BMI As Predictor of CVD Risk May Be More Susceptible to Bias
FRIDAY, March 16, 2018 -- The J-shaped correlation seen for body mass index (BMI) with cardiovascular disease (CVD) risk is susceptible to confounding due to pre-existing comorbidities, according to a study published online March 15 in the European Heart Journal.
Stamatina Iliodromiti, M.D., from the University of Glasgow in the United Kingdom, and colleagues examined the correlations between body composition with incident CVD outcomes in a cohort of 296,535 healthy individuals of white European descent without CVD at baseline. Five different measures of adiposity were included as exposures.
The researchers found that low BMI correlated with higher incidence of CVD; the lowest CVD risk was seen at BMI of 22 to 23 kg/m², with an increase in CVD risk with higher BMI. In subgroup analyses excluding participants with comorbidities, the J-shaped correlation was attenuated substantially. More linear correlations were seen for the other adiposity measures: a one standard deviation increase in waist circumference correlated with a hazard ratio of 1.16 and 1.10 for women and men, respectively, with associations of similar magnitude for waist-to-hip ratio, waist-to-height ratio, and percentage body fat mass.
"Increasing adiposity has a detrimental association with CVD health in middle-aged men and women. The association of BMI with CVD appears more susceptible to confounding due to pre-existing comorbidities when compared with other adiposity measures," the authors write. "Any public misconception of a potential 'protective' effect of fat on CVD risk should be challenged."
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Posted: March 2018