Normal-Weight Central Obesity and Mortality Risk in Older Adults with Coronary Artery Disease

Saurabh Sharma, John A. Batsis, Thais Coutinho, Virend Somers, David O. Hodge, Rickey E. Carter, Ondrej Sochor, Charlotte Kragelund, Alka M. Kanaya, Marianne Zeller, Jong Seon Park, Lars Køber, Christian Torp-Pedersen, Francisco Lopez-Jimenez

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objective To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). Patients and Methods We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Results Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24). Conclusion In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment.

Original languageEnglish (US)
Pages (from-to)343-351
Number of pages9
JournalMayo Clinic Proceedings
Volume91
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Waist-Hip Ratio
Abdominal Obesity
Waist Circumference
Coronary Artery Disease
Weights and Measures
Mortality
Body Mass Index
Obesity
Adiposity
Proportional Hazards Models
Cohort Studies
Odds Ratio

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Normal-Weight Central Obesity and Mortality Risk in Older Adults with Coronary Artery Disease. / Sharma, Saurabh; Batsis, John A.; Coutinho, Thais; Somers, Virend; Hodge, David O.; Carter, Rickey E.; Sochor, Ondrej; Kragelund, Charlotte; Kanaya, Alka M.; Zeller, Marianne; Park, Jong Seon; Køber, Lars; Torp-Pedersen, Christian; Lopez-Jimenez, Francisco.

In: Mayo Clinic Proceedings, Vol. 91, No. 3, 01.03.2016, p. 343-351.

Research output: Contribution to journalArticle

Sharma, S, Batsis, JA, Coutinho, T, Somers, V, Hodge, DO, Carter, RE, Sochor, O, Kragelund, C, Kanaya, AM, Zeller, M, Park, JS, Køber, L, Torp-Pedersen, C & Lopez-Jimenez, F 2016, 'Normal-Weight Central Obesity and Mortality Risk in Older Adults with Coronary Artery Disease', Mayo Clinic Proceedings, vol. 91, no. 3, pp. 343-351. https://doi.org/10.1016/j.mayocp.2015.12.007
Sharma, Saurabh ; Batsis, John A. ; Coutinho, Thais ; Somers, Virend ; Hodge, David O. ; Carter, Rickey E. ; Sochor, Ondrej ; Kragelund, Charlotte ; Kanaya, Alka M. ; Zeller, Marianne ; Park, Jong Seon ; Køber, Lars ; Torp-Pedersen, Christian ; Lopez-Jimenez, Francisco. / Normal-Weight Central Obesity and Mortality Risk in Older Adults with Coronary Artery Disease. In: Mayo Clinic Proceedings. 2016 ; Vol. 91, No. 3. pp. 343-351.
@article{8cd41c66c3184815880dc0ed9d5eca41,
title = "Normal-Weight Central Obesity and Mortality Risk in Older Adults with Coronary Artery Disease",
abstract = "Objective To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). Patients and Methods We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Results Patients' mean age was 73.0±6.0 years (3741 [53{\%}] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95{\%} CI, 1.14-1.46; HR, 1.29; 95{\%} CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95{\%} CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95{\%} CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95{\%} CI, 1.01-1.24). Conclusion In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment.",
author = "Saurabh Sharma and Batsis, {John A.} and Thais Coutinho and Virend Somers and Hodge, {David O.} and Carter, {Rickey E.} and Ondrej Sochor and Charlotte Kragelund and Kanaya, {Alka M.} and Marianne Zeller and Park, {Jong Seon} and Lars K{\o}ber and Christian Torp-Pedersen and Francisco Lopez-Jimenez",
year = "2016",
month = "3",
day = "1",
doi = "10.1016/j.mayocp.2015.12.007",
language = "English (US)",
volume = "91",
pages = "343--351",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "3",

}

TY - JOUR

T1 - Normal-Weight Central Obesity and Mortality Risk in Older Adults with Coronary Artery Disease

AU - Sharma, Saurabh

AU - Batsis, John A.

AU - Coutinho, Thais

AU - Somers, Virend

AU - Hodge, David O.

AU - Carter, Rickey E.

AU - Sochor, Ondrej

AU - Kragelund, Charlotte

AU - Kanaya, Alka M.

AU - Zeller, Marianne

AU - Park, Jong Seon

AU - Køber, Lars

AU - Torp-Pedersen, Christian

AU - Lopez-Jimenez, Francisco

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Objective To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). Patients and Methods We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Results Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24). Conclusion In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment.

AB - Objective To study the relationship between body mass index (BMI) and central obesity and mortality in elderly patients with coronary artery disease (CAD). Patients and Methods We identified 7057 patients 65 years or older from 5 cohort studies assessing mortality risk using either waist circumference (WC) or waist-hip ratio (WHR) in patients with CAD from January 1, 1980, to December 31, 2008. Normal weight, overweight, and obesity were defined using standard BMI cutoffs. High WHR was defined as 0.85 or more for women and 0.90 or more for men. High WC was defined as 88 cm or more for women and 102 cm or more for men. Separate models examined WC or WHR in combination with BMI (6 categories each) as the primary predictor (referent = normal BMI and normal WC or WHR). Cox proportional hazards models investigated the relationship between these obesity categories and mortality. Results Patients' mean age was 73.0±6.0 years (3741 [53%] women). The median censor time was 7.1 years. A normal BMI with central obesity (high WHR or high WC) demonstrated highest mortality risk (hazard ratio [HR], 1.29; 95% CI, 1.14-1.46; HR, 1.29; 95% CI, 1.12-1.50, respectively). High WHR was also predictive of mortality in the overall (HR, 2.14; 95% CI, 1.93-2.38) as well as in the sex-specific cohort. In the overall cohort, high WC was not predictive of mortality (HR, 1.04; 95% CI, 0.97-1.12); however, it predicted higher risk in men (HR, 1.12; 95% CI, 1.01-1.24). Conclusion In older adults with CAD, normal-weight central obesity defined using either WHR or WC is associated with high mortality risk, highlighting a need to combine measures in adiposity-related risk assessment.

UR - http://www.scopus.com/inward/record.url?scp=84959483809&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959483809&partnerID=8YFLogxK

U2 - 10.1016/j.mayocp.2015.12.007

DO - 10.1016/j.mayocp.2015.12.007

M3 - Article

C2 - 26860580

AN - SCOPUS:84959483809

VL - 91

SP - 343

EP - 351

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 3

ER -