Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk cohort: a population-based prospective study.

@article{citeulike:2277437, abstract = {BACKGROUND: Body fat distribution has been cross-sectionally associated with atherosclerotic disease risk factors, but the prospective relation with coronary heart disease remains uncertain. METHODS AND RESULTS: We examined the prospective relation between fat distribution indices and coronary heart disease among 24,508 men and women 45 to 79 years of age using proportional hazards regression. During a mean 9.1 years of follow-up, 1708 men and 892 women developed coronary heart disease. The risk for developing subsequent coronary heart disease increased continuously across the range of waist-hip ratio. Hazard ratios (95\% CI) of the top versus bottom fifth of waist-hip ratio were 1.55 (1.28 to 1.73) in men and 1.91 (1.44 to 2.54) in women after adjustment for body mass index and other coronary heart disease risk factors. Hazard ratios increased with waist circumference, but risk estimates for waist circumference without hip circumference adjustment were lower by 10\% to 18\%. After adjustment for waist circumference, body mass index, and coronary heart disease risk factors, hazard ratios for 1-SD increase in hip circumference were 0.80 (95\% CI, 0.74 to 0.87) in men and 0.80 (95\% CI, 0.69 to 0.93) in women. Hazard ratios for body mass index were greatly attenuated when we adjusted for waist-hip ratio or waist circumference and other covariates. CONCLUSIONS: Indices of abdominal obesity were more consistently and strongly predictive of coronary heart disease than body mass index. These simple and inexpensive measurements could be used to assess obesity-related coronary heart disease risk in relatively healthy men and women.}, address = {Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. dexter.canoy@manchester.ac.uk}, author = {Canoy, D. and Boekholdt, S. M. and Wareham, N. and Luben, R. and Welch, A. and Bingham, S. and Buchan, I. and Day, N. and Khaw, K. T. }, citeulike-article-id = {2277437}, comment = {Recently published population based Norfolk Cohort study once again brings attention to body fat distribution and risk for coronary heart disease. In this prospective population based European prospective trial into cancer and nutrition they examined the relation between fat distribution and coronary heart disease in 24508 men and women 45 to 79 years of age. During this 9.1 year follow up they have coronary heart disease develop in 1708 men and 892 women. As was seen in the INTERHEART trial there was a stronger correlation with coronary heart disease with waist hip ratio than was simple BMI. The practical message for health care professionals was a reduction of 1 kg in weight translated into a risk reduction in coronary heart disease by 2\%. Another calculation was reducing waist circumference by 5 cm (2.3 inches) could lower risk by 11\% in men and 15\% in women over this 9.1 year period. Results: The strongest hazard ratios for coronary heart disease were found first with waist-hip ratio then waist circumference and weakest was body mass index. This is very similar to findings from the INTERHEART in with waist-hip ratio being the best for correlation with coronary heart disease. The waist circumference was close in comparison to the waist hip ratio. Summary: coronary heart disease risk is clearly associated with increasing weigh above normal values and most importantly weight loss does show significant improvement in reducing coronary heart disease risk. --Robert J. Chilton, DO FACC }, doi = {10.1161/CIRCULATIONAHA.106.673756}, issn = {1524-4539}, journal = {Circulation}, keywords = {bmi, chd, risk}, month = {December}, number = {25}, pages = {2933--2943}, posted-at = {2008-01-22 20:33:46}, priority = {2}, title = {Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk cohort: a population-based prospective study.}, url = {http://dx.doi.org/10.1161/CIRCULATIONAHA.106.673756}, volume = {116}, year = {2007} }

TY - JOUR ID - citeulike:2277437 L3 - citeulike-article-id:2277437 TI - Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk cohort: a population-based prospective study. JF - Circulation VL - 116 IS - 25 SP - 2933 EP - 2943 AD - Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. dexter.canoy@manchester.ac.uk SN - 1524-4539 N2 - BACKGROUND: Body fat distribution has been cross-sectionally associated with atherosclerotic disease risk factors, but the prospective relation with coronary heart disease remains uncertain. METHODS AND RESULTS: We examined the prospective relation between fat distribution indices and coronary heart disease among 24,508 men and women 45 to 79 years of age using proportional hazards regression. During a mean 9.1 years of follow-up, 1708 men and 892 women developed coronary heart disease. The risk for developing subsequent coronary heart disease increased continuously across the range of waist-hip ratio. Hazard ratios (95% CI) of the top versus bottom fifth of waist-hip ratio were 1.55 (1.28 to 1.73) in men and 1.91 (1.44 to 2.54) in women after adjustment for body mass index and other coronary heart disease risk factors. Hazard ratios increased with waist circumference, but risk estimates for waist circumference without hip circumference adjustment were lower by 10% to 18%. After adjustment for waist circumference, body mass index, and coronary heart disease risk factors, hazard ratios for 1-SD increase in hip circumference were 0.80 (95% CI, 0.74 to 0.87) in men and 0.80 (95% CI, 0.69 to 0.93) in women. Hazard ratios for body mass index were greatly attenuated when we adjusted for waist-hip ratio or waist circumference and other covariates. CONCLUSIONS: Indices of abdominal obesity were more consistently and strongly predictive of coronary heart disease than body mass index. These simple and inexpensive measurements could be used to assess obesity-related coronary heart disease risk in relatively healthy men and women. KW - bmi KW - chd KW - risk N1 - Recently published population based Norfolk Cohort study once again brings attention to body fat distribution and risk for coronary heart disease. In this prospective population based European prospective trial into cancer and nutrition they examined the relation between fat distribution and coronary heart disease in 24508 men and women 45 to 79 years of age. During this 9.1 year follow up they have coronary heart disease develop in 1708 men and 892 women. As was seen in the INTERHEART trial there was a stronger correlation with coronary heart disease with waist hip ratio than was simple BMI. The practical message for health care professionals was a reduction of 1 kg in weight translated into a risk reduction in coronary heart disease by 2%. Another calculation was reducing waist circumference by 5 cm (2.3 inches) could lower risk by 11% in men and 15% in women over this 9.1 year period. Results: The strongest hazard ratios for coronary heart disease were found first with waist-hip ratio then waist circumference and weakest was body mass index. This is very similar to findings from the INTERHEART in with waist-hip ratio being the best for correlation with coronary heart disease. The waist circumference was close in comparison to the waist hip ratio. Summary: coronary heart disease risk is clearly associated with increasing weigh above normal values and most importantly weight loss does show significant improvement in reducing coronary heart disease risk. --Robert J. Chilton, DO FACC AU - Canoy, D AU - Boekholdt, SM AU - Wareham, N AU - Luben, R AU - Welch, A AU - Bingham, S AU - Buchan, I AU - Day, N AU - Khaw, KT PY - 2007/12/18/ UR - http://dx.doi.org/10.1161/CIRCULATIONAHA.106.673756 ER -