The influence of hip circumference on the relationship between abdominal obesity and mortality

Adrian J. Cameron, Dianna J. Magliano, Jonathan E. Shaw, Paul Z. Zimmet, Bendix Carstensen, K. George M M Alberti, Jaakko Tuomilehto, Elizabeth L M Barr, Vassen K. Pauvaday, Sudhirsen Kowlessur, Stefan Söderberg

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background: Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction. Methods: In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of >25% and a decrease of >20% after waist and hip circumference were added to the model was calculated. Results: Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by >25% for 23.7% of those who died and 15.7% of those censored. Cumulative mortality decreased by >20% for 4.5% of those who died and 14.8% of those censored. Conclusions: The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models. Published by Oxford University Press on behalf of the International Epidemiological Association

LanguageEnglish
Article numberdyr198
Pages484-494
Number of pages11
JournalInternational journal of epidemiology
Volume41
Issue number2
DOIs
Publication statusPublished - 1 Apr 2012

Keywords

  • African
  • Hip circumference
  • Mortality
  • Obesity
  • South Asian
  • Waist circumference

ASJC Scopus subject areas

  • Epidemiology

Cite this

Cameron, A. J., Magliano, D. J., Shaw, J. E., Zimmet, P. Z., Carstensen, B., Alberti, K. G. M. M., ... Söderberg, S. (2012). The influence of hip circumference on the relationship between abdominal obesity and mortality. International journal of epidemiology, 41(2), 484-494. [dyr198]. https://doi.org/10.1093/ije/dyr198
Cameron, Adrian J. ; Magliano, Dianna J. ; Shaw, Jonathan E. ; Zimmet, Paul Z. ; Carstensen, Bendix ; Alberti, K. George M M ; Tuomilehto, Jaakko ; Barr, Elizabeth L M ; Pauvaday, Vassen K. ; Kowlessur, Sudhirsen ; Söderberg, Stefan. / The influence of hip circumference on the relationship between abdominal obesity and mortality. In: International journal of epidemiology. 2012 ; Vol. 41, No. 2. pp. 484-494.
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abstract = "Background: Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction. Methods: In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of >25{\%} and a decrease of >20{\%} after waist and hip circumference were added to the model was calculated. Results: Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by >25{\%} for 23.7{\%} of those who died and 15.7{\%} of those censored. Cumulative mortality decreased by >20{\%} for 4.5{\%} of those who died and 14.8{\%} of those censored. Conclusions: The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models. Published by Oxford University Press on behalf of the International Epidemiological Association",
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Cameron, AJ, Magliano, DJ, Shaw, JE, Zimmet, PZ, Carstensen, B, Alberti, KGMM, Tuomilehto, J, Barr, ELM, Pauvaday, VK, Kowlessur, S & Söderberg, S 2012, 'The influence of hip circumference on the relationship between abdominal obesity and mortality', International journal of epidemiology, vol. 41, no. 2, dyr198, pp. 484-494. https://doi.org/10.1093/ije/dyr198

The influence of hip circumference on the relationship between abdominal obesity and mortality. / Cameron, Adrian J.; Magliano, Dianna J.; Shaw, Jonathan E.; Zimmet, Paul Z.; Carstensen, Bendix; Alberti, K. George M M; Tuomilehto, Jaakko; Barr, Elizabeth L M; Pauvaday, Vassen K.; Kowlessur, Sudhirsen; Söderberg, Stefan.

In: International journal of epidemiology, Vol. 41, No. 2, dyr198, 01.04.2012, p. 484-494.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The influence of hip circumference on the relationship between abdominal obesity and mortality

AU - Cameron, Adrian J.

AU - Magliano, Dianna J.

AU - Shaw, Jonathan E.

AU - Zimmet, Paul Z.

AU - Carstensen, Bendix

AU - Alberti, K. George M M

AU - Tuomilehto, Jaakko

AU - Barr, Elizabeth L M

AU - Pauvaday, Vassen K.

AU - Kowlessur, Sudhirsen

AU - Söderberg, Stefan

PY - 2012/4/1

Y1 - 2012/4/1

N2 - Background: Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction. Methods: In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of >25% and a decrease of >20% after waist and hip circumference were added to the model was calculated. Results: Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by >25% for 23.7% of those who died and 15.7% of those censored. Cumulative mortality decreased by >20% for 4.5% of those who died and 14.8% of those censored. Conclusions: The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models. Published by Oxford University Press on behalf of the International Epidemiological Association

AB - Background: Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction. Methods: In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of >25% and a decrease of >20% after waist and hip circumference were added to the model was calculated. Results: Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by >25% for 23.7% of those who died and 15.7% of those censored. Cumulative mortality decreased by >20% for 4.5% of those who died and 14.8% of those censored. Conclusions: The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models. Published by Oxford University Press on behalf of the International Epidemiological Association

KW - African

KW - Hip circumference

KW - Mortality

KW - Obesity

KW - South Asian

KW - Waist circumference

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Cameron AJ, Magliano DJ, Shaw JE, Zimmet PZ, Carstensen B, Alberti KGMM et al. The influence of hip circumference on the relationship between abdominal obesity and mortality. International journal of epidemiology. 2012 Apr 1;41(2):484-494. dyr198. https://doi.org/10.1093/ije/dyr198