Health and mortality consequences of abdominal obesity: evidence from the AusDiab study.
OBJECTIVE
To provide an estimate of the morbidity and mortality resulting from abdominal overweight and obesity in the Australian population.


METHODS
Prospective, national, population-based study (the Australian Diabetes, Obesity and Lifestyle [AusDiab] study).


METHODS
6072 men and women aged>or=25 years at study entry between May 1999 and December 2000, and aged<or=75 years, not pregnant and for whom there were waist circumference data at the follow-up survey between June 2004 and December 2005.


METHODS
Incident health outcomes (type 2 diabetes, hypertension, dyslipidaemia, the metabolic syndrome and cardiovascular diseases) at 5 years and mortality at 8 years. Comparison of outcome measures between those classified as abdominally overweight or obese and those with a normal waist circumference at baseline, and across quintiles of waist circumference, and (for mortality only) waist-to-hip ratio.


RESULTS
Abdominal obesity was associated with odds ratios of between 2 and 5 for incident type 2 diabetes, dyslipidaemia, hypertension and the metabolic syndrome. The risk of myocardial infarction among obese participants was similarly increased in men (hazard ratio [HR], 2.75; 95% CI, 1.08-7.03), but not women (HR, 1.43; 95% CI, 0.37-5.50). Abdominal obesity-related population attributable fractions for these outcomes ranged from 13% to 47%, and were highest for type 2 diabetes. No significant associations were observed between all-cause mortality and increasing quintiles of abdominal obesity.


CONCLUSIONS
Our findings confirm that abdominal obesity confers a considerably heightened risk for type 2 diabetes, the metabolic syndrome (as well as its components) and cardiovascular disease, and they provide important information that enables a more precise estimate of the burden of disease attributable to obesity in Australia.
Cameron
Adrian J
AJ
Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia. Adrian.Cameron@bakeridi.edu.au
Dunstan
David W
DW
Owen
Neville
N
Zimmet
Paul Z
PZ
Barr
Elizabeth L M
EL
Tonkin
Andrew M
AM
Magliano
Dianna J
DJ
Murray
Shirley G
SG
Welborn
Timothy A
TA
Shaw
Jonathan E
JE
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D050171:Dyslipidemias / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D019317:Evidence-Based Medicine; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D049629:Waist-Hip Ratio