Visceral obesity is not an independent risk factor of mortality in subjects over 65 years

Figures & data

Table 1 Population characteristics (mean ± SEM for quantitative variable and % [n] for dichotomous variables), according to age groups

	Men				Women
	<55 years	55–65 years	>65 years	P-value	<55 years	55–65 years	>65 years	P-value
N	63,365	12,876	3,084		28,649	7,799	3,317
Age (years)	40.7±8.7	58.5±2.7	68.9±3.3		39.3 (10.1)	58.9 (2.7)	69.3 (3.3)
Weight (kg)	78.2±11.8	78.9±11.7	77.4±11.3	<0.0001	65.3±12.2	65.5±11.3	64.8±11.0	0.002
Height (cm)	175.2±6.9	172.3±6.7	170.4±6.7	<0.0001	161.9±6.5	159.7±6.1	157.3±6.2	<0.0001
BMI (kg/m^2)	25.4±3.4	26.5±3.5	26.6±3.4	<0.0001	24.9 (4.5)	25.7±4.3	26.2±4.3	<0.0001
BMI >30 kg/m^2, % (n)	9.6 (6,086)	14.8 (1,906)	16.0 (493)	<0.0001	12.9 (3,701)	14.8 (1,157)	16.7 (553)	<0.0001
Waist circumference (cm)	88.3±9.9	93.5±9.8	95.2±10.0	<0.0001	77.5±10.7	81.0±10.9	83.9±11.2	<0.0001
Waist circumference high, % (n)*	9.6 (6,100)	19.1 (2,468)	25.8 (797)	<0.0001	15.9 (4,564)	23.6 (1,839)	33.0 (1,096)	<0.0001
Hypertension, % (n)	26.9 (17,065)	52.4 (6,742)	65.6 (2,024)	<0.0001	17.6 (5,040)	45.4 (3,544)	64.6 (2,144)	<0.0001
Treated hypertension, % (n)	1.7 (1,088)	9.2 (1,189)	19.6 (604)	<0.0001	2.9 (828)	12.8 (996)	22.94 (761)	<0.0001
SBP (mmHg)	130.1±16.4	140.2±19.6	146.3±20.9	<0.0001	122.7±17.3	136.6±20.4	147.1±22.2	<0.0001
DBP (mmHg)	77.6±11.7	84.6±11.7	84.39±11.6	<0.0001	74.1±11.2	79.4±11.7	80.9±12.0	<0.0001
Total cholesterol (mg/dL)	211.4±0.2	224.5±0.4	218.7±0.73	<0.0001	200.8±0.24	232.0±0.5	235.9±0.7	<0.0001
LDL cholesterol (mg/dL)	134.5±0.1	143.5±0.3	138.0±0.7	<0.0001	118.±0.2	141.3±0.4	143.8±0.6	<0.0001
HDL cholesterol (mg/dL)	55.3±13.8	57.2±14.4	58,1±14,6	<0.0001	66.1±16.5	71.5±17.6	71.6±17.5	<0.0001
Triglycerides (mg/dL)	108.1±67.5	118.8±71.9	113.3±59.7	<0.0001	79.3±40.1	96.0±47.8	102.2±48.0	<0.0001
Diabetes, % (n)	1.9 (1208)	7.1 (918)	11.2 (345)	<0.0001	1.5 (417)	3.7 (292)	5.67 (188)	<0.0001
Treated diabetes, % (n)	0.4 (255)	2.6 (333)	6.6 (202)	<0.0001	0.8 (230)	2.0 (157)	3.7 (121)	<0.0001
Fasting blood glucose (mg/dL)	96.8±15.1	103.8±23.2	106.1±27.6	<0.0001	90.9±13.8	97.0±17.7	99.4±20.3	<0.0001
Previous CV event, % (n)	0.42 (265)	1.65 (212)	4.80 (148)	<0.0001	0.46 (132)	1.36 (106)	2.14 (71)	<0.0001
Previous myocardial infarction, % (n)	0.13 (82)	0.87 (112)	2.92 (90)	<0.0001	0.09 (26)	0.21 (16)	0.69 (23)	<0.0001
Previous stroke, % (n)	0.29 (184)	0.81 (104)	2.01 (62)	<0.0001	0.38 (109)	1.15 (90)	1.48 (49)	<0.0001
EKG changes, % (n)	6.2 (3,843)	12.0 (1,515)	23.0 (681)	<0.0001	4.7 (1,299)	9.8 (744)	17.4 (560)	<0.0001
Current smoker, % (n)	35.4 (22,454)	25.0 (3,217)	15.5 (479)	<0.0001	27.3 (7,822)	14.2 (1,109)	8,53 (283)	<0.0001
Physical activity, % (n)	45.7 (28,982)	47.0 (6,055)	55.9 (1,725)	<0.0001	40.6 (11,626)	46.7 (3,560)	49.2 (1,631)	<0.0001
High socioprofessional category, % (n)	42.4 (26,888)	48.6 (6,256)	58.0 (1,787)	<0.0001	17.5 (5,008)	24.6 (1,916)	25.9 (857)	<0.0001
Total mortality, % (n)	0.77 (489)	2.11 (272)	6.26 (193)	<0.0001	0.34 (97)	1.21 (94)	3.44 (114)	<0.0001

