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Gong X, Zeng X, Fu P. Association Between Weight Change During Adulthood and Chronic Kidney Disease: Results from a National Survey 2011-2018. Diabetes Metab Syndr Obes 2023; 16:3817-3826. [PMID: 38028993 PMCID: PMC10680485 DOI: 10.2147/dmso.s435886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/12/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose This study aimed to investigate the intricate relationship between weight change patterns and the onset of chronic kidney disease (CKD). Although obesity is recognized as a predisposing factor for CKD, the dynamics of weight fluctuation and its impact on CKD development are not well-defined. By analyzing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2018, we sought to elucidate the association between weight trajectories and CKD risk. Patients and Methods We included participants aged ≥40 years, employing body mass index (BMI) measurements at three life stages-baseline, age 25, and a decade preceding baseline-to categorize weight change patterns. Logistic regression was employed to evaluate the association of these patterns with CKD onset, adjusting for potential confounders. Results The study encompassed 12,284 participants, with 2893 individuals diagnosed with CKD. Transitioning from normal weight to obesity and staying obese throughout adulthood were found to increase the risk of developing CKD. These associations remained consistent after adjusting for covariates but were statistically insignificant after adjusting for comorbidities. Notably, individuals transitioning from obesity to normal weight from age 25 to baseline and from 10 years before baseline to baseline demonstrated significant correlations with CKD but not between age 25 and 10 years before baseline. Conclusion Obesity, weight gain throughout adulthood, and weight loss in middle-to-late adulthood are associated with an increased risk of CKD. This emphasizes the importance of long-term weight change patterns and maintaining a healthy weight throughout adulthood.
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Affiliation(s)
- Xuemei Gong
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Division of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xiaoxi Zeng
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Ping Fu
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Division of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
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Cao Q, Li M, Qin G, Yan L, He J, Xu M, Xu Y, Wang T, Chen Y, Wang S, Lin H, Zhao Z, Gao Z, Zeng T, Hu R, Yu X, Chen G, Su Q, Mu Y, Chen L, Tang X, Wan Q, Wang G, Shen F, Luo Z, Qin Y, Chen L, Huo Y, Li Q, Ye Z, Zhang Y, Liu C, Wang Y, Wu S, Yang T, Deng H, Zhao J, Shi L, Ning G, Wang W, Lu J, Bi Y. Early adulthood weight change, midlife "Life's essential 8" health status and risk of cardiometabolic diseases: a chinese nationwide cohort study. Nutr Metab (Lond) 2023; 20:48. [PMID: 37915057 PMCID: PMC10621175 DOI: 10.1186/s12986-023-00765-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/04/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The association between weight change during early adulthood and cardiometabolic diseases remains uncertain in Chinese population. Whether the association varies with comprehensive cardiovascular health (CVH) in midlife assessed by "Life's Essential 8" has not been characterized. We aim to examine the associations of early adulthood weight change and midlife "Life's Essential 8" CVH status with cardiometabolic outcomes in a Chinese cohort. METHODS The study participants were from the China Cardiometabolic Disease and Cancer Cohort (4 C) Study. This analysis included 72,610 middle-aged and older participants followed for a median of 3.6 years. At baseline, the participants recalled body weight at age 20 and 40 years, and we calculated change in weight and BMI between 20 and 40 years of age. Health behaviors information in "Life's Essential 8" was collected by questionnaire, and health factors were measured in the study center. During follow-up, we ascertained incident cardiovascular events based on medical records, and diagnosed incident diabetes according to the American Diabetes Association 2010 criteria. RESULTS 72,610 study participants were included with a mean age of 56.0 ± 8.8 years and 29% of them were males. Weight gain of more than 10 kg between 20 and 40 years of age was associated with 22% increased risk of incident cardiovascular events (HR: 1.22; 95%CI: 1.04-1.43) and 38% increased risk of diabetes (HR: 1.38; 95%CI: 1.25-1.53) compared to stable weight. Besides, the association of weight gain more than 10 kg in early adulthood with cardiometabolic risk was even stronger in those with low CVH score in midlife (HR: 2.44; 95%CI: 2.01-2.97 for incident cardiovascular events; HR: 2.20; 95%CI: 1.90-2.55 for incident diabetes) or with few ideal cardiovascular health metrics in midlife. CONCLUSIONS Our study indicated that weight gain in early adulthood was associated with significantly increased risk of cardiometabolic diseases. And the association could be stronger in those with poor CVH profiles in midlife. These findings confirmed the significance of weight management during early adulthood and suggested that individuals who experienced substantial weight gain in early life should be encouraged to maintain good CVH status in Chinese population.
