The influence of hip circumference on the relationship between abdominal obesity and mortality

Abstract

Background Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to traditional risk factors would significantly improve CVD risk prediction.Methods In a population-based survey among South Asian and African Mauritians (n = 7978), 1241 deaths occurred during 15 years of follow-up. In a model that included variables used in previous CVD risk calculations (a Framingham-type model), the association between waist circumference and mortality was examined before and after adjustment for hip circumference. The percentage with an increase in estimated 10-year cumulative mortality of >25% and a decrease of >20% after waist and hip circumference were added to the model was calculated.Results Waist circumference was strongly related to mortality only after adjustment for hip circumference and vice versa. Adding waist and hip circumference to a Framingham-type model increased estimated 10-year cumulative CVD mortality by >25% for 23.7% of those who died and 15.7% of those censored. Cumulative mortality decreased by >20% for 4.5% of those who died and 14.8% of those censored.Conclusions The effect of central obesity on mortality risk is seriously underestimated without adjustment for hip circumference. Adding waist and hip circumference to a Framingham-type model for CVD mortality substantially increased predictive power. Both may be important inclusions in CVD risk prediction models.

Salivary adiponectin concentration in healthy adult males in relation to anthropometric measures and fat distribution

“…Hip circumference was measured at the maximum circumference over the buttocks. Th en the WHR was calculated (Cameron et al 2012).…”

Differences between Adiposity Indicators for Predicting All-Cause Mortality in a Representative Sample of United States Non-Elderly Adults

“…Previous prospective studies of community-based, non-elderly adults have described how all-cause mortality was associated with measured BMI [25][26][27][28][29][30][31][32][33][34][35], WC [26][27][28][29][30]33,34,36,37], WHtR [26,33,34], WHR [26][27][28]30,33,34,36,38] or WTR [29,30]. Most of the cohorts occurred in Europe, Asia or Australia.…”

Fat Type Level: A Simpler Way for Men to Understand Body Shape and Health Risks

“…The WHR and the WC are trustworthy substitutes for BMI and can provide men with a realistic and practical picture of their health status [4,16,43,44]. Taken together, the WHR and WC are better alternatives than the BMI for measuring body shape, adiposity, determine health risk [4,45]. Both the WHR and WC are simple and inexpensive methods that correlate well with more precise imaging studies of dysfunctional truncal fat [45].…”

“…Taken together, the WHR and WC are better alternatives than the BMI for measuring body shape, adiposity, determine health risk [4,45]. Both the WHR and WC are simple and inexpensive methods that correlate well with more precise imaging studies of dysfunctional truncal fat [45]. The greater the WHR, the greater the risk of metabolically damaging fat located in the abdominal area [46].…”