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

Abstract

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. The apVAT with a validated regression equation that included age, body mass index, and waist and thigh circumferences were predicted. 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 (Ptrend < .001), cardiovascular-specific (Ptrend < .001), and cancer-specific mortality (Ptrend = .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). 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.