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

Christakoudi S 1 , Tsilidis KK 2 , Muller DC 2 , Freisling H 3 , Weiderpass E 3 , Overvad K 4 Show all authors , Söderberg S 5 , Häggström C 6 , Pischon T 7 , Dahm CC 4 , Zhang J 4 , Tjønneland A 8 , Halkjær J 8 , MacDonald C 9 , Boutron-Ruault MC 9 , Mancini FR 9 , Kühn T 10 , Kaaks R 10 , Schulze MB 11 , Trichopoulou A 12 , Karakatsani A 12 , Peppa E 12 , Masala G 13 , Pala V 14 , Panico S 15 , Tumino R 16 , Sacerdote C 17 , Quirós JR 18 , Agudo A 19 , Sánchez MJ 20 , Cirera L 21 , Barricarte-Gurrea A 21 , Amiano P 21 , Memarian E 22 , Sonestedt E 23 , Bueno-de-Mesquita B 2 , May AM 24 , Khaw KT 25 , Wareham NJ 26 , Tong TYN 27 , Huybrechts I 3 , Noh H 3 , Aglago EK 3 , Ellingjord-Dale M 2 , Ward HA 2 , Aune D 2 , Riboli E 2

Affiliations 

  • 1 Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK. s.christakoudi@imperial.ac.uk
  • 2 Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, St Mary's Campus, London, W2 1PG, UK
  • 3 International Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372, Lyon CEDEX 08, France
  • 4 Department of Public Health, Aarhus University, DK-8000, Aarhus, Denmark
  • 5 Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
  • 6 Department of Biobank Research, Umeå University, Umeå, Sweden
  • 7 Max Delbrück Center for Molecular Medicine, 13125, Berlin, Germany
  • 8 Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen Ø, Denmark
  • 9 Centre de recherche en Epidemiologie et Sante des Populations (CESP), Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
  • 10 German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
  • 11 Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  • 12 Hellenic Health Foundation, Athens, Greece
  • 13 Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
  • 14 Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian, 1, 20133, Milan, Italy
  • 15 Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
  • 16 Cancer Registry and Histopathology Department, Azienda Sanitaria Provinciale Ragusa (ASP), Ragusa, Italy
  • 17 Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
  • 18 Public Health Directorate, Asturias, Spain
  • 19 Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
  • 20 Andalusian School of Public Health (EASP), Granada, Spain
  • 21 CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
  • 22 Dept. Clinical Sciences, Skane University Hospital, Lund University, 20502, Malmö, Sweden
  • 23 Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
  • 24 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, STR 6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
  • 25 School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 2QQ, UK
  • 26 MRC Epidemiology Unit, Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
  • 27 Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
Sci Rep, 2020 Sep 03;10(1):14541.
PMID: 32883969 DOI: 10.1038/s41598-020-71302-5

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 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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