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- Berit L Heitmann, professor, director of research1, head of section, health promotion in hospitals2,
- Peder Frederiksen, statistician1
- 1Research Unit for Dietary Studies, Institute of Preventive Medicine, Copenhagen University Hospital, DK-1357 Copenhagen K, Denmark
- 2Research 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
- Accepted 30 May 2009
Objective To examine associations between thigh circumference and incident cardiovascular disease and coronary heart disease and total mortality.
Design Prospective observational cohort study with Cox proportional hazards model and restricted cubic splines.
Setting Random subset of adults in Denmark.
Participants 1436 men and 1380 women participating in the Danish MONICA 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 and coronary heart disease and 12.5 years of follow-up for total death.
Results A small thigh circumference was associated with an increased risk of cardiovascular and coronary heart diseases and total mortality in both men and women. A threshold effect for thigh circumference was evident, with greatly increased risk of premature death below around 60 cm. Above the threshold there seemed to be 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 pressure and lipid concentration.
Conclusion A low thigh circumference seems to be associated with an increased risk of developing heart disease or premature death. The adverse effects of small thighs might be related to too little muscle mass in the region. The measure of thigh circumference might be a relevant anthropometric measure to help general practitioners in early identification of individuals at an increased risk of premature morbidity and mortality.
These data were collected while BLH was at the Research Centre for Prevention and Health, Glostrup University Hospital, DK-2600 Glostrup, Denmark.
Contributors: BLH planned the study and is guarantor. PF undertook all statistical analyses. Both authors contributed to reporting the work.
Funding: The study was funded by the Danish Medical Research Council. Both researchers were independent of the funding agency.
Competing interests: None declared.
Ethical approval: This study was approved by the ethics committee for the Copenhagen County and is in accordance with the Helsinki II declaration on human rights. All participants in the study signed a letter of informed consent.
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