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Grants
- 21QA1408100 Shanghai Rising-Star Program
- 2022ZD0162102 National Key Research and Development Program of China
- 81970728, 82022011, 82088102, 91857205, 81930021 National Natural Science Foundation of China
- 81970728, 82022011, 82088102, 91857205, 81930021 National Natural Science Foundation of China
- 81970728, 82022011, 82088102, 91857205, 81930021 National Natural Science Foundation of China
- 81970728, 82022011, 82088102, 91857205, 81930021 National Natural Science Foundation of China
- 22Y31900300 Shanghai Municipal People's Government
- Shanghai Municipal People’s Government
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Affiliation(s)
- Qiuyu Cao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guijun Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Lin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengnan Gao
- Dalian Municipal Central Hospital, Dalian, China
| | - Tianshu Zeng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuefeng Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Qing Su
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiming Mu
- Chinese people's Liberation Army General Hospital, Beijing, China
| | - Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xulei Tang
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Qin Wan
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Guixia Wang
- The First Hospital of Jilin University, Changchun, China
| | - Feixia Shen
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Chen
- Qilu Hospital of Shandong University, Jinan, China
| | - Yanan Huo
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Qiang Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yinfei Zhang
- Central Hospital of Shanghai Jiading District, Shanghai, China
| | - Chao Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - Youmin Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shengli Wu
- Karamay Municipal People's Hospital, Xinjiang, China
| | - Tao Yang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huacong Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiajun Zhao
- Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Lixin Shi
- Guiqian International General Hospital, Guiyang, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China.
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China.
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Kwon SY, Kim G, Lee J, Park J, Lee YB, Jin SM, Hur KY, Kim JH. Association of body weight change with all-cause and cause-specific mortality: A nationwide population-based study. Diabetes Res Clin Pract 2023; 199:110666. [PMID: 37031890 DOI: 10.1016/j.diabres.2023.110666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/09/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
AIMS Weight gain and loss increase the risk of all-cause mortality. This study explored the association of short-term weight change with all-cause and cause-specific mortality in middle-aged to older people. METHODS This was a 8.4-year retrospective cohort study of 645,260 adults aged 40 to 80 who underwent health checkups twice within a 2-year interval between January 2009 and December 2012. Cox analyses were used to analyze the association between short-term weight change and all-cause and cause-specific mortality. RESULTS Weight gain and loss were associated with an increased risk of all-cause mortality: the hazard ratios were 2.05 (95% confidence interval [CI], 1.93-2.16), 1.21 (95% CI, 1.16-1.25), 1.12 (95% CI 1.08-1.17), and 1.60 (95% CI, 1.49-1.70) for the severe weight loss, moderate weight loss, moderate weight gain, and severe weight gain groups, respectively. This U-shaped association was also seen between weight change and cause-specific mortality. Within the weight loss group, those who regained weight after two years had a reduced mortality risk. CONCLUSIONS In a middle-aged and elderly population, weight gain or loss of more than 3% during a 2-year interval was related to an elevated risk of all-cause and cause-specific mortality.
