The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000 elderly persons

Ellen L. de Hollander; Wanda JE Bemelmans; Hendriek C. Boshuizen; Nele Friedrich; Henri Wallaschofski; Pilar Guallar-castillón; Stefan Walter; M. Carola Zillikens; Annika Rosengren; Lauren Lissner; Julie K. Bassett; Graham G. Giles; Nicola Orsini; Noor Heim; Marjolein Visser; Lisette CPGM De groot; V. Sundh; S. Blair; D. C. Lee; X. Sui; M. Woodward; T. Welborn; S. Dhaliwal; G. Wannamethee; E. Roure; C. Castell; M. L. Biggs; A. Wolk; P. Ducimetiere; M. Verschuren; J. Kaprio; A. Menotti; I. M. Lee; H. Sesso; P. Knekt; K. Sääksjärvi; J. Dekker; G. Nijpels; C. Stehouwer; S. Bandinelli; A. M. Corsi; F. Lauretani; M. Visser; T. Seeman; S. Ishii; A. Spiro; C. Phillips; D. Blazer; L. Lind; A. Uitterlinden; A. Hofman; H. Tiemeier; H. Wallaschofski; S. Baumeister; F. Rodríguez-artalejo; I. Skoog; H. Tunstall-pedoe; M. Shipley; M. Kivimäki

doi:10.1093/ije/dys008

The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000 elderly persons

Ellen L. de Hollander, Wanda JE Bemelmans, Hendriek C. Boshuizen, Nele Friedrich, Henri Wallaschofski, Pilar Guallar-castillón, Stefan Walter, M. Carola Zillikens, Annika Rosengren, Lauren Lissner, Julie K. Bassett, Graham G. Giles, Nicola Orsini, Noor Heim, Marjolein Visser, Lisette CPGM De groot, V. Sundh, S. Blair, D. C. Lee, X. SuiM. Woodward, T. Welborn, S. Dhaliwal, G. Wannamethee, E. Roure, C. Castell, M. L. Biggs, A. Wolk, P. Ducimetiere, M. Verschuren, J. Kaprio, A. Menotti, I. M. Lee, H. Sesso, P. Knekt, K. Sääksjärvi, J. Dekker, G. Nijpels, C. Stehouwer, S. Bandinelli, A. M. Corsi, F. Lauretani, M. Visser, T. Seeman, S. Ishii, A. Spiro, C. Phillips, D. Blazer, L. Lind, A. Uitterlinden, A. Hofman, H. Tiemeier, H. Wallaschofski, S. Baumeister, F. Rodríguez-artalejo, I. Skoog, H. Tunstall-pedoe, M. Shipley, M. Kivimäki

Research output: Contribution to journal › Article › peer-review

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Abstract

Background For the elderly, the association between waist circumference (WC) and mortality considering body mass index (BMI) remains unclear, and thereby also the evidence base for using these anthropometric measures in clinical practice. This meta-analysis examined the association between WC categories and (cause-specific) mortality within BMI categories. Furthermore, the association of continuous WC with lowest and increased mortality risks was examined. Methods Age- and smoking-adjusted relative risks (RRs) of mortality associated with WC-BMI categories and continuous WC (including WC and WC²) were calculated by the investigators and pooled by means of random-effects models. Results During a 5-year-follow-up of 32 678 men and 25 931 women, we ascertained 3318 and 1480 deaths, respectively. A large WC (men: >102 cm, women: >88 cm) was associated with increased all-cause mortality RRs for those in the 'healthy' weight {1.7 [95% confidence interval (CI): 1.2-2.2], 1.7 (95% CI: 1.3-2.3)}, overweight [1.1(95% CI: 1.0-1.3), 1.4 (95%: 1.1-1.7)] and obese [1.1 (95% CI: 1.0-1.3), 1.6 (95% CI: 1.3-1.9)] BMI category compared with the 'healthy' weight (20-24.9 kg/m²) and a small WC (<94 cm, men; <80 cm, women) category. Underweight was associated with highest all-cause mortality RRs in men [2.2 (95% CI: 1.8-2.8)] and women [2.3 (95% CI: 1.8-3.1]. We found a J-shaped association for continuous WC with all-cause, cardiovascular (CVD) and cancer, and a U-shaped association with respiratory disease mortality (P < 0.05). An all-cause (CVD) mortality RR of 2.0 was associated with a WC of 132 cm (123 cm) in men and 116 cm (105 cm) in women. Conclusions Our results showed increased mortality risks for elderly people with an increased WC-even across BMI categories- and for those who were classified as 'underweight' using BMI. The results provide a solid basis for re-evaluation of WC cut-points in ageing populations. Published by Oxford University Press on behalf of the International Epidemiological Association

