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ABSI (A Body Shape Index) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort

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Title: ABSI (A Body Shape Index) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort
Authors: Christakoudi, S
Tsilidis, KK
Muller, DC
Freisling, H
Weiderpass, E
Overvad, K
Söderberg, S
Häggström, C
Pischon, T
Dahm, CC
Zhang, J
Tjønneland, A
Halkjær, J
MacDonald, C
Boutron-Ruault, M-C
Mancini, FR
Kühn, T
Kaaks, R
Schulze, MB
Trichopoulou, A
Karakatsani, A
Peppa, E
Masala, G
Pala, V
Panico, S
Tumino, R
Sacerdote, C
Quirós, JR
Agudo, A
Sánchez, M-J
Cirera, L
Barricarte-Gurrea, A
Amiano, P
Memarian, E
Sonestedt, E
Bueno-de-Mesquita, B
May, AM
Khaw, K-T
Wareham, NJ
Tong, TYN
Huybrechts, I
Noh, H
Aglago, EK
Ellingjord-Dale, M
Ward, HA
Aune, D
Riboli, E
Item Type: Journal Article
Abstract: Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI<18.5 kg/m2) or obese (BMI≥30 kg/m2) categories, while the highest quartile of ABSI separated 18%-39% of the individuals within each BMI category, which had 22%-55% higher risk of death. In conclusion, only a waist index independent of BMI by design, such as ABSI, complements BMI and enables efficient risk stratification, which could facilitate personalisation of screening, treatment and monitoring.
Issue Date: 3-Sep-2020
Date of Acceptance: 6-Aug-2020
URI: http://hdl.handle.net/10044/1/82220
DOI: 10.1038/s41598-020-71302-5
ISSN: 2045-2322
Publisher: Nature Publishing Group
Journal / Book Title: Scientific Reports
Volume: 10
Copyright Statement: © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: Cancer Research UK
Cancer Research UK
Funder's Grant Number: C57955/A24390
Keywords: Obesity
Obesity, Abdominal
Body Mass Index
Publication Status: Published
Article Number: ARTN 14541
Appears in Collections:Faculty of Medicine
School of Public Health

This item is licensed under a Creative Commons License Creative Commons