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Central obesity increased risk for CV, all-cause death despite normal BMI
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Data presented at the European Society of Cardiology Congress in Munich suggest that the risk for death from cardiovascular causes was nearly three times higher among those with central obesity and a normal BMI compared with those who do not have central fat distribution.
Karine Sahakyan, MD, PhD, MPH, CV research fellow at the Mayo Clinic in Rochester, Minn., and colleagues included 12,785 participants (mean age, 44 years; 47.4% men) from the Third National Health and Nutrition Examination Survey in their study. They examined body measurements, such as height, weight, waist and hip circumferences, and socioeconomic status, comorbidities, and physiological and laboratory results. Median follow-up lasted 14.3 years. During this time, 2,562 deaths, of which 1,138 were CV-related, occurred.
The researchers categorized the participants into three groups according to BMI (normal, 18.5-24.9; overweight, 25-29.9; and obese, ≥30) and two according to waist-to-hip ratio (<0.85 and ≥0.85 for women, and <0.9 and ≥0.9 for men). Sahakyan and colleagues adjusted for age, sex, race, smoking, hypertension, diabetes, dyslipidemia and baseline BMI.
According to an abstract, the patients with normal BMI but central obesity, defined by waist-to-hip ratio, had the highest risk for both CV and all-cause mortality among all six subgroups.
Moreover, risk for CV mortality was 2.75 times higher and the risk for all-cause mortality was 2.08 times higher in normal-weight obese people compared with those with normal BMI and normal waist-to-hip-ratio (adjusted HR=2.75; P<.0001).
“The high risk of death may be related to a higher visceral fat accumulation in this group, which is associated with insulin resistance and other risk factors, the limited amount of fat located on the hips and legs, which is fat with presumed protective effects and to the relatively limited amount of muscle mass,” Sahakyan said in a press release.
Health professionals should educate patients about the importance of maintaining a healthy weight and normal waist-to-hip-ratio, the researchers said, adding that the location of fat distribution on the body matters when assessing risk for heart disease.
For more information:
Sahakyan K. #2951. Presented at: the European Society of Cardiology Congress; Aug. 25-29, 2012; Munich.
Disclosure: Dr. Sahakyan reports no relevant financial disclosures.