Abstract
Background
Given the fat redistribution in later stages of life, how the associations
between abdominal obesity and the risk of morbidity and mortality have changed
with age have not been elucidated, especially for waist to height ratio
(WHtR).
Objective
To compare the strength of association between obesity indices and chronic
diseases at baseline, and the subsequent mortality risk among US
adults.
Methods
We included 21 109 participants from National Health and Nutrition
Examination Survey 1999–2014. We performed logistic regression and receiver
operating curve analysis to examine the discriminatory power of obesity
indicators on cardiometabolic diseases and cancer at baseline. Sex-stratified
and age-stratified Cox models were constructed to explore the prospective
association between obesity indices and all-cause, cardiovascular and cancer
mortality.
Results
Elevated WHtR, elevated waist circumference (WC) and body mass index
(BMI)-classified obesity are associated with higher odds of hypertension (OR:
1.37-2.13), dyslipidemia (OR: 1.06 to 1.75, all p<0.05) and diabetes (OR:
1.40-3.16, all p<0.05). WHtR had significantly better discriminatory power
to predict cardiometabolic health than BMI, especially for diabetes (area under
the curve: 0.709 vs 0.654). After multivariable adjustment, all obesity
indicators are associated with lower risk of all-cause mortality among females
aged ≥65 years (HR: 0.64 to 0.85), but the association was only significant for
BMI when obesity indicators were mutually adjusted (HR: 0.79).
Conclusions
WHtR and WC appeared to be the better indicators for cardiometabolic
health than BMI. However, BMI had a stronger and inverse association with a
greater risk of all-cause mortality among older females.
Funder
Science and
Technology Plan Project of Guangdong Province
Science and
Technology Program of Guangzhou
National Key
Research and Development Program of China
Natural Science
Foundation of Guangdong Province
Cited by
24 articles.
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