title: Prospective study on waist circumference and risk of all-cause and cardiovascular mortality: pooled analysis of Japanese community-based studies.
abstract: BACKGROUND
  The aim of the present study was to clarify the association between waist circumference and all-cause and cardiovascular disease (CVD) mortality risk in relatively lean Japanese subjects.
  
  
  RESULTS
  A total of 3,554 men and 4,472 women who had no history of CVD were examined and their waist circumference measured at baseline. The subjects were aged ≥40 years and were obtained from 3 prospective cohort studies during 1988-1996. Hazard ratios for all-cause and CVD mortality were analyzed over a follow-up period of 14.7 years using a Cox proportional hazards model and penalized spline method, after adjustment for study cohort, age, smoking, alcohol drinking, hypertension, dyslipidemia, and diabetes. Compared with the lowest quintile, the highest quintile of waist circumference in men was associated with a linear reduction in all-cause mortality risk (multivariate-adjusted hazard ratio, 0.73; 95% confidence interval: 0.60-0.89; P for trend=0.001). CVD mortality risk was increased in men aged ≤65 years with a higher waist circumference. This relationship was U-shaped. Waist circumference was not associated with all-cause or CVD mortality risk in women.
  
  
  CONCLUSIONS
  Waist circumference was associated inversely with increased risk of all-cause death in men, but not in women. Middle-aged men with a greater waist circumference potentially have an increased risk of CVD mortality.
authors.affiliation: Department of Public Health, Social Medicine and Medical Informatics, Ehime University Graduate School of Medicine, Toon, Japan. saitoi@m.ehime-u.ac.jp
authors.forename: Isao
authors.initials: I
authors.lastname: Saito
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kokubo
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Saitoh
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000367:Age Factors; D000368:Aged; D044466:Asian People; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017711:Nonlinear Dynamics; D009765:Obesity / Q000208:ethnology / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D055105:Waist Circumference / Q000208:ethnology