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          Institute: MPI für Psychiatrie     Collection: Publikationen MPI für Psychiatrie     Display Documents

ID: 475614.0, MPI für Psychiatrie / Publikationen MPI für Psychiatrie
The Predictive Value of Different Measures of Obesity for Incident Cardiovascular Events and Mortality
Authors:Schneider, H. J.; Friedrich, N.; Klotsche, J.; Pieper, L.; Nauck, M.; John, U.; Dorr, M.; Felix, S.; Lehnert, H.; Pittrow, D.; Silber, S.; Volzke, H.; Stalla, G. K.; Wallaschofski, H.; Wittchen, H. U.
Date of Publication (YYYY-MM-DD):2010-04
Title of Journal:Journal of Clinical Endocrinology & Metabolism
Issue / Number:4
Start Page:1777
End Page:1785
Review Status:not specified
Audience:Not Specified
Abstract / Description:Context: To date, it is unclear which measure of obesity is the most appropriate for risk stratification. Objective: The aim of the study was to compare the associations of various measures of obesity with incident cardiovascular events and mortality. Design and Setting: We analyzed two German cohort studies, the DETECT study and SHIP, including primary care and general population. Participants: A total of 6355 (mean follow-up, 3.3 yr) and 4297 (mean follow-up, 8.5 yr) individuals participated in DETECT and SHIP, respectively. Interventions: We measured body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) and assessed cardiovascular and all-cause mortality and the composite endpoint of incident stroke, myocardial infarction, or cardiovascular death. Results: In both studies, we found a positive association of the composite endpoint with WHtR but not with BMI. There was no heterogeneity among studies. The relative risks in the highest versus the lowest sex- and age-specific quartile of WHtR, WC, WHR, and BMI after adjustment for multiple confounders were as follows in the pooled data: cardiovascular mortality, 2.75(95% confidence interval, 1.31-5.77), 1.74 (0.84-3.6), 1.71 (0.91-3.22), and 0.74 (0.35-1.57), respectively; all-cause mortality, 1.86 (1.25-2.76), 1.62 (1.22-2.38), 1.36 (0.93-1.69), and 0.77 (0.53-1.13), respectively; and composite endpoint, 2.16 (1.39-3.35), 1.59 (1.04-2.44), 1.49 (1.07-2.07), and 0.57 (0.37-0.89), respectively. Separate analyses of sex and age groups yielded comparable results. Receiver operating characteristics analysis yielded the highest areas under the curve for WHtR for predicting these endpoints. Conclusions: WHtR represents the best predictor of cardiovascular risk and mortality, followed by WC and WHR. Our results discourage the use of the BMI. (J Clin Endocrinol Metab 95: 1777-1785, 2010)
External Publication Status:published
Document Type:Article
Version Comment:Automatic journal name synchronization
Communicated by:N. N.
Affiliations:MPI für Psychiatrie
Identifiers:ISI:000276402300036 [ID No:1]
ISSN:0021-972X [ID No:2]
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