Relation between adiposity and vascular events, malignancy and mortality in patients with stable cerebrovascular disease

• Published in: International Journal of Obesity 2017-12, Vol.41 (12), p.1775-1781
• Main Authors: Jaspers, N E M, Dorresteijn, J A N, van der Graaf, Y, Westerink, J, Kappelle, L J, Nathoe, H M, Algra, A, Visseren, F L J
• Format: Article
• Language: English
• Subjects: 692/308/174; 692/499; 692/699/2743/393; 692/699/75/593/1370; 692/700/139/2818; 692/700/2817; 692/700/459; Abdomen; Adipose tissue; Adiposity - physiology; Adult; Aged; Body Mass Index; Body size; Cardiovascular diseases; Cause of Death - trends; Cerebrovascular disease; Cerebrovascular diseases; Cerebrovascular Disorders - etiology; Cerebrovascular Disorders - mortality; Cerebrovascular Disorders - physiopathology; Chi-square test; Complications and side effects; Confidence intervals; Epidemiology; Female; Hazard assessment; Health Promotion and Disease Prevention; Health risk assessment; Humans; Hypertension; Hypertension - etiology; Hypertension - mortality; Hypertension - physiopathology; Internal Medicine; Male; Malignancy; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Mortality; Neoplasms - mortality; Neoplasms - physiopathology; Nonlinear systems; Nonlinearity; Obesity; Obesity, Abdominal - complications; Obesity, Abdominal - mortality; Obesity, Abdominal - physiopathology; original-article; Patient outcomes; Patients; Prognosis; Proportional Hazards Models; Prospective Studies; Public Health; Reference Values; Risk analysis; Risk Factors; Statistical analysis; Statistical models; Statistical tests; Ultrasound; Waist Circumference; Young Adult
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/ijo.2017.184

Background: Abdominal adiposity is associated with various risk factors including hypertension, and is therefore particularly relevant in patients with stable cerebrovascular disease (CeVD). A U-shaped relation between body mass index (BMI, kg m − 2 ) and cardiovascular events is often described. Whether this U-shape persists for abdominal adiposity, and consequently which reference values should guide clinical practice, is unclear. We described the relation between multiple adiposity measurements and risk of vascular events, vascular mortality, malignancy and all-cause mortality in patients with clinically stable CeVD. Methods: During a median follow-up time of 6.8 years, 1767 patients were prospectively followed. Relations were assessed using multivariable adjusted Cox proportional hazards models. Adiposity was assessed with BMI, waist circumference (stratified by gender) and the contribution of visceral fat to total abdominal fat (VAT%) measured using ultrasound. Relations were nonlinear if the χ 2 -statistic of the nonlinear term was significant ( P -value