Bohmann Patricia, Stein Michael J, Weber Andrea, Konzok Julian, Fontvieille Emma, Peruchet-Noray Laia, Gan Quan, Fervers Béatrice, Viallon Vivian, Baurecht Hansjörg, Leitzmann Michael F, Freisling Heinz, Sedlmeier Anja M
From the Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
International Agency for Research on Cancer (IARC), Nutrition and Metabolism Branch, Lyon, France.
Epidemiology. 2025 Mar 1;36(2):264-274. doi: 10.1097/EDE.0000000000001810. Epub 2024 Nov 13.
Individual traditional anthropometric measures such as body mass index and waist circumference may not fully capture the relation of adiposity to mortality. Investigating multitrait body shapes could overcome this limitation, deepening insights into adiposity and mortality.
Using UK Biobank data from 462,301 adults (40-69 years at baseline: 2006-2010), we derived four body shapes from principal component analysis on body mass index, height, weight, waist and hip circumference, and waist-to-hip ratio. We then used multivariable-adjusted Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between body shapes and mortality for principal component scores of +1 and -1.
During 6,114,399 person-years of follow-up, 28,807 deaths occurred. A generally obese body shape exhibited a U-shaped mortality association. A tall and centrally obese body shape showed increased mortality risk in a dose-response manner (comparing a score of +1 and 0: HR = 1.16, 95% CI = 1.14, 1.18). Conversely, tall and lean or athletic body shapes displayed no increased mortality risks when comparing a score of +1 and 0, with positive relations for the comparison between a score of -1 and 0 in these shapes (short and stout shape: HR = 1.12, 95% CI = 1.10, 1.14; nonathletic shape: HR = 1.15, 95% CI = 1.13, 1.17).
Four distinct body shapes, reflecting heterogeneous expressions of obesity, were differentially associated with all-cause and cause-specific mortality. Multitrait body shapes may refine our insights into the associations between different adiposity subtypes and mortality.
个体传统人体测量指标,如体重指数和腰围,可能无法完全反映肥胖与死亡率之间的关系。研究多特征体型可克服这一局限性,加深对肥胖与死亡率的理解。
利用英国生物银行中462301名成年人(基线年龄40 - 69岁:2006 - 2010年)的数据,我们通过对体重指数、身高、体重、腰围、臀围和腰臀比进行主成分分析得出四种体型。然后,我们使用多变量调整的Cox比例风险模型来估计主成分得分分别为 +1和 -1时体型与死亡率之间关联的风险比(HR)和95%置信区间(CI)。
在6114399人年的随访期间,发生了28807例死亡。总体肥胖体型呈现U型死亡率关联。高且中心性肥胖体型的死亡风险呈剂量反应增加(比较得分 +1和0:HR = 1.16,95% CI = 1.14,1.18)。相反,高且瘦或运动型体型在比较得分 +1和0时未显示死亡风险增加,而在这些体型中得分 -1和0的比较呈正相关(矮胖体型:HR = 1.12,95% CI = 1.10,1.14;非运动型体型:HR = 1.15,95% CI = 1.13,1.17)。
四种不同的体型反映了肥胖的异质性表现,与全因死亡率和特定病因死亡率存在不同关联。多特征体型可能会深化我们对不同肥胖亚型与死亡率之间关联的认识。