BMI, waist circumference, and waist-to-hip trajectories and all-cause, CVD, and cancer mortality by sex in people without diabetes.

OBJECTIVES

We examined the associations of BMI, waist circumference, and waist-to-hip ratio trajectories with mortality in people without diabetes.

METHODS

We analyzed 7601 people without diabetes from the Atherosclerosis Risk in Communities Study. We used latent class analysis to identify trajectory patterns for BMI, waist circumference, and waist-to-hip. We employed propensity score matching to enhance the balance of covariates and used Cox proportional hazards regression models to examine the associations.

RESULTS

In females, the high trajectory of BMI was associated with higher cancer mortality risks than the low group, with the hazard ratio and 95% confidence interval of 1.76 (1.14-2.73). The high waist circumference trajectory was related to increased all-cause, CVD, and cancer mortality risks in males. The moderate and high waist-to-hip ratio trajectories were associated with elevated all-cause and CVD mortality risks in females, and the high trajectory was associated with high all-cause mortality risks in males. The mean lifespan of deceased females did not significantly differ across the trajectories. However, the mean lifespan of males in the waist circumference high group (73.0 years) was shorter than the low group (75.3 years).

CONCLUSIONS

Sex differences were observed in the long-term impact of high BMI, waist circumference, and waist-to-hip ratio on mortality risks and lifespan in people without diabetes.