title: Counterintuitive relationship between visceral fat and all-cause mortality in an elderly Asian population.
abstract: OBJECTIVE
  Abdominal obesity is considered to be a risk factor for mortality. However, recent studies indicate that overweight may be negatively associated with mortality ("obesity paradox"). The relationships between mortality and various obesity markers in an elderly Asian cohort were evaluated.
  
  
  METHODS
  Subjects of the Korean Longitudinal Study on Health and Aging (KLoSHA) (n = 1000, age ≥65 years) were included. The visceral fat area (VFA) and subcutaneous fat area (SFA) were measured using computed tomography.
  
  
  RESULTS
  A total of 222 deaths occurred during the 6-year follow-up (median = 5.2 [range 0.1-6.3] years). Body mass index (BMI), VFA, SFA, and total fat mass were negatively associated with all-cause mortality in the univariable analyses (hazard ratio [HR] 0.67 per 1 SD [95% CI 0.57-0.77], 0.66 [0.55-0.79], 0.73 [0.61-0.86], and 0.74 [0.63-0.87], respectively). BMI and VFA were significantly associated with all-cause mortality in the multivariable analyses (HR 0.85 per 1 SD [95% CI 0.73-0.99] and 0.64 [0.47-0.87], respectively). When stratified by quartiles, the HR associated with VFA was the lowest in the third quartile.
  
  
  CONCLUSIONS
  In this observational study with a short follow-up of elderly Asian people, higher amounts of visceral fat, a marker for central obesity, were associated with decreased all-cause mortality.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Korea; Department of Internal Medicine, Konkuk University College of Medicine and Konkuk University Chungju Hospital, Chungju, Korea.
authors.forename: Eun
authors.initials: E
authors.lastname: Shil Hong
authors.forename: Ah Reum
authors.initials: AR
authors.lastname: Khang
authors.forename: Eun
authors.initials: E
authors.lastname: Roh
authors.forename: Eu
authors.initials: E
authors.lastname: Jeong Ku
authors.forename: Ye
authors.initials: Y
authors.lastname: An Kim
authors.forename: Kyoung
authors.initials: K
authors.lastname: Min Kim
authors.forename: Jae
authors.initials: J
authors.lastname: Hoon Moon
authors.forename: Sung
authors.initials: S
authors.lastname: Hee Choi
authors.forename: Kyong
authors.initials: K
authors.lastname: Soo Park
authors.forename: Ki
authors.initials: K
authors.lastname: Woong Kim
authors.forename: Hak
authors.initials: H
authors.lastname: Chul Jang
authors.forename: Soo
authors.initials: S
authors.lastname: Lim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008137:Longitudinal Studies; D008297:Male; D056128:Obesity, Abdominal / Q000401:mortality*; D050177:Overweight / Q000000981:diagnostic imaging / Q000401:mortality; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed