Body shape index in comparison with other anthropometric measures in prediction of total and cause-specific mortality
Body shape index in comparison with other anthropometric measures in prediction of total and cause-specific mortality
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DOI：
10.1136/jech-2014-205257
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发表时间：
2016-01-01
影响因子：
6.3
通讯作者：
Franco, Oscar H.
中科院分区：
文献类型：
--
作者：
Dhana, Klodian;Kavousi, Maryam;Franco, Oscar H.
研究背景在中老年人中，体重指数（BMI）与死亡率的关系仍存在争议。方法我们评估了BMI、腰围（WC）、腰高比（WHtR）、腰臀比（WHR）和体型指数之间的关系（ABSI=WC/（BMI（2/3）x身高（1/2），在基于人群的前瞻性鹿特丹研究的2626名男性和3740名女性中，使用考克斯比例风险模型评估心血管和癌症死亡率。预测性能进行了评估，通过信息量，c-统计，综合区分改善（IDI），和持续净重新分类的改善（cNRI）。结果在22年的随访中，3675例死亡的所有原因，1195心血管疾病，873癌症发生。在多变量模型中，与BMI、WC、WHtR和WHR相比，ABSI与死亡率的相关性更强。男性和女性ABSI每增加1 SD总死亡率的HR和CI（95% CI）分别为1.15（1.09 - 1.21）和1.09（1.04 - 1.14）。对于心血管和癌症死亡率，男性的HR（95% CI）分别为1.18（1.08至1.29）和1.10（0.99至1.22），女性分别为1.04（0.96至1.12）和1.18（1.07至1.30）。包括ABSI的模型没有增加c-统计量。在男性中，在预测总死亡率时，包括ABSI的模型信息量更大（卡方检验2 =26.4），并提供了风险分层的改善（IDI 0.003，95% CI 0.001至0.005; cNRI 0.13，95%CI 0.06 - 0.21）。结论在我们基于人群的研究中，在不同的人体测量指标中，ABSI与总死亡率、心血管死亡率和癌症死亡率有较强的相关性。然而，ABSI在预测死亡率方面的附加预测价值有限。
Background The association of body mass index (BMI) with mortality remains controversial among the middle-aged and elderly. Moreover, the contribution of other anthropometric measures to predict mortality is unclear.Methods We assessed the association of BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR) and a body shape index (ABSI=WC/(BMI(2/3)xheight(1/2))) with total, cardiovascular and cancer mortality by using Cox proportion hazard models among 2626 men and 3740 women from the prospective population-based Rotterdam Study. Predictive performance was assessed through informativeness, c-statistic, integrated discrimination improvement (IDI), and continuous net reclassification improvement (cNRI).Results During 22 years of follow-up, 3675 deaths from all-causes, 1195 from cardiovascular disease, and 873 from cancer occurred. In the multivariable model, ABSI showed a stronger association with mortality compared with BMI, WC, WHtR and WHR. HRs and CIs (95% CIs) for total mortality per 1 SD increase in ABSI were 1.15 (1.09 to 1.21) for men and 1.09 (1.04 to 1.14) for women. For cardiovascular and cancer mortality, these HRs (95% CI) were 1.18 (1.08 to 1.29) and 1.10 (0.99 to 1.22) for men, 1.04 (0.96 to 1.12) and 1.18 (1.07 to 1.30) for women, respectively. The models including ABSI did not increase the c-statistics. Among men, in prediction of total mortality the model including ABSI was more informative (chi(2)=26.4) and provided improvement in risk stratification (IDI 0.003, 95% CI 0.001 to 0.005; cNRI 0.13, 95% CI 0.06 to 0.21).Conclusions In our population-based study, among different anthropometric measures, ABSI showed a stronger association with total, cardiovascular and cancer mortality. However, the added predictive value of ABSI in prediction of mortality was limited.