Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.

<h4>Background</h4>Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance...

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Autores principales: Miguel A Martínez-González, Ana García-Arellano, Estefanía Toledo, Maira Bes-Rastrollo, Mónica Bulló, Dolores Corella, Montserrat Fito, Emilio Ros, Rosa Maria Lamuela-Raventós, Javier Rekondo, Enrique Gómez-Gracia, Miquel Fiol, Jose Manuel Santos-Lozano, Lluis Serra-Majem, J Alfredo Martínez, Sonia Eguaras, Guillermo Sáez-Tormo, Xavier Pintó, Ramon Estruch
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spelling oai:doaj.org-article:afb701d437014a9182607f8aef998d2f2021-11-25T06:06:47ZObesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.1932-620310.1371/journal.pone.0103246https://doaj.org/article/afb701d437014a9182607f8aef998d2f2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25072784/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality.<h4>Methods</h4>We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009.<h4>Results</h4>After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78-1.34), 1.30 (0.97-1.75) and 1.55 (1.06-2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88-1.59), 1.02 (0.74-1.41) and 1.57 (1.19-2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial.<h4>Conclusions</h4>Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality.<h4>Trial registration</h4>Controlled-Trials.com ISRCTN35739639.Miguel A Martínez-GonzálezAna García-ArellanoEstefanía ToledoMaira Bes-RastrolloMónica BullóDolores CorellaMontserrat FitoEmilio RosRosa Maria Lamuela-RaventósJavier RekondoEnrique Gómez-GraciaMiquel FiolJose Manuel Santos-LozanoLluis Serra-MajemJ Alfredo MartínezSonia EguarasGuillermo Sáez-TormoXavier PintóRamon EstruchPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e103246 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Miguel A Martínez-González
Ana García-Arellano
Estefanía Toledo
Maira Bes-Rastrollo
Mónica Bulló
Dolores Corella
Montserrat Fito
Emilio Ros
Rosa Maria Lamuela-Raventós
Javier Rekondo
Enrique Gómez-Gracia
Miquel Fiol
Jose Manuel Santos-Lozano
Lluis Serra-Majem
J Alfredo Martínez
Sonia Eguaras
Guillermo Sáez-Tormo
Xavier Pintó
Ramon Estruch
Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.
description <h4>Background</h4>Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality.<h4>Methods</h4>We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009.<h4>Results</h4>After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78-1.34), 1.30 (0.97-1.75) and 1.55 (1.06-2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88-1.59), 1.02 (0.74-1.41) and 1.57 (1.19-2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial.<h4>Conclusions</h4>Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality.<h4>Trial registration</h4>Controlled-Trials.com ISRCTN35739639.
format article
author Miguel A Martínez-González
Ana García-Arellano
Estefanía Toledo
Maira Bes-Rastrollo
Mónica Bulló
Dolores Corella
Montserrat Fito
Emilio Ros
Rosa Maria Lamuela-Raventós
Javier Rekondo
Enrique Gómez-Gracia
Miquel Fiol
Jose Manuel Santos-Lozano
Lluis Serra-Majem
J Alfredo Martínez
Sonia Eguaras
Guillermo Sáez-Tormo
Xavier Pintó
Ramon Estruch
author_facet Miguel A Martínez-González
Ana García-Arellano
Estefanía Toledo
Maira Bes-Rastrollo
Mónica Bulló
Dolores Corella
Montserrat Fito
Emilio Ros
Rosa Maria Lamuela-Raventós
Javier Rekondo
Enrique Gómez-Gracia
Miquel Fiol
Jose Manuel Santos-Lozano
Lluis Serra-Majem
J Alfredo Martínez
Sonia Eguaras
Guillermo Sáez-Tormo
Xavier Pintó
Ramon Estruch
author_sort Miguel A Martínez-González
title Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.
title_short Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.
title_full Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.
title_fullStr Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.
title_full_unstemmed Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the PREDIMED study.
title_sort obesity indexes and total mortality among elderly subjects at high cardiovascular risk: the predimed study.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/afb701d437014a9182607f8aef998d2f
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