People with large waist at higher risk of cardiovascular disease

Waist circumference (WC) trajectories are predictive of altered risk of cardiovascular disease (CVD) among adults, even among those without body mass index (BMI)-defined obesity, a study has shown. Such association appears higher in younger adults.

A total of 75,535 participants from a community-based cohort in China, aged >18 years and had no stroke, coronary artery disease, and cancer in 2010 (baseline), were included. The authors repeatedly measured WC and other covariates in 2006, 2008, and 2010.

A latent mixture modeling defined WC trajectories. The association between WC trajectories and incident CVD was examined using a Cox proportional hazards model, adjusting for age, sex, income, education, systolic blood pressure, lipid profiles, plasma concentrations of glucose, C-reactive protein, smoking, and alcohol drinking.

Four WC trajectories were identified based on 2006 WC measurement and change patterns during 2006–2010: low stable (n=12,072; mean WC, 74.1–75.1 cm), moderate stable (n=41,750; mean WC, 85.1–86.6 cm), moderate-high stable (n=19,914; mean WC, 95.6–97.2 cm), and high stable (n=1,799; mean WC, 106.3–110.9 cm). Overall, 2,819 incident CVD events were documented from 2010 to 2016.

During 6 years of follow-up, the risk of CVD events was higher among participants with elevated WC trajectories than those with low-stable WC trajectories. Adjusted hazard ratios were as follows: 1.49 (95 percent confidence interval [CI], 1.21–1.83) for the moderate stable group, 1.71 (95 percent CI, 1.38–2.12) for the moderate-high stable group, and 1.45 (95 percent CI, 1.06–2.00) for the high stable group.

Results persisted after adjusting for BMI or excluding obese participants.

Furthermore, the positive association between WC and incident CVD was higher in individuals who were aged <60 years (p_interaction<0.0001).