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A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort

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Item Type:Article
Title:A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort
Creators Name:Christakoudi, S. and Tsilidis, K.K. and Muller, D.C. and Freisling, H. and Weiderpass, E. and Overvad, K. and Söderberg, S. and Häggström, C. and Pischon, T. and Dahm, C.C. and Zhang, J. and Tjønneland, A. and Halkjær, J. and MacDonald, C. and Boutron-Ruault, M.C. and Mancini, F.R. and Kühn, T. and Kaaks, R. and Schulze, M.B. and Trichopoulou, A. and Karakatsani, A. and Peppa, E. and Masala, G. and Pala, V. and Panico, S. and Tumino, R. and Sacerdote, C. and Quirós, J.R. and Agudo, A. and Sánchez, M.J. and Cirera, L. and Barricarte-Gurrea, A. and Amiano, P. and Memarian, E. and Sonestedt, E. and Bueno-de-Mesquita, B. and May, A.M. and Khaw, K.T. and Wareham, N.J. and Tong, T.Y.N. and Huybrechts, I. and Noh, H. and Aglago, E.K. and Ellingjord-Dale, M. and Ward, H.A. and Aune, D. and Riboli, E.
Abstract: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/m(2)) or obese (BMI ≥ 30 kg/m(2)) 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.
Keywords:Body Mass Index, Cohort Studies, Europe, Abdominal Obesity, Proportional Hazards Models, Risk Factors, Waist Circumference, Waist-Hip Ratio
Source:Scientific Reports
ISSN:2045-2322
Publisher:Nature Publishing Group
Volume:10
Number:1
Page Range:14541
Date:3 September 2020
Official Publication:https://doi.org/10.1038/s41598-020-71302-5
PubMed:View item in PubMed

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