(26-06-11) Waist circumference and mortality: impact of associated risk factors.

Thomas F, Pannier B, Bean K, Danchin N.
Source
Centre IPC, La-P?rouse, Paris, France. [email protected]
Abstract
AIM:
This study was designed to evaluate the risks of all-cause and cardiovascular mortality in subjects with large waist circumferences, with or without associated risk factors, and to determine whether or not waist circumference might identify high-risk subjects.
METHODS:
The population included 55,800 men (aged 52.1 ? 8.2 years) and 28,937 women (aged 54.2 ? 9.1 years) who had undergone a health checkup at the Preventive and Clinical Investigations Centre between January 1999 and December 2004 with a mean follow-up of 4.7 ? 1.7 years. An increased waist circumference was defined as those in the last quintile of distribution. Mortality risk for each waist-circumference quintile, with or without associated risk factors (hypertension, diabetes, elevated LDL cholesterol), was evaluated using Cox's regression models, including age, gender, tobacco and alcohol consumption, and physical activity.
RESULTS:
The percentage of subjects with hypertension, diabetes and raised LDL cholesterol levels increased from the first waist-circumference quintile to the last. After adjusting for variables, all-cause mortality risk did not increase significantly with large waist circumference only (HR: 1.19 [0.84-1.68]), but was significantly higher when an increased waist circumference was associated with at least one risk factor (HR=1.58 [1.26-1.98]; 3.70 [2.05-6.68] for three risk factors). Similar results were observed for cardiovascular mortality (HR: 0.85 [0.19-3.68] with only large waist circumference and 3.56 [2.05-6.57] when waist circumference was associated with at least one risk factor).
CONCLUSION:
In a population with low-to-moderate mortality risk, waist circumference alone did not identify high-risk subjects, thus suggesting that a more global approach is necessary.

Source: Diabetes Metab. 2011 Feb;37(1):33-8. Epub 2010 Oct 16.

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