ArticleBMJ open2023
Association of body fat distribution with all-cause and cardiovascular mortality in US adults: a secondary analysis using NHANES.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Impact of gout on cardiovascular disease mortality: a meta-analysis.Zeitschrift fur Rheumatologie · 2024Pooled it
- Association between android-to-gynoid lean mass ratio and advanced cardiovascular-kidney-metabolic syndrome, and the cross-sectional association decomposition of estimated glucose disposal rate.Clinics (Sao Paulo, Brazil) · 2026Article
- Effects of 12-month combined aerobic and resistance training on physical fitness, cardiometabolic health and quality of life in middle-aged adults with overweight/obesity at high risk of metabolic syndrome in Poland.Preventive medicine reports · 2026Article
- Effects of an 8-Week Time-Restricted Eating and Walking Exercise on Regional Fat Distribution and Lean Mass in Women with Hidden Obesity: A Randomized Controlled Trial.Healthcare (Basel, Switzerland) · 2026Article
- Contemporary concepts in 'exercise as medicine' and related fields.Experimental physiology · 2026Article
- CT-adipose measures identify severe SARS-CoV-2 risk beyond traditional obesity metrics: a C4R cohort study.BMC pulmonary medicine · 2026Article
- Comparison of body composition in female college students with different degrees of obesity.Scientific reports · 2026Article
- Effects of time-restricted feeding (TRF)-model of intermittent fasting on adipose organ: a narrative review.Eating and weight disorders : EWD · 2024Review
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the association of fat and lean mass in specific regions with all-cause and cardiovascular-related mortality.
designPopulation based cohort study.
settingUS National Health and Nutrition Examination Survey (2003-2006 and 2011-2018).
participants22 652 US adults aged 20 years or older. EXPOSURES: Fat and lean mass in specific regions obtained from the whole-body dual-energy X-ray absorptiometry.
main outcome measuresAll-cause and cardiovascular-related mortality.
resultsDuring a median of 83 months of follow-up, 1432 deaths were identified. Associations between body composition metrics and mortality risks were evident above specific thresholds. For all-cause mortality, Android fat mass showed elevated HRs above 2.46 kg (HR: 1.17, 95% CI 1.02 to 1.34), while Android lean mass (ALM) had similar trends above 2.75 kg (HR: 1.17, 95% CI 1.03 to 1.33), and Android total mass above 5.75 kg (HR: 1.08, 95% CI 1.01 to 1.16). Conversely, lower HRs were observed below certain thresholds: Gynoid fat mass (GFM) below 3.71 kg (HR: 0.72, 95% CI 0.56 to 0.93), Gynoid lean mass below 6.44 kg (HR: 0.77, 95% CI 0.64 to 0.92), and Gynoid total mass below 11.78 kg (HR: 0.76, 95% CI 0.70 to 0.84). Notably, below 0.722 kg, the HR of visceral adipose tissue mass (VATM) was 1.25 (95% CI 1.04 to 1.48) for all-cause mortality, and above 3.18 kg, the HR of total abdominal fat mass was 2.41 (95% CI 1.15 to 5.05). Cardiovascular-related mortality exhibited associations as well, particularly for Android fat mass (AFM) above 1.78 kg (HR: 1.22, 95% CI 1.01 to 1.47) and below 7.16 kg (HR: 0.50, 95% CI 0.36 to 0.69). HRs varied for Gynoid total mass below and above 10.98 kg (HRs: 0.70, 95% CI 0.54 to 0.93, and 1.12, 95% CI 1.02 to 1.23). Android per cent fat, subcutaneous fat mass (SFM), AFM/GFM, and VATM/SFM were not statistically associated with all-cause mortality. Android per cent fat, Gynoid per cent fat, AFM/GFM, and VATM/SFM were not statistically associated with cardiovascular-related mortality. Conicity index showed that the ALM/GLM had the highest performance for all-cause and cardiovascular-related mortality with AUCs of 0.785, and 0.746, respectively.
conclusionsThe relationship between fat or lean mass and all-cause mortality varies by region. Fat mass was positively correlated with cardiovascular mortality, regardless of the region in which they located. ALM/GLM might be a better predictor of all-cause and cardiovascular-related mortality than other body components or body mass index.
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