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BMJ. Nov 27, 1993; 307(6916): 1385–1388.
PMCID: PMC1679623

Associations of serum lipid concentrations and obesity with mortality in women: 20 year follow up of participants in prospective population study in Gothenburg, Sweden.

Abstract

OBJECTIVE--To examine association of different measures of serum lipid concentration and obesity with mortality in women. DESIGN--Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years. SETTING--Gothenburg, Sweden. SUBJECTS--1462 randomly selected women aged 38-60 at start of study. MAIN OUTCOME MEASURES--Total mortality and death from myocardial infarction as predicted by serum cholesterol and triglyceride concentrations, body mass index, and ratio of circumference of waist to circumference of hips. RESULTS--170 women died during follow up, 26 from myocardial infarction. Serum triglyceride concentration and waist:hip ratio were significantly associated with both end points (relative risk of total mortality for highest quarter of triglyceride concentration v lower three quarters 1.86 (95% confidence interval 1.30 to 2.67); relative risk for waist:hip ratio 1.67 (1.18 to 2.36)). These associations remained after adjustment for background variables. Serum cholesterol concentration and body mass index were initially associated with death from myocardial infarction, but association was lost after adjustment for background variables. Serum triglyceride concentration and waist:hip ratio were independently predictive of both end points (logistic regression coefficient for total mortality for triglyceride 0.514 (SE 0.150), p = 0.0006; coefficient for waist:hip ratio 7.130 (1.92), p = 0.0002) whereas the other two risk factors were not (coefficient for total mortality for cholesterol concentration -0.102 (0.079), p = 0.20; coefficient for body mass index -0.051 (0.027), p = 0.05). CONCLUSIONS--Lipid risk profile appears to be different in men and women given that serum triglyceride concentration was an independent risk factor for mortality while serum cholesterol concentration was not. Consistent with previous observations in men, localisation of adipose tissue was more important than obesity per se as risk factor in women.

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  • Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjöström L. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J (Clin Res Ed) 1984 Nov 10;289(6454):1257–1261. [PMC free article] [PubMed]
  • Hartz A, Grubb B, Wild R, Van Nort JJ, Kuhn E, Freedman D, Rimm A. The association of waist hip ratio and angiographically determined coronary artery disease. Int J Obes. 1990 Aug;14(8):657–665. [PubMed]
  • Thompson CJ, Ryu JE, Craven TE, Kahl FR, Crouse JR., 3rd Central adipose distribution is related to coronary atherosclerosis. Arterioscler Thromb. 1991 Mar-Apr;11(2):327–333. [PubMed]
  • Lapidus L, Bengtsson C, Lindquist O, Sigurdsson JA, Rybo E. Triglycerides--main lipid risk factor for cardiovascular disease in women? Acta Med Scand. 1985;217(5):481–489. [PubMed]
  • Johansson S, Bondjers G, Fager G, Wedel H, Tsipogianni A, Olofsson SO, Vedin A, Wiklund O, Wilhelmsson C. Serum lipids and apolipoprotein levels in women with acute myocardial infarction. Arteriosclerosis. 1988 Nov-Dec;8(6):742–749. [PubMed]
  • Böttiger LE, Carlson LA. Risk factors for death for males and females. A study of the death pattern in the Stockholm prospective study. Acta Med Scand. 1982;211(6):437–442. [PubMed]
  • Kannel WB, Castelli WP, Gordon T, McNamara PM. Serum cholesterol, lipoproteins, and the risk of coronary heart disease. The Framingham study. Ann Intern Med. 1971 Jan;74(1):1–12. [PubMed]
  • Castelli WP. The triglyceride issue: a view from Framingham. Am Heart J. 1986 Aug;112(2):432–437. [PubMed]
  • Bengtsson C, Blohmé G, Hallberg L, Hällström T, Isaksson B, Korsan-Bengtsen K, Rybo G, Tibblin E, Tibblin G, Westerberg H. The study of women in Gothenburg 1968-1969--a population study. General design, purpose and sampling results. Acta Med Scand. 1973 Apr;193(4):311–318. [PubMed]
  • Bengtsson C, Hallberg L, Hällström T, Hultborn A, Isaksson B, Lennartsson J, Lindquist O, Lindstedt S, Noppa H, Redvall L, et al. The population study of women in Göteborg 1974--1975--the second phase of a longitudinal study. General design, purpose and sampling results. Scand J Soc Med. 1978;6(2):49–54. [PubMed]
  • Bengtsson C, Gredmark T, Hallberg L, Hällström T, Isaksson B, Lapidus L, Lindquist O, Lindstedt S, Lurie M, Nyström E, et al. The population study of women in Gothenburg 1980-81--the third phase of a longitudinal study. Comparison between participants and non-participants. Scand J Soc Med. 1989;17(2):141–145. [PubMed]
  • LEVINE JB, ZAK B. AUTOMATED DETERMINATION OF SERUM TOTAL CHOLESTEROL. Clin Chim Acta. 1964 Oct;10:381–384. [PubMed]
  • LOFLAND HB., Jr A SEMIAUTOMATED PROCEDURE FOR THE DETERMINATION OF TRIGLYCERIDES IN SERUM. Anal Biochem. 1964 Dec;9:393–400. [PubMed]
  • Keys A, Menotti A, Aravanis C, Blackburn H, Djordevic BS, Buzina R, Dontas AS, Fidanza F, Karvonen MJ, Kimura N, et al. The seven countries study: 2,289 deaths in 15 years. Prev Med. 1984 Mar;13(2):141–154. [PubMed]
  • Bradley PJ. Is obesity an advantageous adaptation? Int J Obes. 1982;6(1):43–52. [PubMed]
  • Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, Speizer FE, Hennekens CH. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med. 1990 Mar 29;322(13):882–889. [PubMed]

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