Thigh circumference and risk of heart disease and premature death: prospective cohort study

doi:10.1136/bmj.b3292

Published 3 September 2009, doi:10.1136/bmj.b3292
Cite this as: BMJ 2009;339:b3292

Research

Thigh circumference and risk of heart disease and premature death: prospective cohort study

Berit L Heitmann, professor, director of research, head of section, health promotion in hospitals¹^,2, Peder Frederiksen, statistician¹

¹ Research Unit for Dietary Studies, Institute of Preventive Medicine, Copenhagen University Hospital, DK-1357 Copenhagen K, Denmark, ² Research Centre for Prevention and Health, Glostrup University Hospital, DK-2600 Glostrup, Denmark

Correspondence to: B L Heitmann, Research Unit for Dietary Studies, Institute of Preventive Medicine, Østre Søgade 20, Copenhagen University Hospital, DK-1357 Copenhagen K, Denmark blh{at}ipm.regionh.dk

Objective To examine associations between thigh circumferenceand incident cardiovascular disease and coronary heart diseaseand total mortality.

Design Prospective observational cohort study with Cox proportionalhazards model and restricted cubic splines.

Setting Random subset of adults in Denmark.

Participants 1436 men and 1380 women participating in the DanishMONICA project, examined in 1987-8 for height, weight, and thigh,hip, and waist circumference, and body composition by impedance.

Main outcome measures 10 year incidence of cardiovascular andcoronary heart disease and 12.5 years of follow-up for totaldeath.

Results A small thigh circumference was associated with an increasedrisk of cardiovascular and coronary heart diseases and totalmortality in both men and women. A threshold effect for thighcircumference was evident, with greatly increased risk of prematuredeath below around 60 cm. Above the threshold there seemed tobe no additional benefit of having larger thighs in either sex.These findings were independent of abdominal and general obesity,lifestyle, and cardiovascular risk factors such as blood pressureand lipid concentration.

Conclusion A low thigh circumference seems to be associatedwith an increased risk of developing heart disease or prematuredeath. The adverse effects of small thighs might be relatedto too little muscle mass in the region. The measure of thighcircumference might be a relevant anthropometric measure tohelp general practitioners in early identification of individualsat an increased risk of premature morbidity and mortality.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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Rapid Responses:

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Shame on the BMJ for its news release on this study: Gary J. Schwitzer
bmj.com, 4 Sep 2009 [Full text]
BMJ press release for this paper: Trish Groves
bmj.com, 7 Sep 2009 [Full text]
Typo in Table 1: Thomas G Holstein
bmj.com, 7 Sep 2009 [Full text]
More elderly inactive smokers died?: Michael H Williams
bmj.com, 7 Sep 2009 [Full text]
Exercise-induced increase in muscle mass is associated with improved insulin sensitivity: George Nassis, Ph.D., et al.
bmj.com, 7 Sep 2009 [Full text]
Puzzled: Paola Nisonger
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Thighs and thresholds: Roger M. Harbord, et al.
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what?: john l hutcherson
bmj.com, 12 Sep 2009 [Full text]
Underweight patient and ergoantropometric classification.: Alberto Morales Salinas
bmj.com, 14 Sep 2009 [Full text]
Where was thigh circumference measured?: William R. O'Neal
bmj.com, 24 Sep 2009 [Full text]
Catecholamines, gluconeogenesis, thigh size and heart disease: John A. Lee
bmj.com, 29 Sep 2009 [Full text]
Why published?: Michael Robertson
bmj.com, 30 Sep 2009 [Full text]
Re: Underweight patient and ergoantropometric classification.: Alberto Morales Salinas
bmj.com, 22 Oct 2009 [Full text]