Original language	English (US)
Article number	dys008
Pages (from-to)	805-817
Number of pages	13
Journal	International journal of epidemiology
Volume	41
Issue number	3
DOIs	https://doi.org/10.1093/ije/dys008
State	Published - Jun 2012
Externally published	Yes

Keywords

Body mass index
Elderly
Mortality
Waist circumference

ASJC Scopus subject areas

Epidemiology

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10.1093/ije/dys008

Cite this

de Hollander, E. L., Bemelmans, W. JE., Boshuizen, H. C., Friedrich, N., Wallaschofski, H., Guallar-castillón, P., Walter, S., Zillikens, M. C., Rosengren, A., Lissner, L., Bassett, J. K., Giles, G. G., Orsini, N., Heim, N., Visser, M., De groot, L. CPGM., Sundh, V., Blair, S., Lee, D. C., ... Kivimäki, M. (2012). The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000 elderly persons. International journal of epidemiology, 41(3), 805-817. Article dys008. https://doi.org/10.1093/ije/dys008

The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000 elderly persons. / de Hollander, Ellen L.; Bemelmans, Wanda JE; Boshuizen, Hendriek C. et al.
In: International journal of epidemiology, Vol. 41, No. 3, dys008, 06.2012, p. 805-817.

Research output: Contribution to journal › Article › peer-review

de Hollander, EL, Bemelmans, WJE, Boshuizen, HC, Friedrich, N, Wallaschofski, H, Guallar-castillón, P, Walter, S, Zillikens, MC, Rosengren, A, Lissner, L, Bassett, JK, Giles, GG, Orsini, N, Heim, N, Visser, M, De groot, LCPGM, Sundh, V, Blair, S, Lee, DC, Sui, X, Woodward, M, Welborn, T, Dhaliwal, S, Wannamethee, G, Roure, E, Castell, C, Biggs, ML, Wolk, A, Ducimetiere, P, Verschuren, M, Kaprio, J, Menotti, A, Lee, IM, Sesso, H, Knekt, P, Sääksjärvi, K, Dekker, J, Nijpels, G, Stehouwer, C, Bandinelli, S, Corsi, AM, Lauretani, F, Visser, M, Seeman, T, Ishii, S, Spiro, A, Phillips, C, Blazer, D, Lind, L, Uitterlinden, A, Hofman, A, Tiemeier, H, Wallaschofski, H, Baumeister, S, Rodríguez-artalejo, F, Skoog, I, Tunstall-pedoe, H, Shipley, M & Kivimäki, M 2012, 'The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000 elderly persons', International journal of epidemiology, vol. 41, no. 3, dys008, pp. 805-817. https://doi.org/10.1093/ije/dys008

de Hollander EL, Bemelmans WJE, Boshuizen HC, Friedrich N, Wallaschofski H, Guallar-castillón P et al. The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000 elderly persons. International journal of epidemiology. 2012 Jun;41(3):805-817. dys008. doi: 10.1093/ije/dys008

@article{a40e9a25429049b8847f917622010504,

title = "The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000 elderly persons",

abstract = "Background For the elderly, the association between waist circumference (WC) and mortality considering body mass index (BMI) remains unclear, and thereby also the evidence base for using these anthropometric measures in clinical practice. This meta-analysis examined the association between WC categories and (cause-specific) mortality within BMI categories. Furthermore, the association of continuous WC with lowest and increased mortality risks was examined. Methods Age- and smoking-adjusted relative risks (RRs) of mortality associated with WC-BMI categories and continuous WC (including WC and WC2) were calculated by the investigators and pooled by means of random-effects models. Results During a 5-year-follow-up of 32 678 men and 25 931 women, we ascertained 3318 and 1480 deaths, respectively. A large WC (men: >102 cm, women: >88 cm) was associated with increased all-cause mortality RRs for those in the 'healthy' weight {1.7 [95% confidence interval (CI): 1.2-2.2], 1.7 (95% CI: 1.3-2.3)}, overweight [1.1(95% CI: 1.0-1.3), 1.4 (95%: 1.1-1.7)] and obese [1.1 (95% CI: 1.0-1.3), 1.6 (95% CI: 1.3-1.9)] BMI category compared with the 'healthy' weight (20-24.9 kg/m2) and a small WC (<94 cm, men; <80 cm, women) category. Underweight was associated with highest all-cause mortality RRs in men [2.2 (95% CI: 1.8-2.8)] and women [2.3 (95% CI: 1.8-3.1]. We found a J-shaped association for continuous WC with all-cause, cardiovascular (CVD) and cancer, and a U-shaped association with respiratory disease mortality (P < 0.05). An all-cause (CVD) mortality RR of 2.0 was associated with a WC of 132 cm (123 cm) in men and 116 cm (105 cm) in women. Conclusions Our results showed increased mortality risks for elderly people with an increased WC-even across BMI categories- and for those who were classified as 'underweight' using BMI. The results provide a solid basis for re-evaluation of WC cut-points in ageing populations. Published by Oxford University Press on behalf of the International Epidemiological Association",

keywords = "Body mass index, Elderly, Mortality, Waist circumference",

author = "{de Hollander}, {Ellen L.} and Bemelmans, {Wanda JE} and Boshuizen, {Hendriek C.} and Nele Friedrich and Henri Wallaschofski and Pilar Guallar-castill{\'o}n and Stefan Walter and Zillikens, {M. Carola} and Annika Rosengren and Lauren Lissner and Bassett, {Julie K.} and Giles, {Graham G.} and Nicola Orsini and Noor Heim and Marjolein Visser and {De groot}, {Lisette CPGM} and V. Sundh and S. Blair and Lee, {D. C.} and X. Sui and M. Woodward and T. Welborn and S. Dhaliwal and G. Wannamethee and E. Roure and C. Castell and Biggs, {M. L.} and A. Wolk and P. Ducimetiere and M. Verschuren and J. Kaprio and A. Menotti and Lee, {I. M.} and H. Sesso and P. Knekt and K. S{\"a}{\"a}ksj{\"a}rvi and J. Dekker and G. Nijpels and C. Stehouwer and S. Bandinelli and Corsi, {A. M.} and F. Lauretani and M. Visser and T. Seeman and S. Ishii and A. Spiro and C. Phillips and D. Blazer and L. Lind and A. Uitterlinden and A. Hofman and H. Tiemeier and H. Wallaschofski and S. Baumeister and F. Rodr{\'i}guez-artalejo and I. Skoog and H. Tunstall-pedoe and M. Shipley and M. Kivim{\"a}ki",

year = "2012",

month = jun,

doi = "10.1093/ije/dys008",

language = "English (US)",

volume = "41",

pages = "805--817",

journal = "International journal of epidemiology",

issn = "0300-5771",

publisher = "Oxford University Press",

number = "3",

}

TY - JOUR

T1 - The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds

T2 - A meta-analysis of 29 cohorts involving more than 58 000 elderly persons

AU - de Hollander, Ellen L.

AU - Bemelmans, Wanda JE

AU - Boshuizen, Hendriek C.

AU - Friedrich, Nele

AU - Wallaschofski, Henri

AU - Guallar-castillón, Pilar

AU - Walter, Stefan

AU - Zillikens, M. Carola

AU - Rosengren, Annika

AU - Lissner, Lauren

AU - Bassett, Julie K.

AU - Giles, Graham G.

AU - Orsini, Nicola

AU - Heim, Noor

AU - Visser, Marjolein

AU - De groot, Lisette CPGM

AU - Sundh, V.

AU - Blair, S.

AU - Lee, D. C.

AU - Sui, X.

AU - Woodward, M.

AU - Welborn, T.

AU - Dhaliwal, S.

AU - Wannamethee, G.

AU - Roure, E.

AU - Castell, C.

AU - Biggs, M. L.

AU - Wolk, A.

AU - Ducimetiere, P.

AU - Verschuren, M.

AU - Kaprio, J.

AU - Menotti, A.

AU - Lee, I. M.

AU - Sesso, H.

AU - Knekt, P.

AU - Sääksjärvi, K.

AU - Dekker, J.

AU - Nijpels, G.

AU - Stehouwer, C.

AU - Bandinelli, S.

AU - Corsi, A. M.

AU - Lauretani, F.

AU - Visser, M.

AU - Seeman, T.

AU - Ishii, S.

AU - Spiro, A.

AU - Phillips, C.

AU - Blazer, D.

AU - Lind, L.

AU - Uitterlinden, A.

AU - Hofman, A.

