Correlation between waist-to-height ratio and all-cause/cause-specific death of elderly in Wuhan:a cohort study
Objective To investigate the association between waist-to-height ratio(WHtR)and mortality in elderly population of Wuhan in 2012,and provide evidence to support WHtR as a dependable index for assessing mortality risk in older adults.Methods The data were derived from Wuhan's Basic Public Health Service Program for older people(aged 65 and above)and included demographic information,lifestyles,medical history and physical measurements such as height and circumference,which administered by face-to-face interview.2012 was defined as baseline,and 331 052 individuals were finally included in the analyses.Vital status for each participant was identified through linkage to China Population Death Information Registration System by December 31,2019.Cox proportional hazards regression model was applied to estimate hazard ratios(HR)of WHtR for mortality risk with person-years as time scale.Stratified analyses were conducted by sex,age group,marital status,body mass index(BMI),smoking status,alcohol use,physical activity and chronic condition.The association between each 0.1 unit increase in WHtR and mortality were examined within subgroups as well.Besides,series of sensitivity analyses were conducted to test the robustness of the association between WHtR and mortality.The study utilized SAS 9.4 and R 4.1.3 and employed the Chi-Square test to compare the differences between groups.Results The average age of participates at baseline was(72.1±5.7)years old,with males and females accounting for 46.6％and 53.4％respectively.Participates with WHtR of 0-0.47,0.48-0.51,0.52-0.54 and≥0.55 were accounted for 25.1％,28.2％,19.1％and 27.6％,respectively.The adjusted HR values for WHtR 0.48-0.51,0.52-0.54 and ≥ 0.55 were 1.03(95％CI:1.01-1.05),1.04(95％CI:1.02-1.07)and 1.10(95％CI:1.08-1.13)respectively,with WHtR of 0-0.47 as reference.For older individuals,each 0.1 unit increase in WHtR was associated with 9％higher risk of all-cause mortality and 3％,10％,24％and 13％higher risk of mortality due to cancer,cardiovascular disease(CVD),diabetes and respiratory disease.Additionally,mortality risk was elevated by 16％,8％and 7％in those being underweight,normal weight and obese respectively.No profound differences had been observed compared with overall association between WHtR and mortality risks in sensitive analyses.Conclusion With significantly positive WHtR-mortality association in elderly population,WHtR emerges as a robust predictor for assessing the risk of death among older adults in community settings.
Basic Public Health Service ProgramWaist-to-height ratioAll-cause deathElderlySurvival analysis
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