TY - JOUR

T1 - Combined Influence of Waist and Hip Circumference on Risk of Death in a Large Cohort of European and Australian Adults

AU - Cameron, Adrian J

AU - Romaniuk, Helena

AU - Orellana, Liliana

AU - Dallongeville, Jean

AU - Dobson, Annette J

AU - Drygas, Wojciech

AU - Ferrario, Marco

AU - Ferrieres, Jean

AU - Giampaoli, Simona

AU - Gianfagna, Francesco

AU - Iacoviello, Licia

AU - Jousilahti, Pekka

AU - Kee, Frank

AU - Moitry, Marie

AU - Niiranen, Teemu J

AU - Pająk, Andrzej

AU - Palmieri, Luigi

AU - Palosaari, Tarja

AU - Satu, Männistö

AU - Tamosiunas, Abdonas

AU - Thorand, Barbara

AU - Toft, Ulla

AU - Vanuzzo, Diego

AU - Veikko, Salomaa

AU - Veronesi, Giovanni

AU - Wilsgaard, Tom

AU - Kuulasmaa, Kari

AU - Söderberg, Stefan

PY - 2020/7/7

Y1 - 2020/7/7

N2 - Background Waist circumference and hip circumference are both strongly associated with risk of death; however, their joint association has rarely been investigated. Methods and Results The MONICA Risk, Genetics, Archiving, and Monograph (MORGAM) Project was conducted in 30 cohorts from 11 countries; 90 487 men and women, aged 30 to 74 years, predominantly white, with no history of cardiovascular disease, were recruited in 1986 to 2010 and followed up for up to 24 years. Hazard ratios were estimated using sex-specific Cox models, stratified by cohort, with age as the time scale. Models included baseline categorical obesity measures, age, total and high-density lipoprotein cholesterol, systolic blood pressure, antihypertensive drugs, smoking, and diabetes mellitus. A total of 9105 all-cause deaths were recorded during a median follow-up of 10 years. Hazard ratios for all-cause death presented J- or U-shaped associations with most obesity measures. With waist and hip circumference included in the same model, for all hip sizes, having a smaller waist was strongly associated with lower risk of death, except for men with the smallest hips. In addition, among those with smaller waists, hip size was strongly negatively associated with risk of death, with ≈20% more people identified as being at increased risk compared with waist circumference alone. Conclusions A more complex relationship between hip circumference, waist circumference, and risk of death is revealed when both measures are considered simultaneously. This is particularly true for individuals with smaller waists, where having larger hips was protective. Considering both waist and hip circumference in the clinical setting could help to best identify those at increased risk of death.

AB - Background Waist circumference and hip circumference are both strongly associated with risk of death; however, their joint association has rarely been investigated. Methods and Results The MONICA Risk, Genetics, Archiving, and Monograph (MORGAM) Project was conducted in 30 cohorts from 11 countries; 90 487 men and women, aged 30 to 74 years, predominantly white, with no history of cardiovascular disease, were recruited in 1986 to 2010 and followed up for up to 24 years. Hazard ratios were estimated using sex-specific Cox models, stratified by cohort, with age as the time scale. Models included baseline categorical obesity measures, age, total and high-density lipoprotein cholesterol, systolic blood pressure, antihypertensive drugs, smoking, and diabetes mellitus. A total of 9105 all-cause deaths were recorded during a median follow-up of 10 years. Hazard ratios for all-cause death presented J- or U-shaped associations with most obesity measures. With waist and hip circumference included in the same model, for all hip sizes, having a smaller waist was strongly associated with lower risk of death, except for men with the smallest hips. In addition, among those with smaller waists, hip size was strongly negatively associated with risk of death, with ≈20% more people identified as being at increased risk compared with waist circumference alone. Conclusions A more complex relationship between hip circumference, waist circumference, and risk of death is revealed when both measures are considered simultaneously. This is particularly true for individuals with smaller waists, where having larger hips was protective. Considering both waist and hip circumference in the clinical setting could help to best identify those at increased risk of death.

KW - Adiposity

KW - Adult

KW - Aged

KW - Australia/epidemiology

KW - Cardiovascular Diseases/diagnosis

KW - Cause of Death

KW - Europe/epidemiology

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Obesity/diagnosis

KW - Predictive Value of Tests

KW - Prognosis

KW - Prospective Studies

KW - Protective Factors

KW - Risk Assessment

KW - Risk Factors

KW - Waist Circumference

KW - Waist-Hip Ratio

U2 - 10.1161/JAHA.119.015189

DO - 10.1161/JAHA.119.015189

M3 - Journal article

C2 - 32602397

VL - 9

SP - e015189

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 13

ER -