Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease: Role of “Normal Weight Central Obesity”

Thais Coutinho; Kashish Goel; Daniel Corrêa de Sá; Rickey E Carter; David O Hodge; Charlotte Kragelund; Alka M Kanaya; Marianne Zeller; Jong Seon Park; Lars Kober; Christian Torp-Pedersen; Yves Cottin; Luc Lorgis; Sang-Hee Lee; Young-Jo Kim; Randal Thomas; Véronique L Roger; Virend K Somers; Francisco Lopez-Jimenez

doi:10.1016/j.jacc.2012.10.035

Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease: Role of “Normal Weight Central Obesity”

Thais Coutinho, Kashish Goel, Daniel Corrêa de Sá, Rickey E Carter, David O Hodge, Charlotte Kragelund, Alka M Kanaya, Marianne Zeller, Jong Seon Park, Lars Kober, Christian Torp-Pedersen, Yves Cottin, Luc Lorgis, Sang-Hee Lee, Young-Jo Kim, Randal Thomas, Véronique L Roger, Virend K Somers, Francisco Lopez-Jimenez

168 Citationer (Scopus)

Abstract

Objectives: This study sought to assess the mortality risk of patients with coronary artery disease (CAD) based on a combination of body mass index (BMI) and measures of central obesity. Background: In CAD patients, mortality has been reported to vary inversely with BMI ("obesity paradox"). In contrast, central obesity is directly associated with mortality. Because of this bi-directional relationship, we hypothesized that CAD patients with normal BMI but with central obesity would have worse survival compared with subjects with other combinations of BMI and central adiposity. Methods: We included 15,547 participants with CAD who took part in 5 studies from 3 continents. Multivariate stratified Cox-proportional hazard models that adjusted for potential confounders were used to assess mortality risk according to different patterns of adiposity that combined BMI with measures of central obesity. Results: Mean age was 66 years; 55% were men. There were 4,699 deaths over a median follow-up of 4.7 years. Subjects with normal weight but central obesity had the worst long-term survival: a person with BMI of 22 kg/m² and waist-to-hip ratio (WHR) of 0.98 had higher mortality than a person with similar BMI but WHR of 0.89 (hazard ratio [HR]: 1.10; 95% confidence interval [CI]: 1.05 to 1.17); than a person with BMI of 26 kg/m² and WHR of 0.89 (HR: 1.20; 95% CI: 1.09 to 1.31), than in a person with BMI of 30 kg/m² and WHR of 0.89 (HR: 1.61; 95% CI: 1.39 to 1.86), and than a person with BMI of 30 kg/m ² and WHR of 0.98 (HR: 1.27; 95% CI: 1.18 to 1.39) (p < 0.0001 for all). Conclusions: In patients with CAD, normal weight with central obesity was associated with the highest risk of mortality.

Originalsprog	Engelsk
Tidsskrift	Journal of the American College of Cardiology
Vol/bind	61
Udgave nummer	5
Sider (fra-til)	553-60
Antal sider	8
ISSN	0735-1097
DOI	https://doi.org/10.1016/j.jacc.2012.10.035
Status	Udgivet - 5 feb. 2013

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10.1016/j.jacc.2012.10.035

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Coutinho, T., Goel, K., Corrêa de Sá, D., Carter, R. E., Hodge, D. O., Kragelund, C., Kanaya, A. M., Zeller, M., Park, J. S., Kober, L., Torp-Pedersen, C., Cottin, Y., Lorgis, L., Lee, S-H., Kim, Y-J., Thomas, R., Roger, V. L., Somers, V. K., & Lopez-Jimenez, F. (2013). Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease: Role of “Normal Weight Central Obesity”. Journal of the American College of Cardiology, 61(5), 553-60. https://doi.org/10.1016/j.jacc.2012.10.035

Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease : Role of “Normal Weight Central Obesity”. / Coutinho, Thais; Goel, Kashish; Corrêa de Sá, Daniel et al.