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Affiliation(s)
- So Yoon Kwon
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Jungkuk Lee
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Korea
| | - Jiyun Park
- Division of Endocrine and Metabolism, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Bundang-gu, Seongnam, Gyeonggi-do, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
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Hussain SM, Newman AB, Beilin LJ, Tonkin AM, Woods RL, Neumann JT, Nelson M, Carr PR, Reid CM, Owen A, Ball J, Cicuttini FM, Tran C, Wang Y, Ernst ME, McNeil JJ. Associations of Change in Body Size With All-Cause and Cause-Specific Mortality Among Healthy Older Adults. JAMA Netw Open 2023; 6:e237482. [PMID: 37036703 PMCID: PMC10087052 DOI: 10.1001/jamanetworkopen.2023.7482] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/25/2023] [Indexed: 04/11/2023] Open
Abstract
Importance The association between weight change and subsequent cause-specific mortality among older adults is not well described. The significance of changes in waist circumference (WC) has also not been compared with weight change for this purpose. Objective To examine the associations of changes in body weight and WC with all-cause and cause-specific mortality. Design, Setting, and Participants This cohort study is a post hoc analysis of data from the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial, which recruited participants between March 1, 2010, and December 31, 2014. The study included community-based older adults (16 703 Australian participants aged ≥70 years and 2411 US participants aged ≥65 years) without evident cardiovascular disease (CVD), dementia, physical disability, or life-limiting chronic illness. Data analysis was performed from April to September 2022. Exposures Body weight and WC were measured at baseline and at annual visit 2. Analysis models were adjusted for baseline body mass index because height and weight were measured at baseline, allowing for calculation of body mass index and other variables. Both body weight and WC changes were categorized as change within 5% (stable), decrease by 5% to 10%, decrease by more than 10%, increase by 5% to 10%, and increase by more than 10%. Main Outcomes and Measures All-cause, cancer-specific, CVD-specific, and noncancer non-CVD-specific mortality. Mortality events were adjudicated by an expert review panel. Cox proportional hazards regression and competing risk analyses were used to calculate hazard ratios (HRs) and 95% CIs. Results Among 16 523 participants (mean [SD] age, 75.0 [4.3] years; 9193 women [55.6%]), 1256 deaths were observed over a mean (SD) of 4.4 (1.7) years. Compared with men with stable weight, those with a 5% to 10% weight loss had a 33% higher (HR, 1.33; 95% CI, 1.07-1.66) risk of all-cause mortality, and those with more than a 10% decrease in body weight had a 289% higher (HR, 3.89; 95% CI, 2.93-5.18) risk. Compared with women with stable weight, those with a 5% to 10% weight loss had a 26% higher (HR, 1.26; 95% CI, 1.00-1.60) risk of all-cause mortality, and those with more than a 10% decrease in body weight had a 114% higher (HR, 2.14; 95% CI, 1.58-2.91) risk. Weight loss was associated with a higher cancer-specific mortality (>10% decrease among men: HR, 3.49; 95% CI, 2.26-5.40; 5%-10% decrease among women: HR, 1.44; 95% CI, 1.46-2.04; >10% decrease among women: HR, 2.78; 95% CI, 1.82-4.26), CVD-specific mortality (>10% decrease among men: HR, 3.14; 95% CI, 1.63-6.04; >10% decrease among women: HR, 1.92; 95% CI, 1.05-3.51), and noncancer non-CVD-specific mortality (>10% decrease among men: HR, 4.98; 95% CI, 3.14-7.91). A decrease in WC was also associated with mortality. Conclusions and Relevance This cohort study of healthy older adults suggests that weight loss was associated with an increase in all-cause and cause-specific mortality, including an increased risk of cancer, CVD, and other life-limiting conditions. Physicians should be aware of the significance of weight loss, especially among older men.
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Affiliation(s)
- Sultana Monira Hussain
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anne B. Newman
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lawrence J. Beilin
- Medical School, Royal Perth Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - Andrew M. Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Johannes T. Neumann
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Mark Nelson
- Discipline of General Practice, University of Tasmania, Hobart, Australia
| | - Prudence R. Carr
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Christopher M. Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jocasta Ball
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Flavia M. Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Cammie Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael E. Ernst
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City
- Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Association of body mass index and weight change with pneumonia mortality in a Japanese population: Japan Public Health Center-based Prospective Study. Int J Obes (Lond) 2023; 47:479-486. [PMID: 36869152 DOI: 10.1038/s41366-023-01289-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Accumulating evidence suggests that pneumonia mortality is lower for individuals with high body mass index (BMI) compared to normal BMI, but it remains unclear whether weight change during adulthood influences subsequent mortality due to pneumonia in Asian populations, who have a relatively lean body mass. This study aimed to examine the association of BMI and weight change over 5 years with the subsequent risk of pneumonia mortality in a Japanese population. METHODS The present analysis included 79,564 Japan Public Health Center (JPHC)-based Prospective Study participants who completed a questionnaire between 1995 and 1998 were followed for death through 2016. BMI was categorized into four groups: underweight (<18.5 kg/m2), normal weight (BMI: 18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (BMI: ≥30.0 kg/m2). Weight change was defined as the difference of body weight between questionnaire surveys with a 5-year interval. Cox proportional hazards regression was used to estimate hazard ratios of baseline BMI and weight change for pneumonia mortality. RESULTS During a median follow-up of 18.9 y, we identified 994 deaths from pneumonia. Compared with participants with normal weight, an elevated risk was observed among those who were underweight (hazard ratio = 2.29, 95% confidence interval [CI]: 1.83-2.87), whereas a decreased risk was found among those who were overweight (hazard ratio = 0.63, 95% CI: 0.53-0.75). Regarding weight change, the multivariable-adjusted hazard ratio (95% CI) of pneumonia mortality for a weight loss of 5 kg or more versus a weight change of less than 2.5 kg was 1.75 (1.46-2.10), whereas that for a weight gain of 5 kg or more was 1.59 (1.27-2.00). CONCLUSION Underweight and greater weight change was associated with an increase in the risk of pneumonia mortality in Japanese adults.
