Body Composition and Mortality in Mexican American Adults: Results from the National Health and Nutrition Examination Survey

Howell, Carrie R.; Mehta, Tapan; Ejima, Keisuke; Ness, Kirsten K.; Cherrington, Andrea; Fontaine, Kevin R.

doi:10.1002/oby.22251

Cited by 18 publications

(28 citation statements)

References 44 publications

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“… 35 36 Ultimately, 72 prospective cohort studies with 2 528 297 participants and 150 164 events were included in final analyses. 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 Thirty studies were from Europe, 22 studies were from the United States, 16 studies were from Asia, two studies were from Canada, one from Brazil, and one from Tobago in South America. Twelve studies included only men, 12 studies included only women, and another 48 studies included both sexes.…”

Section: Resultsmentioning

confidence: 99%

“…Three different publications from the third National Health and Nutrition Examination Survey were included in the analyses of waist-to-height ratio,59 thigh circumference,102 and waist circumference, waist-to-hip ratio, and waist-to-thigh ratio 86. Another publication from this study that reported direct estimations for one standard deviation increment in anthropometric measures was included in the analyses of standard deviations 63.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies with 760 190 participants and 23 959 events of all cause mortality were included in the analysis of waist-to-height ratio 50596065818287899091101. The summary hazard ratio for a 0.1 unit increment in waist-to-height ratio was 1.24 (95% confidence interval 1.12 to 1.36, I 2 =94%; fig 6, table 3).…”

Section: Resultsmentioning

confidence: 99%

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Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies

Jayedi

Soltani

Zargar

et al. 2020

BMJ

233

170

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ObjectiveTo quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and to clarify the shape of the dose-response relations.DesignSystematic review and meta-analysis.Data sourcesPubMed and Scopus from inception to July 2019, and the reference lists of all related articles and reviews.Eligibility criteria for selecting studiesProspective cohort studies reporting the risk estimates of all cause mortality across at least three categories of indices of central fatness. Studies that reported continuous estimation of the associations were also included.Data synthesisA random effects dose-response meta-analysis was conducted to assess linear trend estimations. A one stage linear mixed effects meta-analysis was used for estimating dose-response curves.ResultsOf 98 745 studies screened, 1950 full texts were fully reviewed for eligibility. The final analyses consisted of 72 prospective cohort studies with 2 528 297 participants. The summary hazard ratios were as follows: waist circumference (10 cm, 3.94 inch increase): 1.11 (95% confidence interval 1.08 to 1.13, I2=88%, n=50); hip circumference (10 cm, 3.94 inch increase): 0.90 (0.81 to 0.99, I2=95%, n=9); thigh circumference (5 cm, 1.97 inch increase): 0.82 (0.75 to 0.89, I2=54%, n=3); waist-to-hip ratio (0.1 unit increase): 1.20 (1.15 to 1.25, I2=90%, n=31); waist-to-height ratio (0.1 unit increase): 1.24 (1.12 to 1.36, I2=94%, n=11); waist-to-thigh ratio (0.1 unit increase): 1.21 (1.03 to 1.39, I2=97%, n=2); body adiposity index (10% increase): 1.17 (1.00 to 1.33, I2=75%, n=4); and A body shape index (0.005 unit increase): 1.15 (1.10 to 1.20, I2=87%, n=9). Positive associations persisted after accounting for body mass index. A nearly J shaped association was found between waist circumference and waist-to-height ratio and the risk of all cause mortality in men and women. A positive monotonic association was observed for waist-to-hip ratio and A body shape index. The association was U shaped for body adiposity index.ConclusionsIndices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies

Jayedi

Soltani

Zargar

et al. 2020

BMJ

233

170

View full text Add to dashboard Cite

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“…Although studies have shown that WC has been positively associated with CVDs, all-cause mortality, and new-onset T2DM [21][22][23][24][25], it has rarely been studied among patients with T2DM. Sone et al found-in a relatively small cohort study-that a high WC value alone is not sufficient to raise the risk of CVD events significantly and is not an independent risk factor in Japanese diabetic patients [26].…”