I: Journal of the American College of Cardiology, Bind 61, Nr. 5, 05.02.2013, s. 553-60.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Coutinho, T, Goel, K, Corrêa de Sá, D, Carter, RE, Hodge, DO, Kragelund, C, Kanaya, AM, Zeller, M, Park, JS, Kober, L , Torp-Pedersen, C, Cottin, Y, Lorgis, L, Lee, S-H, Kim, Y-J, Thomas, R, Roger, VL, Somers, VK & Lopez-Jimenez, F 2013, 'Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease: Role of “Normal Weight Central Obesity”', Journal of the American College of Cardiology, bind 61, nr. 5, s. 553-60. https://doi.org/10.1016/j.jacc.2012.10.035

@article{96d19f93643f4f3ebbe3401278c10ca1,

title = "Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease: Role of “Normal Weight Central Obesity”",

abstract = "Objectives: This study sought to assess the mortality risk of patients with coronary artery disease (CAD) based on a combination of body mass index (BMI) and measures of central obesity. Background: In CAD patients, mortality has been reported to vary inversely with BMI ({"}obesity paradox{"}). In contrast, central obesity is directly associated with mortality. Because of this bi-directional relationship, we hypothesized that CAD patients with normal BMI but with central obesity would have worse survival compared with subjects with other combinations of BMI and central adiposity. Methods: We included 15,547 participants with CAD who took part in 5 studies from 3 continents. Multivariate stratified Cox-proportional hazard models that adjusted for potential confounders were used to assess mortality risk according to different patterns of adiposity that combined BMI with measures of central obesity. Results: Mean age was 66 years; 55% were men. There were 4,699 deaths over a median follow-up of 4.7 years. Subjects with normal weight but central obesity had the worst long-term survival: a person with BMI of 22 kg/m2 and waist-to-hip ratio (WHR) of 0.98 had higher mortality than a person with similar BMI but WHR of 0.89 (hazard ratio [HR]: 1.10; 95% confidence interval [CI]: 1.05 to 1.17); than a person with BMI of 26 kg/m2 and WHR of 0.89 (HR: 1.20; 95% CI: 1.09 to 1.31), than in a person with BMI of 30 kg/m2 and WHR of 0.89 (HR: 1.61; 95% CI: 1.39 to 1.86), and than a person with BMI of 30 kg/m 2 and WHR of 0.98 (HR: 1.27; 95% CI: 1.18 to 1.39) (p < 0.0001 for all). Conclusions: In patients with CAD, normal weight with central obesity was associated with the highest risk of mortality.",

author = "Thais Coutinho and Kashish Goel and {Corr{\^e}a de S{\'a}}, Daniel and Carter, {Rickey E} and Hodge, {David O} and Charlotte Kragelund and Kanaya, {Alka M} and Marianne Zeller and Park, {Jong Seon} and Lars Kober and Christian Torp-Pedersen and Yves Cottin and Luc Lorgis and Sang-Hee Lee and Young-Jo Kim and Randal Thomas and Roger, {V{\'e}ronique L} and Somers, {Virend K} and Francisco Lopez-Jimenez",

year = "2013",

month = feb,

day = "5",

doi = "10.1016/j.jacc.2012.10.035",

language = "English",

volume = "61",

pages = "553--60",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

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number = "5",

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TY - JOUR

T1 - Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease

T2 - Role of “Normal Weight Central Obesity”

