Body configuration as a predictor of mortality: comparison of five anthropometric measures in a 12 year follow-up of the Norwegian HUNT 2 study.

2.50
Hdl Handle:
http://hdl.handle.net/2336/227554
Title:
Body configuration as a predictor of mortality: comparison of five anthropometric measures in a 12 year follow-up of the Norwegian HUNT 2 study.
Authors:
Petursson, Halfdan; Sigurdsson, Johann A; Bengtsson, Calle; Nilsen, Tom I L; Getz, Linn
Citation:
PLoS ONE 2011, 6(10):e26621
Issue Date:
2011
Abstract:
BACKGROUND: Distribution of body fat is more important than the amount of fat as a prognostic factor for life expectancy. Despite that, body mass index (BMI) still holds its status as the most used indicator of obesity in clinical work. METHODS: We assessed the association of five different anthropometric measures with mortality in general and cardiovascular disease (CVD) mortality in particular using Cox proportional hazards models. Predictive properties were compared by computing integrated discrimination improvement and net reclassification improvement for two different prediction models. The measures studied were BMI, waist circumference, hip circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). The study population was a prospective cohort of 62,223 Norwegians, age 20-79, followed up for mortality from 1995-1997 to the end of 2008 (mean follow-up 12.0 years) in the Nord-Trøndelag Health Study (HUNT 2). RESULTS: After adjusting for age, smoking and physical activity WHR and WHtR were found to be the strongest predictors of death. Hazard ratios (HRs) for CVD mortality per increase in WHR of one standard deviation were 1.23 for men and 1.27 for women. For WHtR, these HRs were 1.24 for men and 1.23 for women. WHR offered the greatest integrated discrimination improvement to the prediction models studied, followed by WHtR and waist circumference. Hip circumference was in strong inverse association with mortality when adjusting for waist circumference. In all analyses, BMI had weaker association with mortality than three of the other four measures studied. CONCLUSIONS: Our study adds further knowledge to the evidence that BMI is not the most appropriate measure of obesity in everyday clinical practice. WHR can reliably be measured and is as easy to calculate as BMI and is currently better documented than WHtR. It appears reasonable to recommend WHR as the primary measure of body composition and obesity.
Description:
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Additional Links:
http://dx.doi.org/10.1371/journal.pone.0026621; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197688/?tool=pubmed
Rights:
Archived with thanks to PloS one

Full metadata record

DC FieldValue Language
dc.contributor.authorPetursson, Halfdanen_GB
dc.contributor.authorSigurdsson, Johann Aen_GB
dc.contributor.authorBengtsson, Calleen_GB
dc.contributor.authorNilsen, Tom I Len_GB
dc.contributor.authorGetz, Linnen_GB
dc.date.accessioned2012-06-05T14:52:36Z-
dc.date.available2012-06-05T14:52:36Z-
dc.date.issued2011-
dc.date.submitted2012-06-05-
dc.identifier.citationPLoS ONE 2011, 6(10):e26621en_GB
dc.identifier.issn1932-6203-
dc.identifier.pmid22028926-
dc.identifier.doi10.1371/journal.pone.0026621-
dc.identifier.urihttp://hdl.handle.net/2336/227554-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.en_GB
dc.description.abstractBACKGROUND: Distribution of body fat is more important than the amount of fat as a prognostic factor for life expectancy. Despite that, body mass index (BMI) still holds its status as the most used indicator of obesity in clinical work. METHODS: We assessed the association of five different anthropometric measures with mortality in general and cardiovascular disease (CVD) mortality in particular using Cox proportional hazards models. Predictive properties were compared by computing integrated discrimination improvement and net reclassification improvement for two different prediction models. The measures studied were BMI, waist circumference, hip circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). The study population was a prospective cohort of 62,223 Norwegians, age 20-79, followed up for mortality from 1995-1997 to the end of 2008 (mean follow-up 12.0 years) in the Nord-Trøndelag Health Study (HUNT 2). RESULTS: After adjusting for age, smoking and physical activity WHR and WHtR were found to be the strongest predictors of death. Hazard ratios (HRs) for CVD mortality per increase in WHR of one standard deviation were 1.23 for men and 1.27 for women. For WHtR, these HRs were 1.24 for men and 1.23 for women. WHR offered the greatest integrated discrimination improvement to the prediction models studied, followed by WHtR and waist circumference. Hip circumference was in strong inverse association with mortality when adjusting for waist circumference. In all analyses, BMI had weaker association with mortality than three of the other four measures studied. CONCLUSIONS: Our study adds further knowledge to the evidence that BMI is not the most appropriate measure of obesity in everyday clinical practice. WHR can reliably be measured and is as easy to calculate as BMI and is currently better documented than WHtR. It appears reasonable to recommend WHR as the primary measure of body composition and obesity.en_GB
dc.description.sponsorshipResearch Unit of General Practice, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Norwegian Medical Association Icelandic College of Family Physiciansen_GB
dc.language.isoenen
dc.publisherPublic Library of Scienceen_GB
dc.relation.urlhttp://dx.doi.org/10.1371/journal.pone.0026621en_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197688/?tool=pubmeden_GB
dc.rightsArchived with thanks to PloS oneen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshBody Weights and Measuresen_GB
dc.subject.meshCardiovascular Diseasesen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshHealth Surveysen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMortalityen_GB
dc.subject.meshNorwayen_GB
dc.subject.meshObesityen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshYoung Adulten_GB
dc.titleBody configuration as a predictor of mortality: comparison of five anthropometric measures in a 12 year follow-up of the Norwegian HUNT 2 study.en
dc.typeArticleen
dc.contributor.departmentResearch Unit of General Practice, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. halfdanpe@gmail.comen_GB
dc.identifier.journalPloS oneen_GB

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