Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality.

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  • Additional Information
    • Affiliation:
      Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
      Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
      Department of Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
      Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
      Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
      Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
      Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland, USA
      The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
      Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
      Liver and Pancreaticobiliary Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
      Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland, USA
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Background: It is unclear which anthropometric obesity indicator best predicts adverse health outcomes. This study aimed to investigate the association of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and hip-adjusted WC with all-cause and cardiovascular mortality. Methods: 50 045 people aged 40-75 (58% women, median BMI: 26.3 kg/m²) participated in the population-based Golestan Cohort Study. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) for the association of obesity indicators with mortality. We also examined the association of these indicators with intermediate outcomes, including hypertension, blood glucose, dyslipidemia, carotid atherosclerosis, nonalcoholic fatty liver, and visceral abdominal fat. Results: After a median follow-up of 10.9 years (success rate: 99.1%), 6651 deaths (2778 cardiovascular) occurred. Comparing 5th to the 1st quintile, HRs (95% CIs) for all-cause and cardiovascular mortality were 1.12 (1.02-1.22) and 1.59 (1.39-1.83) for BMI, 1.16 (1.07-1.27) and 1.66 (1.44-1.90) for WC, 1.28 (1.17-1.40) and 1.88 (1.63-2.18) for WHtR, 1.44 (1.32-1.58) and 2.04 (1.76-2.36) for WHR, and 1.84 (1.62-2.09) and 2.72 (2.23-3.32) for hip-adjusted WC, respectively. Hip-adjusted WC had the strongest associations with the intermediate outcomes. Conclusion: Indicators of visceral adiposity (e.g., hip-adjusted WC) were much stronger predictors of overall and cardiovascular mortality than were indicators of general adiposity (e.g., BMI). The full-strength effect of visceral adiposity becomes apparent only when both WC, as a risk factor, and hip circumference, as a protective factor, are individually and simultaneously taken into consideration.
    • Journal Subset:
      Biomedical; Editorial Board Reviewed; Expert Peer Reviewed; Middle East; Peer Reviewed
    • ISSN:
      1029-2977
    • MEDLINE Info:
      NLM UID: 100889644
    • Publication Date:
      20190715
    • Publication Date:
      20190716
    • Accession Number:
      137440393
  • Citations
    • ABNT:
      NALINI, M. et al. Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality. Archives of Iranian Medicine (AIM), [s. l.], v. 22, n. 6, p. 301–309, 2019. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=137440393. Acesso em: 7 ago. 2020.
    • AMA:
      Nalini M, Sharafkhah M, Poustchi H, et al. Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality. Archives of Iranian Medicine (AIM). 2019;22(6):301-309. Accessed August 7, 2020. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=137440393
    • APA:
      Nalini, M., Sharafkhah, M., Poustchi, H., Sepanlou, S. G., Pourshams, A., Radmard, A. R., Khoshnia, M., Gharavi, A., Dawsey, S. M., Abnet, C. C., Boffetta, P., Brennan, P., Sotoudeh, M., Nikmanesh, A., Merat, S., Etemadi, A., Shakeri, R., Malekzadeh, R., & Kamangar, F. (2019). Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality. Archives of Iranian Medicine (AIM), 22(6), 301–309.
    • Chicago/Turabian: Author-Date:
      Nalini, Mahdi, Maryam Sharafkhah, Hossein Poustchi, Sadaf G. Sepanlou, Akram Pourshams, Amir Reza Radmard, Masoud Khoshnia, et al. 2019. “Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality.” Archives of Iranian Medicine (AIM) 22 (6): 301–9. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=137440393.
    • Harvard:
      Nalini, M. et al. (2019) ‘Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality’, Archives of Iranian Medicine (AIM), 22(6), pp. 301–309. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=137440393 (Accessed: 7 August 2020).
    • Harvard: Australian:
      Nalini, M, Sharafkhah, M, Poustchi, H, Sepanlou, SG, Pourshams, A, Radmard, AR, Khoshnia, M, Gharavi, A, Dawsey, SM, Abnet, CC, Boffetta, P, Brennan, P, Sotoudeh, M, Nikmanesh, A, Merat, S, Etemadi, A, Shakeri, R, Malekzadeh, R & Kamangar, F 2019, ‘Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality’, Archives of Iranian Medicine (AIM), vol. 22, no. 6, pp. 301–309, viewed 7 August 2020, .
    • MLA:
      Nalini, Mahdi, et al. “Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality.” Archives of Iranian Medicine (AIM), vol. 22, no. 6, June 2019, pp. 301–309. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=137440393.
    • Chicago/Turabian: Humanities:
      Nalini, Mahdi, Maryam Sharafkhah, Hossein Poustchi, Sadaf G. Sepanlou, Akram Pourshams, Amir Reza Radmard, Masoud Khoshnia, et al. “Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality.” Archives of Iranian Medicine (AIM) 22, no. 6 (June 2019): 301–9. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=137440393.
    • Vancouver/ICMJE:
      Nalini M, Sharafkhah M, Poustchi H, Sepanlou SG, Pourshams A, Radmard AR, et al. Comparing Anthropometric Indicators of Visceral and General Adiposity as Determinants of Overall and Cardiovascular Mortality. Archives of Iranian Medicine (AIM) [Internet]. 2019 Jun [cited 2020 Aug 7];22(6):301–9. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=137440393