title: A comparison of adiposity measures as predictors of all-cause mortality: the Melbourne Collaborative Cohort Study.
abstract: OBJECTIVE
  Our goal was to examine five different measures of adiposity as predictors of all-cause mortality.
  
  
  METHODS
  Subjects were 16,969 men and 24,344 women enrolled between 1990 and 1994 in the Melbourne Collaborative Cohort Study (27 to 75 years of age). There were 2822 deaths over a median follow-up period of 11 years. BMI, waist circumference, and waist-to-hip ratio were obtained from direct anthropometric measurements. Fat mass and percentage fat were estimated by bioelectric impedance analysis.
  
  
  RESULTS
  Comparing the top quintile with the second quintile, for men there was an increased risk of between 20% and 30% for all-cause mortality associated with each of the anthropometric measures. For women, there was an increased risk of 30% (95% confidence interval for hazard ratio, 1.1-1.6) observed for waist circumference and 50% (1.2-1.8) for waist-to-hip ratio, but little or no increased risk for BMI, fat mass, and percentage fat. Waist-to-hip ratio was positively and monotonically associated with all-cause mortality for both men and women. There was a linear association between waist circumference and all-cause mortality for men, whereas a U-shaped association was observed for women.
  
  
  CONCLUSIONS
  Measures of central adiposity were better predictors of mortality in women in the Melbourne Collaborative Cohort Study compared with measures of overall adiposity. We recommend measuring waist and hip circumferences in population studies investigating the risk of all-cause mortality associated with obesity. The use of additional measures such as bioelectric impedance is not justified for this outcome.
authors.affiliation: Cancer Epidemiology Centre, Council Council Victoria, and Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Level 2/723 Swanston St., Carlton, Victoria 3053, Australia. julieas@unimelb.edu.au
authors.forename: Julie A
authors.initials: JA
authors.lastname: Simpson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: MacInnis
authors.forename: Anna
authors.initials: A
authors.lastname: Peeters
authors.forename: John L
authors.initials: JL
authors.lastname: Hopper
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Dallas R
authors.initials: DR
authors.lastname: English
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D001315:Australia; D015992:Body Mass Index; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016016:Proportional Hazards Models; D012306:Risk; D049629:Waist-Hip Ratio