Abstract 11184: Adiposity, Inflammation, and Risk for Death in Black and White Men and Women in the US: The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study
While obesity is a global epidemic associated with adverse health consequences, population-based studies have paradoxically shown that obese individuals have similar mortality risk as normal weight individuals. We test whether a pro-inflammatory state among the obese would distinguish those at higher mortality risk compared to normal weight subjects, and secondly, whether this relationship differed for whites and blacks.
Methods: Baseline BMI, waist circumference, and C-reactive protein (CRP) concentration were measured among 16,486 white and 11,168 black subjects in REGARDS (REasons for Geographic and Racial Differences in Stroke). Hazard ratios (HR) for all-cause mortality were obtained from Cox proportional hazard models.
Results: Over a 6-year period, 927 whites and 669 blacks died. In age-adjusted models, there was a U-shaped association between BMI and death among whites but not blacks. For example, compared to normal weight (BMI 20–24. 9 kg/m2) whites, severely obese (BMI ≥35 kg/m)2 whites had a 1.5–2.0 fold higher risk for death [HR 2.11 (1.46–3.06), white women; HR 1.53 (1.13–2.07), white men]. The HR associated with severe obesity was not increased for blacks [HR 0.91 (0.68–1.40), black women; HR 0.84 (0.57–1.24), black men]. For whites and blacks with CRP >3 mg/L, mortality risk among the obese or severely obese compared to the normal weight was not increased (figure). Among individuals with CRP <1 mg/L, a U-shaped association between BMI and mortality was maintained in whites, with no increased mortality risk for blacks with high BMI. Among whites and black women, higher waist circumference was associated with an increased mortality risk which was not modified by CRP levels (p=0.47 for whites and p=0.25 for blacks).
Conclusions: Among middle-aged and older adults, obesity was associated with increased risk for death among whites but not blacks. Compared to normal weight subjects, high CRP among the obese was not associated with greater mortality risk.
- © 2010 by American Heart Association, Inc.