Reference details
de Hollander EL, Bemelmans WJ, Boshuizen HC, Friedrich N, Wallaschofski H, Guallar-Castillon P, Walter S, Zillikens MC, Rosengren A, Lissner L, Bassett JK, Giles GG, Orsini N, Heim N, Visser M, de Groot LC (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. Int J Epidemiol 41:805-817
ABTRACT
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 WC(2)) 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/m(2)) and a small WC (<94 cm,="" men;="">94><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="">80>< 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="">
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