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Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults

AIMS: Results of previous studies of abdominal adiposity and risk of vascular-metabolic mortality in Hispanic populations have been conflicting. We report results from a large prospective study of Mexican adults with high levels of abdominal adiposity. METHODS AND RESULTS: A total of 159 755 adults...

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Autores principales: Gnatiuc, Louisa, Tapia-Conyer, Roberto, Wade, Rachel, Ramirez-Reyes, Raúl, Aguilar-Ramirez, Diego, Herrington, William, Hill, Michael, Lewington, Sarah, Torres, Jason, Trichia, Eirini, Collins, Rory, Peto, Richard, Clarke, Robert, Kuri-Morales, Pablo, Emberson, Jonathan R, Alegre-Díaz, Jesus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9071366/
https://www.ncbi.nlm.nih.gov/pubmed/33693634
http://dx.doi.org/10.1093/eurjpc/zwab038
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author Gnatiuc, Louisa
Tapia-Conyer, Roberto
Wade, Rachel
Ramirez-Reyes, Raúl
Aguilar-Ramirez, Diego
Herrington, William
Hill, Michael
Lewington, Sarah
Torres, Jason
Trichia, Eirini
Collins, Rory
Peto, Richard
Clarke, Robert
Kuri-Morales, Pablo
Emberson, Jonathan R
Alegre-Díaz, Jesus
author_facet Gnatiuc, Louisa
Tapia-Conyer, Roberto
Wade, Rachel
Ramirez-Reyes, Raúl
Aguilar-Ramirez, Diego
Herrington, William
Hill, Michael
Lewington, Sarah
Torres, Jason
Trichia, Eirini
Collins, Rory
Peto, Richard
Clarke, Robert
Kuri-Morales, Pablo
Emberson, Jonathan R
Alegre-Díaz, Jesus
author_sort Gnatiuc, Louisa
collection PubMed
description AIMS: Results of previous studies of abdominal adiposity and risk of vascular-metabolic mortality in Hispanic populations have been conflicting. We report results from a large prospective study of Mexican adults with high levels of abdominal adiposity. METHODS AND RESULTS: A total of 159 755 adults aged ≥35 years from Mexico City were enrolled in a prospective study and followed for 16 years. Cox regression, adjusted for confounders, yielded mortality rate ratios (RRs) associated with three markers of abdominal adiposity (waist circumference, waist–hip ratio, and waist–height ratio) and one marker of gluteo-femoral adiposity (hip circumference) for cause-specific mortality before age 75 years. To reduce reverse causality, deaths in the first 5 years of follow-up and participants with diabetes or other prior chronic disease were excluded. Among 113 163 participants without prior disease and aged 35–74 years at recruitment, all adiposity markers were positively associated with vascular-metabolic mortality. Comparing the top versus bottom tenth of the sex-specific distributions, the vascular-metabolic mortality RRs at ages 40–74 years were 2.32 [95% confidence interval (CI) 1.84–2.94] for waist circumference, 2.22 (1.71–2.88) for the waist–hip ratio, 2.63 (2.06–3.36) for the waist–height ratio, and 1.58 (1.29–1.93) for hip circumference. The RRs corresponding to each standard deviation (SD) higher usual levels of these adiposity markers were 1.34 (95% CI 1.27–1.41), 1.31 (1.23–1.39), 1.38 (1.31–1.45), and 1.18 (1.13–1.24), respectively. For the markers of abdominal adiposity, the RRs did not change much after further adjustment for other adiposity markers, but for hip circumference the association was reversed; given body mass index and waist circumference, the RR for vascular-metabolic mortality for each one SD higher usual hip circumference was 0.80 (0.75–0.86). CONCLUSIONS: In this study of Mexican adults, abdominal adiposity (and in particular the waist–height ratio) was strongly and positively associated with vascular-metabolic mortality. For a given amount of general and abdominal adiposity, however, higher hip circumference was associated with lower vascular-metabolic mortality.
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spelling pubmed-90713662022-05-06 Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults Gnatiuc, Louisa Tapia-Conyer, Roberto Wade, Rachel Ramirez-Reyes, Raúl Aguilar-Ramirez, Diego Herrington, William Hill, Michael Lewington, Sarah Torres, Jason Trichia, Eirini Collins, Rory Peto, Richard Clarke, Robert Kuri-Morales, Pablo Emberson, Jonathan R Alegre-Díaz, Jesus Eur J Prev Cardiol Full Research Papers AIMS: Results of previous studies of abdominal adiposity and risk of vascular-metabolic mortality in Hispanic populations have been conflicting. We report results from a large prospective study of Mexican adults with high levels of abdominal adiposity. METHODS AND RESULTS: A total of 159 755 adults aged ≥35 years from Mexico City were enrolled in a prospective study and followed for 16 years. Cox regression, adjusted for confounders, yielded mortality rate ratios (RRs) associated with three markers of abdominal adiposity (waist circumference, waist–hip ratio, and waist–height ratio) and one marker of gluteo-femoral adiposity (hip circumference) for cause-specific mortality before age 75 years. To reduce reverse causality, deaths in the first 5 years of follow-up and participants with diabetes or other prior chronic disease were excluded. Among 113 163 participants without prior disease and aged 35–74 years at recruitment, all adiposity markers were positively associated with vascular-metabolic mortality. Comparing the top versus bottom tenth of the sex-specific distributions, the vascular-metabolic mortality RRs at ages 40–74 years were 2.32 [95% confidence interval (CI) 1.84–2.94] for waist circumference, 2.22 (1.71–2.88) for the waist–hip ratio, 2.63 (2.06–3.36) for the waist–height ratio, and 1.58 (1.29–1.93) for hip circumference. The RRs corresponding to each standard deviation (SD) higher usual levels of these adiposity markers were 1.34 (95% CI 1.27–1.41), 1.31 (1.23–1.39), 1.38 (1.31–1.45), and 1.18 (1.13–1.24), respectively. For the markers of abdominal adiposity, the RRs did not change much after further adjustment for other adiposity markers, but for hip circumference the association was reversed; given body mass index and waist circumference, the RR for vascular-metabolic mortality for each one SD higher usual hip circumference was 0.80 (0.75–0.86). CONCLUSIONS: In this study of Mexican adults, abdominal adiposity (and in particular the waist–height ratio) was strongly and positively associated with vascular-metabolic mortality. For a given amount of general and abdominal adiposity, however, higher hip circumference was associated with lower vascular-metabolic mortality. Oxford University Press 2021-03-09 /pmc/articles/PMC9071366/ /pubmed/33693634 http://dx.doi.org/10.1093/eurjpc/zwab038 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Full Research Papers
Gnatiuc, Louisa
Tapia-Conyer, Roberto
Wade, Rachel
Ramirez-Reyes, Raúl
Aguilar-Ramirez, Diego
Herrington, William
Hill, Michael
Lewington, Sarah
Torres, Jason
Trichia, Eirini
Collins, Rory
Peto, Richard
Clarke, Robert
Kuri-Morales, Pablo
Emberson, Jonathan R
Alegre-Díaz, Jesus
Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults
title Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults
title_full Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults
title_fullStr Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults
title_full_unstemmed Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults
title_short Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 Mexican adults
title_sort abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150 000 mexican adults
topic Full Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9071366/
https://www.ncbi.nlm.nih.gov/pubmed/33693634
http://dx.doi.org/10.1093/eurjpc/zwab038
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