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Pink AE, Lee LL, Low DY, Yang Y, Fong LZ, Kang AYH, Liu P, Kim H, Wang Y, Padmanabhan P, Cobiac L, Gulyás B, Pettersson S, Cheon BK. Implicit satiety goals and food-related expectations predict portion size in older adults: Findings from the BAMMBE cohort. Appetite 2023; 180:106361. [PMID: 36332849 PMCID: PMC9742320 DOI: 10.1016/j.appet.2022.106361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/07/2022]
Abstract
Portion size selection is an indicator of appetite and within younger adults, is predicted by factors such as expected satiety, liking and motivations to achieve an ideal sensation of fullness (i.e., implicit satiety goals). Currently, there is limited research available on the determinants of portion size selection within older adults. Therefore, the current study aimed to examine the relationship between individual differences in implicit satiety goals, food-related expectations, and portion size selection in older adults. Free-living older adult Singaporeans (N = 115; Nmales = 62; age: M = 66.21 years, SD = 4.78, range = 60-83 years) participated as part of the Brain, Ageing, Microbiome, Muscle, Bone, and Exercise Study (BAMMBE). Participants completed questionnaires on their subjective requirements for experiencing different states of satiety and food-related expectations (i.e., liking, how filling) as well as a computerised portion size selection task. Using a multiple regression, we found that goals to feel comfortably full (B = 3.08, SE = 1.04, t = 2.96, p = .004) and to stop hunger (B = -2.25, SE = 0.82, t = -2.75, p = .007) significantly predicted larger portion size selection (R2 = 0.24, F(4,87) = 6.74, p < .001). Larger portion sizes (R2 = 0.53, F(5,90) = 20.58, p < .001) were also predicted by greater expected satiety (B = 0.47, SE = 0.09, t = 5.15, p < .001) and lower perceptions of how filling foods are (B = -2.92, SE = 0.77, t = -3.79, p < .001) but not liking (B = -0.09, SE = 0.91, t = -0.10, p = .925) or frequency (B = -18.42, SE = 16.91, t = -1.09, p = .279) of consumption of target foods. Comparing our findings to results of studies conducted with younger adults suggests the influence of factors such as satiety related goals on portion size selection may change with ageing while the influence of other factors (e.g., expected satiety/fullness delivered by foods) may remain consistent. These findings may inform future strategies to increase/decrease portion size accordingly to ensure older adults maintain an appropriate healthy weight.
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Affiliation(s)
- Aimee E Pink
- School of Social Sciences, Nanyang Technological University, 639818, Singapore; Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), 138632, Singapore; Singapore Institute for Clinical Sciences (A*STAR), Agency for Science, Technology and Research (A*STAR), Singapore, 117599.
| | - Li Ling Lee
- School of Social Sciences, Nanyang Technological University, 639818, Singapore.
| | - Dorrain Yanwen Low
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Yifan Yang
- Physical Education and Sports Science, National Institute of Education (NIE), Nanyang Technological University, 637616, Singapore; Office of Education Research, National Institute of Education (NIE), Nanyang Technological University, 637616, Singapore.
| | - LaiGuan Zoey Fong
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Alicia Yi Hui Kang
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Peijia Liu
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Hyejin Kim
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Yulan Wang
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore; Singapore Phenome Centre (SPC), Nanyang Technological University, 636921, Singapore.
| | | | - Lynne Cobiac
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health and Biosecurity, Adelaide, South Australia, 5001, Australia.
| | - Balázs Gulyás
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore; Cognitive Neuroimaging Centre (CONIC), Nanyang Technological University, 636921, Singapore; Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Sven Pettersson
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore; Department of Neurobiology, Care and Society, Karolinska Institutet, 171 77, Stockholm, Sweden; National Neuroscience Institute, Tan Tock Seng Hospital, 308433, Singapore; Sunway University, Faculty of Medical Sciences, Kuala Lumpur, 47500, Malaysia.
| | - Bobby K Cheon
- Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA, 20847.
