Abdominal adiposity in women strongly associated with all-cause, cardiovascular, and cancer mortality independently of body mass index
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This prospective cohort study of 44,636 women from the Nurses’ Health Study was aimed to investigate the association between abdominal obesity and all-cause, cardiovascular disease (CVD) and cancer mortality. During the 16-year follow-up period, 3,507 deaths were reported, including 751 cardiovascular deaths and 1,748 cancer deaths. After adjusting for body mass index and potential confounders, the relative risks across the lowest to the highest waist circumference quintiles were 1.00, 1.11, 1.17, 1.31, and 1.79 for all-cause mortality; 1.00, 1.04, 1.04, 1.28, and 1.99 for CVD mortality; and 1.00, 1.18, 1.20, 1.34, and 1.63 for cancer mortality. Among normal-weight women, abdominal obesity was significantly associated with elevated CVD mortality, the relative risk associated with waist circumference ≥88 cm being 3.02, and the relative risk associated with waist-to-hip ratio >0.88 being 3.45. After adjusting for waist circumference, hip circumference was significantly inversely associated with CVD mortality. In conclusion, abdominal obesity was positively associated with all-cause, CVD, and cancer mortality, independently of body mass index. Even among normal-weight women, elevated waist circumference was associated with significantly increased CVD mortality.
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