Notes: Comparisons between age groups were performed using ANOVA for quantitative variables and chi-square tests for dichotomous variables

* ≥102 cm in men and ≥88cm in women.

Abbreviations: ANOVA, analysis of variance; BMI, body mass index; CV, cardiovascular; DBP, diastolic blood pressure; EKG; electrocardiogram; HDL, high-density lipoprotein; LDL, low-density lipoprotein; SBP, systolic blood pressure; SEM, standard error of the mean.

Figure 1 Unadjusted rates for all-cause mortality in (A) women and (B) men, according to BMI and WC categories, in the entire study population.

Note: In men with a WC >102 cm and a BMI of 20–24.9 kg/m², mortality was 8.2% (4/49 participants) (data not shown).
Abbreviations: BMI, body mass index; WC, waist circumference.

Figure 2 Mortality rates (%), according to WC and BMI, in individuals (A) <55 years, (B) 55–65 years, and (C) >65 years.

Notes: WC classification was sex-specified. For men, WC1: <94 cm; WC2: 94–101 cm; WC3: ≥102 cm. For women, WC1: <80 cm; WC2: 80–87 cm; WC3: ≥88 cm. P-values indicate the effect of WC in each BMI group.
Abbreviations: BMI, body mass index; WC, waist circumference.

Table 2 All-cause mortality associated with obesity and related risk factors, according to age

	<55 years	55–65 years	>65 years
BMI (kg/m^2)	1.007 (0.985–1.030)	1.011 (0.983–1.040)	1.030 (0.998–1.062)
WC (cm)	1.012 (1.004–1.020)*	1.011 (1.000–1.021)*	1.012 (1.001–1.023)*
BMI adjusted for WC (kg/m^2)	0.943 (0.908–0.979)*	0.960 (0.913–1.009)	1.007 (0.957–1.059)
WC adjusted for BMI (cm)	1.030 (1.016–1.043)**	1.023 (1.005–1.042)*	1.010 (0.993–1.028)
Age (years)	1.079 (1.066–1.092)**	1.063 (1.023–1.104)*	1.103 (1.074–1.133)**
Female sex	0.671 (0.518–0.870)*	0.912 (0.664–1.252)	0.720 (0.521–0.995)*
Current smoker (yes/no)	1.580 (1.204–2.072)**	1.794 (1.577–2.042)**	1.33 (1.138–1.555)*
Hypertension (yes/no)	1.717 (1.442–2.042)**	1.494 (1.196–1.865)*	1.313 (1.012–1.705)*
Total cholesterol (mg/dL)	0.999 (0.997–1.001)	1.000 (0.997–1.002)	0.997 (0.994–1.001)
Triglycerides (mg/dL)	1.000 (0.999–1.002)	0.999 (0.998–1.001)	1.001 (0.998–1.003)
Diabetes (yes/no)	1.397 (0.955–2.042)	1.654 (1.172–2.336)*	1.038 (0.689–1.565)
High socioprofessional category (yes/no)	0.576 (0.511–0.649)**	0.874 (0.759–1.007)	1.049 (0.859–1.281)

Notes: Mortality was analyzed using multiple Cox regression models. Data are expressed as hazard ratios (95% confidence intervals). For nonbinary variables, the hazard ratio corresponds to the change in risk per unit (specified in parentheses) of the variable. The model included age, sex, diabetes, hypertension, total cholesterol and triglycerides, current smoking, socioprofessional category, physical activity, and family history of CV disease and diabetes.

* P<0.05

** P<0.0001.

Abbreviations: BMI, body mass index; WC, waist circumference.