A New Body Shape Index Predicts Mortality Hazard Independently of Body Mass Index
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{"title"=>"A new body shape index predicts mortality hazard independently of body mass index", "type"=>"journal", "authors"=>[{"first_name"=>"Nir Y.", "last_name"=>"Krakauer", "scopus_author_id"=>"6506316395"}, {"first_name"=>"Jesse C.", "last_name"=>"Krakauer", "scopus_author_id"=>"7003596904"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84864008927", "doi"=>"10.1371/journal.pone.0039504", "sgr"=>"84864008927", "isbn"=>"10.1371/journal.pone.0039504", "pmid"=>"22815707", "issn"=>"19326203", "pui"=>"365274719"}, "id"=>"8a3d7b8c-ba7b-36b3-9797-666ffc2c5497", "abstract"=>"BACKGROUND: Obesity, typically quantified in terms of Body Mass Index (BMI) exceeding threshold values, is considered a leading cause of premature death worldwide. For given body size (BMI), it is recognized that risk is also affected by body shape, particularly as a marker of abdominal fat deposits. Waist circumference (WC) is used as a risk indicator supplementary to BMI, but the high correlation of WC with BMI makes it hard to isolate the added value of WC. METHODS AND FINDINGS: We considered a USA population sample of 14,105 non-pregnant adults (age ≥ 18) from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 with follow-up for mortality averaging 5 yr (828 deaths). We developed A Body Shape Index (ABSI) based on WC adjusted for height and weight: ABSI ≡ WC/(BMI(2/3)height(1/2)). ABSI had little correlation with height, weight, or BMI. Death rates increased approximately exponentially with above average baseline ABSI (overall regression coefficient of +33% per standard deviation of ABSI [95% confidence interval: +20%-+48%), whereas elevated death rates were found for both high and low values of BMI and WC. 22% (8%-41%) of the population mortality hazard was attributable to high ABSI, compared to 15% (3%-30%) for BMI and 15% (4%-29%) for WC. The association of death rate with ABSI held even when adjusted for other known risk factors including smoking, diabetes, blood pressure, and serum cholesterol. ABSI correlation with mortality hazard held across the range of age, sex, and BMI, and for both white and black ethnicities (but not for Mexican ethnicity), and was not weakened by excluding deaths from the first 3 yr of follow-up. CONCLUSIONS: Body shape, as measured by ABSI, appears to be a substantial risk factor for premature mortality in the general population derivable from basic clinical measurements. ABSI expresses the excess risk from high WC in a convenient form that is complementary to BMI and to other known risk factors.", "link"=>"http://www.mendeley.com/research/new-body-shape-index-predicts-mortality-hazard-independently-body-mass-index", "reader_count"=>237, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>21, "Librarian"=>3, "Researcher"=>47, "Student > Doctoral Student"=>17, "Student > Ph. D. Student"=>27, "Student > Postgraduate"=>10, "Other"=>18, "Student > Master"=>39, "Student > Bachelor"=>31, "Lecturer"=>5, "Lecturer > Senior Lecturer"=>2, "Professor"=>14}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>21, "Librarian"=>3, "Researcher"=>47, "Student > Doctoral Student"=>17, "Student > Ph. D. 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  • {"files"=>["https://ndownloader.figshare.com/files/609001"], "description"=>"<p>Results of Cox proportional hazard modeling for mortality risk with ABSI, BMI, or WC z scores taken as linear predictors. Ranges in parentheses are 95% confidence intervals. The restricted models are unadjusted but included only those people who had all the measurements required for the adjusted model. The adjusted models included as additional predictors sex, ethnicity, smoking, presence of diabetes, blood pressure, and serum cholesterol.</p><p>SD  =  standard deviation.</p>", "links"=>[], "tags"=>["scores"], "article_id"=>279500, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504.t002", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Body_size_and_shape_z_scores_and_mortality_hazard_/279500", "title"=>"Body size and shape z scores and mortality hazard.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-18 02:38:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/608578"], "description"=>"<p>Markers show the sample quantities for each age; the smooth curves shown were used to convert values to z scores. Units are for ABSI, for BMI, and for WC.