title: Waist circumference as compared with body-mass index in predicting mortality from specific causes.
abstract: BACKGROUND
  Whether waist circumference provides clinically meaningful information not delivered by body-mass index regarding prediction of cause-specific death is uncertain.
  
  
  METHODS
  We prospectively examined waist circumference (WC) and body-mass index (BMI) in relation to cause-specific death in 225,712 U.S. women and men. Cox regression was used to estimate relative risks and 95% confidence intervals (CI). Statistical analyses were conducted using SAS version 9.1.
  
  
  RESULTS
  During follow-up from 1996 through 2005, we documented 20,977 deaths. Increased WC consistently predicted risk of death due to any cause as well as major causes of death, including deaths from cancer, cardiovascular disease, and non-cancer/non-cardiovascular diseases, independent of BMI, age, sex, race/ethnicity, smoking status, and alcohol intake. When WC and BMI were mutually adjusted in a model, WC was related to 1.37 fold increased risk of death from any cancer and 1.82 fold increase risk of death from cardiovascular disease, comparing the highest versus lowest WC categories. Importantly, WC, but not BMI showed statistically significant positive associations with deaths from lung cancer and chronic respiratory disease. Participants in the highest versus lowest WC category had a relative risk of death from lung cancer of 1.77 (95% CI, 1.41 to 2.23) and of death from chronic respiratory disease of 2.77 (95% CI, 1.95 to 3.95). In contrast, subjects in the highest versus lowest BMI category had a relative risk of death from lung cancer of 0.94 (95% CI, 0.75 to 1.17) and of death from chronic respiratory disease of 1.18 (95% CI, 0.89 to 1.56).
  
  
  CONCLUSIONS
  Increased abdominal fat measured by WC was related to a higher risk of deaths from major specific causes, including deaths from lung cancer and chronic respiratory disease, independent of BMI.
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, United States of America. michael.leitzmann@klinik.uni-regensburg.de
authors.forename: Michael F
authors.initials: MF
authors.lastname: Leitzmann
authors.forename: Steven C
authors.initials: SC
authors.lastname: Moore
authors.forename: Annemarie
authors.initials: A
authors.lastname: Koster
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Albert
authors.initials: A
authors.lastname: Hollenbeck
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D009369:Neoplasms / Q000401:mortality; D012307:Risk Factors; D055105:Waist Circumference / Q000502:physiology*