JOURNAL ARTICLE

Health and mortality consequences of abdominal obesity: evidence from the AusDiab study

Adrian J Cameron, David W Dunstan, Neville Owen, Paul Z Zimmet, Elizabeth L M Barr, Andrew M Tonkin, Dianna J Magliano, Shirley G Murray, Timothy A Welborn, Jonathan E Shaw
Medical Journal of Australia 2009 August 17, 191 (4): 202-8
19705980

OBJECTIVE: To provide an estimate of the morbidity and mortality resulting from abdominal overweight and obesity in the Australian population.

DESIGN AND SETTING: Prospective, national, population-based study (the Australian Diabetes, Obesity and Lifestyle [AusDiab] study).

PARTICIPANTS: 6072 men and women aged>or=25 years at study entry between May 1999 and December 2000, and aged<or=75 years, not pregnant and for whom there were waist circumference data at the follow-up survey between June 2004 and December 2005.

MAIN OUTCOME MEASURES: Incident health outcomes (type 2 diabetes, hypertension, dyslipidaemia, the metabolic syndrome and cardiovascular diseases) at 5 years and mortality at 8 years. Comparison of outcome measures between those classified as abdominally overweight or obese and those with a normal waist circumference at baseline, and across quintiles of waist circumference, and (for mortality only) waist-to-hip ratio.

RESULTS: Abdominal obesity was associated with odds ratios of between 2 and 5 for incident type 2 diabetes, dyslipidaemia, hypertension and the metabolic syndrome. The risk of myocardial infarction among obese participants was similarly increased in men (hazard ratio [HR], 2.75; 95% CI, 1.08-7.03), but not women (HR, 1.43; 95% CI, 0.37-5.50). Abdominal obesity-related population attributable fractions for these outcomes ranged from 13% to 47%, and were highest for type 2 diabetes. No significant associations were observed between all-cause mortality and increasing quintiles of abdominal obesity.

CONCLUSIONS: Our findings confirm that abdominal obesity confers a considerably heightened risk for type 2 diabetes, the metabolic syndrome (as well as its components) and cardiovascular disease, and they provide important information that enables a more precise estimate of the burden of disease attributable to obesity in Australia.

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