</p>", "links"=>[], "tags"=>["deviation", "wc"], "article_id"=>279081, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504.g001", "stats"=>{"downloads"=>4, "page_views"=>20, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Mean_and_standard_deviation_of_ABSI_BMI_and_WC_by_age_and_sex_/279081", "title"=>"Mean and standard deviation of ABSI, BMI, and WC by age and sex.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-07-18 02:31:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/317005"], "description"=>"<div><h3>Background</h3><p>Obesity, typically quantified in terms of Body Mass Index (BMI) exceeding threshold values, is considered a leading cause of premature death worldwide. For given body size (BMI), it is recognized that risk is also affected by body shape, particularly as a marker of abdominal fat deposits. Waist circumference (WC) is used as a risk indicator supplementary to BMI, but the high correlation of WC with BMI makes it hard to isolate the added value of WC.</p> <h3>Methods and Findings</h3><p>We considered a USA population sample of 14,105 non-pregnant adults () from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 with follow-up for mortality averaging 5 yr (828 deaths). We developed A Body Shape Index (ABSI) based on WC adjusted for height and weight:</p><p></p><p></p> <p>ABSI had little correlation with height, weight, or BMI. Death rates increased approximately exponentially with above average baseline ABSI (overall regression coefficient of per standard deviation of ABSI [95% confidence interval: –]), whereas elevated death rates were found for both high and low values of BMI and WC. (–) of the population mortality hazard was attributable to high ABSI, compared to (–) for BMI and (–) for WC. The association of death rate with ABSI held even when adjusted for other known risk factors including smoking, diabetes, blood pressure, and serum cholesterol. ABSI correlation with mortality hazard held across the range of age, sex, and BMI, and for both white and black ethnicities (but not for Mexican ethnicity), and was not weakened by excluding deaths from the first 3 yr of follow-up.</p> <h3>Conclusions</h3><p>Body shape, as measured by ABSI, appears to be a substantial risk factor for premature mortality in the general population derivable from basic clinical measurements. ABSI expresses the excess risk from high WC in a convenient form that is complementary to BMI and to other known risk factors.</p> </div>", "links"=>[], "tags"=>["independently"], "article_id"=>122583, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504", "stats"=>{"downloads"=>12, "page_views"=>32, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/A_New_Body_Shape_Index_Predicts_Mortality_Hazard_Independently_of_Body_Mass_Index/122583", "title"=>"A New Body Shape Index Predicts Mortality Hazard Independently of Body Mass Index", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-18 00:43:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/608854"], "description"=>"<p>Estimates are from proportional hazard modeling where log mortality hazard is a smoothing-spline function in ABSI, BMI, or WC. Dashed curves show 95% confidence intervals. Corresponding population percentiles are given in the top axis; the range shown is the 1st through 99th percentiles. The vertical axis is logarithmic. This is the same as <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039504#pone-0039504-g002\" target=\"_blank\">Figure 2</a>, but with ABSI, BMI, or WC, rather than their z scores, used as predictors. Units are for ABSI, for BMI, and for WC.</p>", "links"=>[], "tags"=>["public health and epidemiology", "Non-clinical medicine"], "article_id"=>279352, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504.g004", "stats"=>{"downloads"=>2, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Mortality_hazard_by_ABSI_BMI_and_WC_/279352", "title"=>"Mortality hazard by ABSI, BMI, and WC.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-07-18 02:35:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/608976"], "description"=>"<p>Cox proportional hazard modeling for mortality hazard ratio per unit of ABSI, BMI or WC z score (standard deviation). Ranges in parentheses are 95% confidence intervals. The sign of significant interaction terms is given. High BMI is defined as exceeding the age- and sex-specific population mean.</p>", "links"=>[], "tags"=>["public health and epidemiology", "Non-clinical medicine"], "article_id"=>279479, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504.t003", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Mortality_hazard_by_subgroup_/279479", "title"=>"Mortality hazard by subgroup.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-18 02:37:59"}
