Risk of Mortality According to Body Mass Index and Body Composition Among Postmenopausal Women.
Obesity, often defined as a body mass index (BMI; weight (kg)/height (m)(2)) of 30 or higher, has been associated with mortality, but age-related body composition changes can be masked by stable BMI. A subset of Women's Health Initiative participants (postmenopausal women aged 50-79 years) enrolled between 1993 and 1998 who had received dual-energy x-ray absorptiometry scans for estimation of total body fat (TBF) and lean body mass (LBM) (n = 10,525) were followed for 13.6 (standard deviation, 4.6) years to test associations between BMI, body composition, and incident mortality. Overall, BMI ≥35 was associated with increased mortality (adjusted hazard ratio (HR) = 1.45, 95% confidence interval (CI): 1.16, 1.82), while TBF and LBM were not. However, an interaction between age and body composition (P < 0.001) necessitated age stratification. Among women aged 50-59 years, higher %TBF increased risk of death (HR = 2.44, 95% CI: 1.38, 4.34) and higher %LBM decreased risk of death (HR = 0.41, 95% CI: 0.23, 0.74), despite broad-ranging BMIs (16.4-69.1). However, the relationships were reversed among women aged 70-79 years (P < 0.05). BMI did not adequately capture mortality risk in this sample of postmenopausal women. Our data suggest the clinical utility of evaluating body composition by age group to more robustly assess mortality risk among postmenopausal women.
Jennifer W
JW
Bea
Cynthia A
CA
Thomson
Betsy C
BC
Wertheim
J Skye
JS
Nicholas
Kacey C
KC
Ernst
Chengcheng
C
Hu
Rebecca D
RD
Jackson
Jane A
JA
Cauley
Cora E
CE
Lewis
Bette
B
Caan
Denise J
DJ
Roe
Zhao
Z
Chen
D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008875:Middle Aged; D009026:Mortality; D017698:Postmenopause; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology
body fat; body mass index; death; lean body mass; menopause