AU - Tiemeier, H.

AU - Wallaschofski, H.

AU - Baumeister, S.

AU - Rodríguez-artalejo, F.

AU - Skoog, I.

AU - Tunstall-pedoe, H.

AU - Shipley, M.

AU - Kivimäki, M.

PY - 2012/6

Y1 - 2012/6

N2 - Background For the elderly, the association between waist circumference (WC) and mortality considering body mass index (BMI) remains unclear, and thereby also the evidence base for using these anthropometric measures in clinical practice. This meta-analysis examined the association between WC categories and (cause-specific) mortality within BMI categories. Furthermore, the association of continuous WC with lowest and increased mortality risks was examined. Methods Age- and smoking-adjusted relative risks (RRs) of mortality associated with WC-BMI categories and continuous WC (including WC and WC2) were calculated by the investigators and pooled by means of random-effects models. Results During a 5-year-follow-up of 32 678 men and 25 931 women, we ascertained 3318 and 1480 deaths, respectively. A large WC (men: >102 cm, women: >88 cm) was associated with increased all-cause mortality RRs for those in the 'healthy' weight {1.7 [95% confidence interval (CI): 1.2-2.2], 1.7 (95% CI: 1.3-2.3)}, overweight [1.1(95% CI: 1.0-1.3), 1.4 (95%: 1.1-1.7)] and obese [1.1 (95% CI: 1.0-1.3), 1.6 (95% CI: 1.3-1.9)] BMI category compared with the 'healthy' weight (20-24.9 kg/m2) and a small WC (<94 cm, men; <80 cm, women) category. Underweight was associated with highest all-cause mortality RRs in men [2.2 (95% CI: 1.8-2.8)] and women [2.3 (95% CI: 1.8-3.1]. We found a J-shaped association for continuous WC with all-cause, cardiovascular (CVD) and cancer, and a U-shaped association with respiratory disease mortality (P < 0.05). An all-cause (CVD) mortality RR of 2.0 was associated with a WC of 132 cm (123 cm) in men and 116 cm (105 cm) in women. Conclusions Our results showed increased mortality risks for elderly people with an increased WC-even across BMI categories- and for those who were classified as 'underweight' using BMI. The results provide a solid basis for re-evaluation of WC cut-points in ageing populations. Published by Oxford University Press on behalf of the International Epidemiological Association

AB - Background For the elderly, the association between waist circumference (WC) and mortality considering body mass index (BMI) remains unclear, and thereby also the evidence base for using these anthropometric measures in clinical practice. This meta-analysis examined the association between WC categories and (cause-specific) mortality within BMI categories. Furthermore, the association of continuous WC with lowest and increased mortality risks was examined. Methods Age- and smoking-adjusted relative risks (RRs) of mortality associated with WC-BMI categories and continuous WC (including WC and WC2) were calculated by the investigators and pooled by means of random-effects models. Results During a 5-year-follow-up of 32 678 men and 25 931 women, we ascertained 3318 and 1480 deaths, respectively. A large WC (men: >102 cm, women: >88 cm) was associated with increased all-cause mortality RRs for those in the 'healthy' weight {1.7 [95% confidence interval (CI): 1.2-2.2], 1.7 (95% CI: 1.3-2.3)}, overweight [1.1(95% CI: 1.0-1.3), 1.4 (95%: 1.1-1.7)] and obese [1.1 (95% CI: 1.0-1.3), 1.6 (95% CI: 1.3-1.9)] BMI category compared with the 'healthy' weight (20-24.9 kg/m2) and a small WC (<94 cm, men; <80 cm, women) category. Underweight was associated with highest all-cause mortality RRs in men [2.2 (95% CI: 1.8-2.8)] and women [2.3 (95% CI: 1.8-3.1]. We found a J-shaped association for continuous WC with all-cause, cardiovascular (CVD) and cancer, and a U-shaped association with respiratory disease mortality (P < 0.05). An all-cause (CVD) mortality RR of 2.0 was associated with a WC of 132 cm (123 cm) in men and 116 cm (105 cm) in women. Conclusions Our results showed increased mortality risks for elderly people with an increased WC-even across BMI categories- and for those who were classified as 'underweight' using BMI. The results provide a solid basis for re-evaluation of WC cut-points in ageing populations. Published by Oxford University Press on behalf of the International Epidemiological Association

KW - Body mass index

KW - Elderly

KW - Mortality

KW - Waist circumference

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The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000 elderly persons

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