{"id":24781,"date":"2023-11-11T04:12:00","date_gmt":"2023-11-10T20:12:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24781"},"modified":"2023-11-11T09:44:10","modified_gmt":"2023-11-11T01:44:10","slug":"jama-new-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%82%a5%e8%83%96%e6%9b%bf%e4%bb%a3%e6%8c%87%e6%a0%87%e4%b8%8e%e6%ad%bb%e4%ba%a1%e7%8e%87","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24781","title":{"rendered":"[JAMA New Open\u53d1\u8868\u8bba\u6587]\uff1a\u80a5\u80d6\u66ff\u4ee3\u6307\u6807\u4e0e\u6b7b\u4ea1\u7387"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Diabetes and Endocrinology<\/p>\n\n\n\n

September 20, 2023<\/p>\n\n\n\n

Surrogate Adiposity Markers and Mortality<\/h1>\n\n\n\n

Irfan Khan, Michael Chong, Ann Le, et al<\/h3>\n\n\n\n

JAMA Netw Open. <\/em>2023;6(9):e2334836. doi:10.1001\/jamanetworkopen.2023.34836<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Among body mass index, fat mass index, and waist-to-hip (WHR) ratio, what is the optimal adiposity measure with the strongest association with mortality outcomes in adults?<\/p>\n\n\n\n

Findings<\/strong>  In this cohort study consisting of 387\u202f672 UK adult participants from the UK Biobank, WHR was found to have the strongest and most consistent association with all-cause and cause-specific mortality.<\/p>\n\n\n\n

Meaning<\/strong>  In this study, WHR had the most robust association with mortality risk and may serve as a more appropriate target for health care intervention.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Body mass index (BMI) is an easily obtained adiposity surrogate. However, there is variability in body composition and adipose tissue distribution between individuals with the same BMI, and there is controversy regarding the BMI associated with the lowest mortality risk.<\/p>\n\n\n\n

Objective<\/strong>  To evaluate which of BMI, fat mass index (FMI), and waist-to-hip (WHR) has the strongest and most consistent association with mortality.<\/p>\n\n\n\n

Design, Setting, and Participant<\/strong>  This cohort study used incident deaths from the UK Biobank (UKB; 2006-2022), which includes data from 22 clinical assessment centers across the United Kingdom. UKB British participants of British White ancestry (N\u2009=\u2009387\u202f672) were partitioned into a discovery cohort (n\u2009=\u2009337\u202f078) and validation cohort (n\u2009=\u200950\u202f594), with the latter consisting of 25\u202f297 deaths and 25\u202f297 controls. The discovery cohort was used to derive genetically determined adiposity measures while the validation cohort was used for analyses. Exposure-outcome associations were analyzed through observational and mendelian randomization (MR) analyses.<\/p>\n\n\n\n

Exposures<\/strong>  BMI, FMI, and WHR.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  All-cause and cause-specific (cancer, cardiovascular disease [CVD], respiratory disease, or other causes) mortality.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0There were 387\u202f672 and 50\u202f594 participants in our observational (mean [SD] age, 56.9 [8.0] years; 177\u202f340 [45.9%] male, 210\u202f332 [54.2%], female), and MR (mean [SD] age, 61.6 [6.2] years; 30\u202f031 [59.3%] male, 20\u202f563 [40.6%], female) analyses, respectively. Associations between measured BMI and FMI with all-cause mortality were J-shaped, whereas the association of WHR with all-cause mortality was linear using the hazard ratio (HR) scale (HR per SD increase of WHR, 1.41 [95% CI, 1.38-1.43]). Genetically determined WHR had a stronger association with all-cause mortality than BMI (odds ratio [OR] per SD increase of WHR, 1.51 [95% CI, 1.32-1.72]; OR per SD increase of BMI, 1.29 [95% CI, 1.20-1.38];\u00a0P\u00a0<\/em>for heterogeneity\u2009=\u2009.02). This association was stronger in male than female participants (OR, 1.89 [95% CI, 1.54-2.32];\u00a0P\u00a0<\/em>for heterogeneity\u2009=\u2009.01). Unlike BMI or FMI, the genetically determined WHR\u2013all-cause mortality association was consistent irrespective of observed BMI.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this cohort study, WHR had the strongest and most consistent association with mortality irrespective of BMI. Clinical recommendations should consider focusing on adiposity distribution compared with mass.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Diabetes and Endocrinology […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24781"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24781"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24781\/revisions"}],"predecessor-version":[{"id":25047,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24781\/revisions\/25047"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24781"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24781"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24781"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}