AU - Coutinho, Thais

AU - Goel, Kashish

AU - Corrêa de Sá, Daniel

AU - Carter, Rickey E

AU - Hodge, David O

AU - Kragelund, Charlotte

AU - Kanaya, Alka M

AU - Zeller, Marianne

AU - Park, Jong Seon

AU - Kober, Lars

AU - Torp-Pedersen, Christian

AU - Cottin, Yves

AU - Lorgis, Luc

AU - Lee, Sang-Hee

AU - Kim, Young-Jo

AU - Thomas, Randal

AU - Roger, Véronique L

AU - Somers, Virend K

AU - Lopez-Jimenez, Francisco

PY - 2013/2/5

Y1 - 2013/2/5

N2 - Objectives: This study sought to assess the mortality risk of patients with coronary artery disease (CAD) based on a combination of body mass index (BMI) and measures of central obesity. Background: In CAD patients, mortality has been reported to vary inversely with BMI ("obesity paradox"). In contrast, central obesity is directly associated with mortality. Because of this bi-directional relationship, we hypothesized that CAD patients with normal BMI but with central obesity would have worse survival compared with subjects with other combinations of BMI and central adiposity. Methods: We included 15,547 participants with CAD who took part in 5 studies from 3 continents. Multivariate stratified Cox-proportional hazard models that adjusted for potential confounders were used to assess mortality risk according to different patterns of adiposity that combined BMI with measures of central obesity. Results: Mean age was 66 years; 55% were men. There were 4,699 deaths over a median follow-up of 4.7 years. Subjects with normal weight but central obesity had the worst long-term survival: a person with BMI of 22 kg/m2 and waist-to-hip ratio (WHR) of 0.98 had higher mortality than a person with similar BMI but WHR of 0.89 (hazard ratio [HR]: 1.10; 95% confidence interval [CI]: 1.05 to 1.17); than a person with BMI of 26 kg/m2 and WHR of 0.89 (HR: 1.20; 95% CI: 1.09 to 1.31), than in a person with BMI of 30 kg/m2 and WHR of 0.89 (HR: 1.61; 95% CI: 1.39 to 1.86), and than a person with BMI of 30 kg/m 2 and WHR of 0.98 (HR: 1.27; 95% CI: 1.18 to 1.39) (p < 0.0001 for all). Conclusions: In patients with CAD, normal weight with central obesity was associated with the highest risk of mortality.

AB - Objectives: This study sought to assess the mortality risk of patients with coronary artery disease (CAD) based on a combination of body mass index (BMI) and measures of central obesity. Background: In CAD patients, mortality has been reported to vary inversely with BMI ("obesity paradox"). In contrast, central obesity is directly associated with mortality. Because of this bi-directional relationship, we hypothesized that CAD patients with normal BMI but with central obesity would have worse survival compared with subjects with other combinations of BMI and central adiposity. Methods: We included 15,547 participants with CAD who took part in 5 studies from 3 continents. Multivariate stratified Cox-proportional hazard models that adjusted for potential confounders were used to assess mortality risk according to different patterns of adiposity that combined BMI with measures of central obesity. Results: Mean age was 66 years; 55% were men. There were 4,699 deaths over a median follow-up of 4.7 years. Subjects with normal weight but central obesity had the worst long-term survival: a person with BMI of 22 kg/m2 and waist-to-hip ratio (WHR) of 0.98 had higher mortality than a person with similar BMI but WHR of 0.89 (hazard ratio [HR]: 1.10; 95% confidence interval [CI]: 1.05 to 1.17); than a person with BMI of 26 kg/m2 and WHR of 0.89 (HR: 1.20; 95% CI: 1.09 to 1.31), than in a person with BMI of 30 kg/m2 and WHR of 0.89 (HR: 1.61; 95% CI: 1.39 to 1.86), and than a person with BMI of 30 kg/m 2 and WHR of 0.98 (HR: 1.27; 95% CI: 1.18 to 1.39) (p < 0.0001 for all). Conclusions: In patients with CAD, normal weight with central obesity was associated with the highest risk of mortality.

U2 - 10.1016/j.jacc.2012.10.035

DO - 10.1016/j.jacc.2012.10.035

M3 - Journal article

C2 - 23369419

SN - 0735-1097

VL - 61

SP - 553

EP - 560

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 5

ER -

Combining Body Mass Index With Measures of Central Obesity in the Assessment of Mortality in Subjects With Coronary Disease: Role of “Normal Weight Central Obesity”

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