Prediction of cardiovascular disease by abdominal obesity measures is dependent on body weight and sex – Results from two community based cohort studies

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2014, Vol.24 (8), p.891-899
• Main Authors: Carlsson, A.C, Riserus, U, Ärnlöv, J, Borné, Y, Leander, K, Gigante, B, Hellénius, M.-L, Bottai, M, de Faire, U
• Format: Article
• Language: English
• Subjects: Body Mass Index; Body Weight; Cardiac and Cardiovascular Systems; Cardiovascular; Cardiovascular Diseases - epidemiology; Clinical Medicine; Cohort Studies; Epidemiology; Female; Follow-Up Studies; Gender; Health and Welfare; Humans; Hälsa och välfärd; Incident cardiovascular disease; Kardiologi; Klinisk medicin; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Obesity, Abdominal - epidemiology; Predictive Value of Tests; Proportional Hazards Models; Risk Factors; Sagittal Abdominal Diameter; Sex Factors; Waist Circumference; Waist-Hip Ratio; Waist-hip-height ratio
• ISSN: 0939-4753; 1590-3729; 1590-3729
• DOI: 10.1016/j.numecd.2014.02.001

Abstract Aim To study waist-hip ratio (WHR), waist circumference (WC), sagittal abdominal diameter (SAD), and waist-hip-height ratio (WHHR) as predictors of CVD, in men and women stratified by BMI (cut-off ≥25). Methods and results A cohort of n  = 3741 (53% women) 60-year old individuals without CVD was followed for 11-years (375 CVD cases). To replicate the results, we also assessed another large independent cohort; The Malmö Diet and Cancer study – cardiovascular cohort (MDCC, ( n  = 5180, 60% women, 602 CVD cases during 16-years). After adjustment for established risk factors in normal-weight women, the hazard ratio (HR) per one standard deviation (SD) were; WHR; 1.91 (95% confidence interval (CI) 1.35–2.70), WC; 1.81 (95% CI 1.02–3.20), SAD; 1.25 (95% CI 0.74–2.11), and WHHR; 1.97 (95% CI 1.40–2.78). In men the association with WHR, WHHR and WC were not significant, whereas SAD was the only measure that significantly predicted CVD in men (HR 1.19 (95% CI 1.04–1.35). After adjustments for established risk factors in overweight/obese women, none of the measures were significantly associated with CVD risk. In men, however, all measures were significant predictors; WHR; 1.24 (955 CI 1.04–1.47), WC 1.19 (95% CI 1.00–1.42), SAD 1.21 (95% CI 1.00–1.46), and WHHR; 1.23 (95% CI 1.05–1.44). Only the findings in men with BMI ≥ 25 were verified in MDCC. Conclusion In normal weight individuals, WHHR and WHR were the best predictors in women, whereas SAD was the only independent predictor in men. Among overweight/obese individuals all measures failed to predict CVD in women, whereas WHHR was the strongest predictor after adjustments for CVD risk factors in men.