Anthropometric measures are interconnected risk factors for diseases and mortality. This study aims to elucidate the association between body shape phenotype using anthropometric measures and all-cause and cause-specific mortality.

The 112,813 study participants aged 40–70 years were obtained from the Health Examinees cohort. The mortality was confirmed using the death records of the Korea National Statistics Office. We defined 4 body shapes calculating the averaged principal components (AvPCs) through PC analysis from 6 anthropometric measures: height, weight, body mass index (BMI), hip and waist circumference, and waist-hip ratio (WHR). Multivariable Cox proportional hazard regression was used for the risk of all-cause, cancer, and cardiovascular disease (CVD) mortality according to the PCs scores.

The Mean follow-up was 11.1±2.0 years. We obtained 3,391 deaths including 1,695 from cancer and 529 from CVD. Four PCs were identified, explaining 99.89% of the variation in the dataset. PC1 (General Obesity) showed a reduced risk for all-cause mortality in men (HR=0.92, 0.91–0.97) but not in women. PC2 (Tall & Normal BMI) was associated with reduced risk of all-cause (0.93, 0.90–0.96 for all) and CVD mortality (0.88, 0.78–0.98 and 0.83, 0.72–0.95 for men and women, respectively). PC3 (Tall & Abdominal obesity) showed an increased risk of all-cause mortality for both men (1.09, 1.05–1.14) and women (1.07, 1.02–1.13) and the risk of cancer mortality (1.08, 1.02–1.16) in men only. PC4 (Short & Abdominal obesity) was associated with increased risk of all-cause (1.07, 1.03–1.12) and CVD mortality (1.15, 1.03–1.29) only in men.

The mortality risk differed according to body shape; Tall & Normal BMI was inversely associated with all-cause and CVD mortality risk in both men and women, while Tall & Abdominal obesity and Short & Abdominal obesity were unfavorably associated with all-cause or CVD mortality in men.