 1.13, 1.62) and DKD (OR 1.38; 95% CI 1.12, 1.70) (both P < 0.05). In women, a one SD increase in CVAI level was significantly associated with a greater prevalence of CVD (OR 1.32; 95% CI 1.04, 1.69) and DKD (OR 2.50; 95% CI 1.81, 3.47) (both P < 0.05). A one SD increase in NC was significantly associated with a greater prevalence of CCA plaque in both men (OR 1.26; 95% CI 1.10, 1.44) and women (OR 1.20; 95% CI 1.07, 1.35). These associations were all adjusted for potential confounding factors.ConclusionsCVAI was most strongly associated with the prevalence of CVD and DKD among the abdominal obesity indices, and NC was unique associated with the prevalence of CCA plaque in Chinese adults with diabetes. Trial registration ChiCTR1800017573, www.chictr.org.cn . Registered 04 August 2018.

Dataset Information

Comparison of the associations between non-traditional and traditional indices of adiposity and cardiovascular mortality: an observational study of one million person-years of follow-up.

Background/objective

Methods

Results

Conclusion

Publications

Comparison of the associations between non-traditional and traditional indices of adiposity and cardiovascular mortality: an observational study of one million person-years of follow-up.

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