Anthropometrically-predicted visceral adipose tissue and mortality among men and women in the third national health and nutrition examination survey (NHANES III)

Abstract

Objective: This study seeks to quantify the relationship between anthropometrically-predicted visceral adipose tissue (apVAT) and all-cause and cause-specific mortality among individuals of European descent in a population-based prospective cohort study of 10,624 participants.

Methods: The apVAT with a validated regression equation that included age, body mass index, and waist and thigh circumferences were predicted.

Results: During a median of 18.8 years, 3531 participants died with 1153 and 741 deaths attributable to cardiovascular disease and cancer, respectively. In multivariable-adjusted analyses that accounted for demographic, clinical, and behavioral characteristics, higher apVAT was associated with an increased risk of all-cause (P_trend < .001), cardiovascular-specific (P_trend < .001), and cancer-specific mortality (P_trend = .007). Excluding participants with a history of cancer, myocardial infarction, heart failure, or diabetes at baseline did not substantively alter effect estimates. apVAT more accurately predicted all-cause, cardiovascular-specific, and cancer-specific mortality than body mass index (P < .001), waist circumference (P < .001), or the combination of body mass index and waist circumference (P < .001).

Conclusions: These data provide evidence that apVAT is associated with all-cause and cause-specific mortality in a large population-based sample of men and women of European descent. These results support the use of apVAT to risk-stratify individuals for premature mortality when imaging data are not available such as in routine clinical practice or in large clinical trials.

Keywords: anthropometrics; body mass index; population-based; waist circumference.

Figure 1

Kaplan-Meier survival estimates according to quintile of anthropometrically-predicted visceral adipose tissue for A) all-cause mortality; B) cardiovascular-specific mortality; and C) cancer-specific mortality.