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Obesity Indexes and Total Mortality among Elderly Subjects at High Cardiovascular Risk: The PREDIMED Study

By 1957- Miguel Ángel Martínez-González, Ana García-Arellano, Estefanía Toledo, Maira Bes-Rastrollo, Mònica Bulló, Dolores Corella Piquer, Montserrat Fitó Colomer, Emilio Ros Rahola, Rosa Ma. Lamuela Raventós, Javier Rekondo, Enrique Gómez-Gracia, Miguel Fiol Sala, Jose Manuel Santos-Lozano, Lluís Serra Majem, J. Alfredo Martínez, Sonia Eguaras, Guillermo Sáez-Tormo, Xavier Pintó Sala and Ramon Estruch Riba

Abstract

Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. Methods: We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. Results: After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78-1.34), 1.30 (0.97-1.75) and 1.55 (1.06-2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88-1.59), 1.02 (0.74-1.41) and 1.57 (1.19-2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. Conclusions: Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality

Topics: Antropometria, Malalties cardiovasculars, Obesitat, Anthropometry, Cardiovascular diseases, Obesity
Publisher: Public Library of Science (PLoS)
Year: 2014
DOI identifier: 10.1371/journal.pone.0103246
OAI identifier: oai:diposit.ub.edu:2445/59264
Journal:

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