  • {"files"=>["https://ndownloader.figshare.com/files/608921"], "description"=>"<p>Results of Cox proportional hazard modeling for mortality risk with ABSI, BMI, or WC, as well as sex, taken as linear predictors. Ranges in parentheses are 95% confidence intervals. The restricted models are unadjusted but included only those people who had all the measurements required for the adjusted model. The adjusted models included as additional predictors ethnicity, smoking, presence of diabetes, blood pressure, and serum cholesterol.</p><p>This is the same as <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0039504#pone-0039504-t002\" target=\"_blank\">Table 2</a>, but with ABSI, BMI, or WC, rather than their z scores, used as predictors.</p><p>SD  =  standard deviation. The population standard deviations used here are for ABSI, for BMI, and for WC.</p>", "links"=>[], "tags"=>["public health and epidemiology", "Non-clinical medicine"], "article_id"=>279416, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504.t005", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Body_size_and_shape_and_mortality_hazard_/279416", "title"=>"Body size and shape and mortality hazard.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-18 02:36:56"}
  • {"files"=>["https://ndownloader.figshare.com/files/608941"], "description"=>"<p>Cox proportional hazard modeling for mortality risk with ABSI, BMI or WC z score quintiles taken as the predictors. Hazard ratios are relative to the middle quintile in each case. Ranges in parentheses are 95% confidence intervals.</p><p>The between-quintile cut points are for ABSI; for BMI; and for WC.</p>", "links"=>[], "tags"=>["public health and epidemiology", "Non-clinical medicine"], "article_id"=>279446, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504.t004", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Mortality_by_quintile_/279446", "title"=>"Mortality by quintile.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-18 02:37:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/609031"], "description"=>"<p>Correlation coefficients between height, weight, BMI, WC, and ABSI among NHANES nonpregnant adults (). Right side (above diagonal) shows correlations of the raw values; left side (below diagonal) shows correlations of the z scores relative to age- and sex-specific means.</p>", "links"=>[], "tags"=>["public health and epidemiology", "Non-clinical medicine"], "article_id"=>279539, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504.t001", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Correlations_between_body_size_and_shape_/279539", "title"=>"Correlations between body size and shape.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-18 02:38:59"}
  • {"files"=>["https://ndownloader.figshare.com/files/608733"], "description"=>"<p>Estimates are from proportional hazard modeling where log mortality hazard is a smoothing-spline function in ABSI, BMI, or WC. Dashed curves show 95% confidence intervals. Corresponding population percentiles are given in the top axis; the range shown is the 1st through 99th percentiles. The vertical axis is logarithmic.</p>", "links"=>[], "tags"=>["wc"], "article_id"=>279236, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504.g002", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Mortality_hazard_by_ABSI_BMI_and_WC_z_score_relative_to_age_and_sex_specific_normals_/279236", "title"=>"Mortality hazard by ABSI, BMI, and WC z score relative to age and sex specific normals.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-07-18 02:33:56"}
  • {"files"=>["https://ndownloader.figshare.com/files/608800"], "description"=>"<p>The ranges of BMI and ABSI shown correspond to the 1st through 99th percentiles. The contour interval is 0.25.</p>", "links"=>[], "tags"=>["bmi", "absi"], "article_id"=>279295, "categories"=>["Medicine", "Biotechnology"], "users"=>["Nir Y. Krakauer", "Jesse C. Krakauer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039504.g003", "stats"=>{"downloads"=>2, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Estimated_mortality_hazard_relative_to_the_population_mean_by_combination_of_BMI_and_ABSI_z_score_/279295", "title"=>"Estimated mortality hazard (relative to the population mean) by combination of BMI and ABSI z score.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-07-18 02:34:55"}

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Relative Metric

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