Abdominal Obesity and Its Attribution to All-cause Mortality in the General Population with 14 Years Follow-up: Findings from Shanxi Cohort in China

Objective This study aimed to assess the association of waist circumference（WC） with all-cause mortality among Chinese adults.Methods The baseline data were from Shanxi Province of 2002 China Nutrition and Health Survey. The death investigation and follow-up visit were conducted from December 2015 to March 2016. The visits covered up to 5,360 of 7,007 participants, representing a response rate of 76.5%. The Cox regression model and floating absolute risk were used to estimate hazard ratio and 95% floating CI of death by gender and age groups（≥ 60 and ＜ 60 years old）. Sensitivity analysis was performed by excluding current smokers; participants with stroke, hypertension, and diabetes; participants who accidentally died; and participants who died during the first 2 years of follow-up.Results This study followed 67,129 person-years for 12.5 years on average, including 615 deaths. The mortality density was 916 per 100,000 person-years. Low WC was associated with all-cause mortality among men. Multifactor-adjusted hazard ratios（HR） were 1.60（1.35–1.90） for WC ＜ 75.0 cm and 1.40（1.11–1.76） for WC ranging from 75.0 cm to 79.9 cm. Low WC（＜ 70.0 cm and 70.0–74.9 cm） and high WC（≥ 95.0 cm） groups had a high risk of mortality among women. The adjusted HRs of death were 1.43（1.11–1.83）, 1.39（1.05–1.84）, and 1.91（1.13–3.22）.Conclusion WC was an important predictor of death independent of body mass index（BMI）. WC should be used as a simple rapid screening and predictive indicator of the risk of death.