The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]

The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada] Publisher Pubmed

Saadati HM¹ ; Sabour S¹ ; Mansournia MA² ; Mehrabi Y¹ ; Nazari SSH³

Show Affiliations

1. Departamento de Epidemiologia, Faculdade de Saude Publica e Seguranca, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2. Departamento de Epidemiologia e Bioestatistica, Faculdade de Saude Publica, Tehran University of Medical Sciences, Tehran, Iran
3. Centro de Pesquisa de Prevencao de Doencas Cardiovasculares, Faculdade de Saude Publica e Seguranca, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Arquivos Brasileiros de Cardiologia Published:2021

Abstract

Background: Body mass index (BMI) is the most commonly used index to categorize a person as obese or non-obese, which is subject to important limitations. Objective: To evaluate the direct effect of BMI on cardiovascular outcomes among participants without central obesity. Methods: This analysis included 14,983 males and females aged 45-75 years from the Atherosclerosis Risk in Communities Study (ARIC). BMI was measured as general obesity, and waist circumference (WC), waist-to-hip ratio (WHR) and hip circumference as central obesity. Targeted maximum likelihood estimation (TMLE) was used to estimate the total effects (TEs) and the controlled direct effects (CDEs). The proportion of TE that would be eliminated if all participants were non-obese regarding central obesity was computed using the proportion eliminated (PE) index. P <0.05 was considered statistically significant. Analyses were performed in the TMLE R package. Results: The risk of cardiovascular outcomes attributed to BMI was significantly reversed by eliminating WHR obesity (p<0.001). The proportion eliminated of BMI effects was more tangible for non-obese participants regarding WC (PE=127%; 95%CI (126,128)) and WHR (PE=97%; 95%CI (96,98)) for coronary heart disease (CHD), and WHR (PE=92%; 95%CI (91,94)) for stroke, respectively. With respect to sex, the proportion eliminated of BMI effects was more tangible for non-obese participants regarding WHR (PE=428%; 95%CI (408,439)) for CHD in males, and WC (PE=99%; 95%CI (89,111)) for stroke in females, respectively. Conclusion: These results indicate different potential effects of eliminating central obesity on the association between BMI and cardiovascular outcomes for males and females. (Arq Bras Cardiol. 2021; 116(5):879-886). © 2021, Arquivos Brasileiros de Cardiologia. All rights reserved.

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Experts (# of related papers)

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Mohammad Ali Mansournia (19)

Saharnaz Nedjat (3)

Style	Citing Format
MLA	Saadati HM, et al.. "The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]." Arquivos Brasileiros de Cardiologia, vol. 116, no. 5, 2021, pp. 879-886.
APA	Saadati HM, Sabour S, Mansournia MA, Mehrabi Y, Nazari SSH (2021). The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]. Arquivos Brasileiros de Cardiologia, 116(5), 879-886.
Chicago	Saadati HM, Sabour S, Mansournia MA, Mehrabi Y, Nazari SSH. "The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]." Arquivos Brasileiros de Cardiologia 116, no. 5 (2021): 879-886.
Harvard	Saadati HM et al. (2021) 'The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]', Arquivos Brasileiros de Cardiologia, 116(5), pp. 879-886.
Vancouver	Saadati HM, Sabour S, Mansournia MA, Mehrabi Y, Nazari SSH. The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]. Arquivos Brasileiros de Cardiologia. 2021;116(5):879-886.
BibTex	@article{ author = {Saadati HM and Sabour S and Mansournia MA and Mehrabi Y and Nazari SSH}, title = {The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]}, journal = {Arquivos Brasileiros de Cardiologia}, volume = {116}, number = {5}, pages = {879-886}, year = {2021} }
RIS	TY - JOUR AU - Saadati HM AU - Sabour S AU - Mansournia MA AU - Mehrabi Y AU - Nazari SSH TI - The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada] JO - Arquivos Brasileiros de Cardiologia VL - 116 IS - 5 SP - 879 EP - 886 PY - 2021 ER -

Style

Citing Format

MLA

Saadati HM, et al.. "The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]." Arquivos Brasileiros de Cardiologia, vol. 116, no. 5, 2021, pp. 879-886.

APA

Saadati HM, Sabour S, Mansournia MA, Mehrabi Y, Nazari SSH (2021). The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]. Arquivos Brasileiros de Cardiologia, 116(5), 879-886.

Chicago

Saadati HM, Sabour S, Mansournia MA, Mehrabi Y, Nazari SSH. "The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]." Arquivos Brasileiros de Cardiologia 116, no. 5 (2021): 879-886.

Harvard

Saadati HM et al. (2021) 'The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]', Arquivos Brasileiros de Cardiologia, 116(5), pp. 879-886.

Vancouver

Saadati HM, Sabour S, Mansournia MA, Mehrabi Y, Nazari SSH. The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]. Arquivos Brasileiros de Cardiologia. 2021;116(5):879-886.

BibTex

@article{ author = {Saadati HM and Sabour S and Mansournia MA and Mehrabi Y and Nazari SSH}, title = {The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]}, journal = {Arquivos Brasileiros de Cardiologia}, volume = {116}, number = {5}, pages = {879-886}, year = {2021} }

RIS

TY - JOUR
AU - Saadati HM
AU - Sabour S
AU - Mansournia MA
AU - Mehrabi Y
AU - Nazari SSH
TI - The Direct Effect of Body Mass Index on Cardiovascular Outcomes Among Participants Without Central Obesity by Targeted Maximum Likelihood Estimation; [O Efeito Direto Do Indice De Massa Corporal Nos Resultados Cardiovasculares Entre Participantes Sem Obesidade Central Pela Estimativa Por Maxima Verossimilhanca Direcionada]
JO - Arquivos Brasileiros de Cardiologia
VL - 116
IS - 5
SP - 879
EP - 886
PY - 2021
ER -

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Abstract