Combining BMI with Central Obesity for risk of mortality in subjects with Coronary Disease

In patients with coronary artery disease (CAD), normal weight in combination with central obesity is associated with the highest risk of mortality. This is the conclusion of a meta-analysis conducted with data of 15,547 participants (mean age 66 years) with CAD who took part in 5 studies from 3 continents. 

The researchers identified 4,699 deaths in 4.7 years. After adjusting for potential confounders, the worst long-term survival was observed in the subjects with normal weight but who had central obesity. In other words: a person with a BMI below 25 kg/m², but who had a waist-to-hip ratio (WHR) of 0.98 had significantly higher mortality than a person with a similar BMI and a WHR of 0.89. More surprisingly, these people had significantly higher mortality than a person with a BMI of 30 kg/m² and WHR of 0.89 or 0.98.

Source: Journal of the American College of Cardiology

During a median follow-up of 4.7 years, the researchers identified 4,699 deaths. The worst long-term survival was observed in people of normal weight who displayed central obesity: a person with a BMI of 22 kg/m² who had a waist-to-hip ratio (WHR) of 0.98 had significantly higher mortality than a person with a similar BMI and a WHR of 0.89 (hazard ratio, 1.10); they also had significantly higher mortality than a person with a BMI of 30 kg/m² and WHR of 0.89 or 0.98 (hazard ratios, 1.61 and 1.27, respectively).

Read more at: http://medicalxpress.com/news/2013-01-cad-highest-mortality-central-obesity.html#jCp

During a median follow-up of 4.7 years, the researchers identified 4,699 deaths. The worst long-term survival was observed in people of normal weight who displayed central obesity: a person with a BMI of 22 kg/m² who had a waist-to-hip ratio (WHR) of 0.98 had significantly higher mortality than a person with a similar BMI and a WHR of 0.89 (hazard ratio, 1.10); they also had significantly higher mortality than a person with a BMI of 30 kg/m² and WHR of 0.89 or 0.98 (hazard ratios, 1.61 and 1.27, respectively).

Read more at: http://medicalxpress.com/news/2013-01-cad-highest-mortality-central-obesity.html#jCp

During a median follow-up of 4.7 years, the researchers identified 4,699 deaths. The worst long-term survival was observed in people of normal weight who displayed central obesity: a person with a BMI of 22 kg/m² who had a waist-to-hip ratio (WHR) of 0.98 had significantly higher mortality than a person with a similar BMI and a WHR of 0.89 (hazard ratio, 1.10); they also had significantly higher mortality than a person with a BMI of 30 kg/m² and WHR of 0.89 or 0.98 (hazard ratios, 1.61 and 1.27, respectively).

Read more at: http://medicalxpress.com/news/2013-01-cad-highest-mortality-central-obesity.html#jCp

Another way to measure obesity

Traditionally, Body Mass Index (BMI) has been used to measure obesity. Now, scientists propose a novel method that includes waist circumference (WC) in addition to BMI, providing better information about the risk of premature death for an individual. Known as A Body Shape Index (ABSI), the metric was tested on national health and nutrition data from 14,000 adults in the United States. This new parameter is based on WC adjusted for height and weight and was found to show a better correlation with death rate than does the BMI.

Death rates increased approximately exponentially with above average baseline ABSI, whereas elevated death rates were found for both high and low values of BMI and WC. The association of death rate with ABSI held even when adjusted for other known risk factors including smoking, diabetes, blood pressure, and serum cholesterol. ABSI correlation with mortality hazard held across the range of age, sex, and BMI, and for both white and black ethnicities (but not for Mexican ethnicity), and was not weakened by excluding deaths from the first 3 yr of follow-up.

Source: PloS ONE