Section: Introductionmentioning

confidence: 99%

Waist circumference is associated with major adverse cardiovascular events in male but not female patients with type-2 diabetes mellitus

Xing

Peng

Wang

et al. 2020

Cardiovasc Diabetol

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Background: Although studies have shown that waist circumference (WC) is positively associated with an increased risk of cardiovascular diseases among the normal population, few studies have investigated WC in patients with type-2 diabetes mellitus (T2DM). Methods: This was a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. The Cox proportional hazards models was used to investigate the relationship between WC and major adverse cardiovascular events (MACEs) in T2DM patients with cardiovascular disease (CVD) or high risk factors of CVD. Results: A total of 10,251 T2DM patients (6299 men [61.4%], 3952 women [38.6%]) were included in our analysis. The mean age was 64.0 ± 7.53 years. After a mean follow-up at 9.2 ± 2.4 years later, 1804 patients (event rate of 23 per 1000 person-years) had developed MACEs. MACEs rates in men and women were 18.0 and 26.0 events per 1000 person-years, respectively. After multivariable adjustment, each increase in WC of 1 SD increased the risk of MACEs (HR: 1.10, 95% CI 1.04-1.17; P < 0.01) in men, with a non-significant increase in MACEs (HR: 1.04, 95% CI 0.95-1.13; P = 0.40) in women. Compared with those in the first quartile of WC, male patients in the fourth quartile of WC had a hazard ratio (HR) of 1.24 (95% CI 1.05-1.46) for MACEs; female patients in the fourth quartile of WC had an HR of 1.22 (95% CI 0.96-1.56) for MACEs. Conclusions: Higher WC is associated with increased risks of MACEs in male but not female T2DM patients.

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“…Within similar BMI, increased muscle mass is associated with increased insulin sensitivity and better metabolic profile. Increased waist circumference and waist to hip ratio (that have been shown to be good surrogate markers for adiposity) are associated with increased mortality in specific ethnicities like Mexican Americans [ 35 ]. Prior studies have also shown that fasting insulin levels, HDL cholesterol as well as triglyceride levels are independently related to body fat percent and waist to hip ratio [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Body fat predicts exercise capacity in persons with Type 2 Diabetes Mellitus: A machine learning approach

2021

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Diabetes mellitus is associated with increased cardiovascular disease (CVD) related morbidity, mortality and death. Exercise capacity in persons with type 2 diabetes has been shown to be predictive of cardiovascular events. In this study, we used the data from the prospective randomized LOOK AHEAD study and used machine learning algorithms to help predict exercise capacity (measured in Mets) from the baseline data that included cardiovascular history, medications, blood pressure, demographic information, anthropometric and Dual-energy X-Ray Absorptiometry (DXA) measured body composition metrics. We excluded variables with high collinearity and included DXA obtained Subtotal (total minus head) fat percentage and Subtotal lean mass (gms). Thereafter, we used different machine learning methods to predict maximum exercise capacity. The different machine learning models showed a strong predictive performance for both females and males. Our study shows that using baseline data from a large prospective cohort, we can predict maximum exercise capacity in persons with diabetes mellitus. We show that subtotal fat percentage is the most important feature for predicting the exercise capacity for males and females after accounting for other important variables. Until now, BMI and waist circumference were commonly used surrogates for adiposity and there was a relative under-appreciation of body composition metrics for understanding the pathophysiology of CVD. The recognition of body fat percentage as an important marker in determining CVD risk has prognostic implications with respect to cardiovascular morbidity and mortality.

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Body Composition and Mortality in Mexican American Adults: Results from the National Health and Nutrition Examination Survey

Abstract: Waist circumference and WHtR were associated with increased risk of all-cause and diabetes-related mortality in US-residing Mexican American adults.

Cited by 18 publications

References 44 publications

Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies

Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies

Waist circumference is associated with major adverse cardiovascular events in male but not female patients with type-2 diabetes mellitus

Body fat predicts exercise capacity in persons with Type 2 Diabetes Mellitus: A machine learning approach

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