TY - JOUR
T1 - A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity
T2 - results from a large European cohort
AU - Christakoudi, Sofia
AU - Tsilidis, Konstantinos K.
AU - Muller, David C.
AU - Freisling, Heinz
AU - Weiderpass, Elisabete
AU - Overvad, Kim
AU - Söderberg, Stefan
AU - Häggström, Christel
AU - Pischon, Tobias
AU - Dahm, Christina C.
AU - Zhang, Jie
AU - Tjønneland, Anne
AU - Halkjær, Jytte
AU - MacDonald, Conor
AU - Boutron-Ruault, Marie Christine
AU - Mancini, Francesca Romana
AU - Kühn, Tilman
AU - Kaaks, Rudolf
AU - Schulze, Matthias B.
AU - Trichopoulou, Antonia
AU - Karakatsani, Anna
AU - Peppa, Eleni
AU - Masala, Giovanna
AU - Pala, Valeria
AU - Panico, Salvatore
AU - Tumino, Rosario
AU - Sacerdote, Carlotta
AU - Quirós, J. Ramón
AU - Agudo, Antonio
AU - Sánchez, Maria Jose
AU - Cirera, Lluís
AU - Barricarte-Gurrea, Aurelio
AU - Amiano, Pilar
AU - Memarian, Ensieh
AU - Sonestedt, Emily
AU - Bueno-de-Mesquita, Bas
AU - May, Anne M.
AU - Khaw, Kay Tee
AU - Wareham, Nicholas J.
AU - Tong, Tammy Y.N.
AU - Huybrechts, Inge
AU - Noh, Hwayoung
AU - Aglago, Elom K.
AU - Ellingjord-Dale, Merete
AU - Ward, Heather A.
AU - Aune, Dagfinn
AU - Riboli, Elio
PY - 2020
Y1 - 2020
N2 - Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI < 18.5 kg/m2) or obese (BMI ≥ 30 kg/m2) categories, while the highest quartile of ABSI separated 18–39% of the individuals within each BMI category, which had 22–55% higher risk of death. In conclusion, only a waist index independent of BMI by design, such as ABSI, complements BMI and enables efficient risk stratification, which could facilitate personalisation of screening, treatment and monitoring.
AB - Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI < 18.5 kg/m2) or obese (BMI ≥ 30 kg/m2) categories, while the highest quartile of ABSI separated 18–39% of the individuals within each BMI category, which had 22–55% higher risk of death. In conclusion, only a waist index independent of BMI by design, such as ABSI, complements BMI and enables efficient risk stratification, which could facilitate personalisation of screening, treatment and monitoring.
U2 - 10.1038/s41598-020-71302-5
DO - 10.1038/s41598-020-71302-5
M3 - Article
C2 - 32883969
AN - SCOPUS:85090137097
SN - 2045-2322
VL - 10
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 14541
ER -