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Zhu F, Wang W, Wu L, Han S, Wu X. Weight loss and all-cause mortality: A propensity score matching cohort study. Obes Res Clin Pract 2022; 16:476-483. [PMID: 36198567 DOI: 10.1016/j.orcp.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Weight loss was supposed to help with decreasing risk of premature mortality. However, results on this topic remain debatable and limited by study design. OBJECTIVE The present study aimed to investigate the association between weight loss and all-cause mortality among US adults with overweight or obesity in a national cohort study by using propensity score matching (PSM) analysis. METHODS A total of 5486 pairs of participants were matched in the National Health and Nutrition Examination Survey (NHANES, 2003-2015) after PSM. Hazard ratios (95% confidence intervals) (HRs (95% CIs)) were employed to evaluate the association between weight loss indicated by long-term weight loss (LTWL) and all-cause mortality by using Cox proportional hazards regression models. RESULTS During a median follow-up of 6.8 years, 674 participants died from all-cause mortality. In each PSM match, compared with participants with LTWL < 5%, the HRs (95% CIs) for participants with LTWL of 5-9.9% (2877 pairs), 10-14.9% (1315 pairs), and ≥ 15% (1294 pairs) were 1.18 (0.83-1.68) (P = 0.366), 1.65 (1.17-2.34) (P = 0.005), and 1.91 (1.21-3.00) (P = 0.006), respectively. The significant increased risk of all-cause mortality for LTWL ≥ 15% remained among male, female, participants aged ≥ 65 years, without weight loss intention, with non-communicable diseases, and without exceeding estimated energy requirement. CONCLUSION Weight loss especially for being ≥ 15% should be cautious for US adults with overweight or obesity.
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Affiliation(s)
- Fangzhou Zhu
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin, China
| | - Wenjie Wang
- Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lanlan Wu
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin, China
| | - Shan Han
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin, China
| | - Xiaoyan Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Guilin Medical University, Guilin, China; Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin, China.
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8
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Deravi N, Moazzeni SS, Hasheminia M, Hizomi Arani R, Azizi F, Hadaegh F. Three-year weight change and risk of all-cause, cardiovascular, and cancer mortality among Iranian adults: over a decade of follow-up in the Tehran Lipid and Glucose Study. BMC Public Health 2022; 22:1762. [PMID: 36114528 PMCID: PMC9482273 DOI: 10.1186/s12889-022-14126-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 09/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background We investigated the impact of weight change on mortality in a population-based cohort setting. Methods We conducted two weight measurements for 5436 participants aged ≥ 30 years with an approximate 3-year interval. Based on their weight change, we categorized participants to: > 5% weight loss, 3–5% weight loss, stable weight (± < 3%), 3–5% weight gain, > 5% weight gain. We followed participants for mortality annually up to March 20th 2018. We applied the multivariable Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of weight change categories for all-cause, cardiovascular (CV), and cancer mortality, considering stable weight as reference. The Cox models was adjusted for age, sex, educational level, body mass index, smoking status, hypertension, hypercholesterolemia, diabetes, and cardiovascular disease (CVD) at baseline. Results During a median follow-up of 14.4 years, 629 deaths (247 CV and 126 cancer deaths) have occurred. Over 5% weight loss and gain were associated with increased risk of all-cause mortality in multivariable analysis with HRs of 1.47 [95% CI: 1.17–1.85] and 1.27 [1.02–1.57], respectively; however, a 3–5% loss or gain did not alter the risk of all-cause mortality significantly. These significant risks for wight change > 5% were not modified by the presence of diabetes, obesity, and smoking status; however, the unfavorable impact of weight change on mortality events was more prominent in those older than > 65 years (P-value for interaction: 0.042). After excluding those with history of CVD, diabetes, and cancer during the weight measurements period, these associations significantly attenuated (HR: 1.29 [0.89–1.87] for > 5% weight loss and 1.12 [0.84–1.50] for > 5% weight gain). Additionally, a > 5% weight loss was also associated with about 60% higher risk for CV mortality (HR: 1.62 [1.15–2.28]), and a 3–5% weight loss was associated with about 95% higher risk of cancer mortality (HR: 1.95 [1.13–3.38]). Conclusions Our findings showed a U-shaped association across weight change categories for all-cause mortality risk with over 5% weight gain and loss causing higher risk. Moreover, weight loss can have adverse impact on CV and cancer mortality events. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14126-4.
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9
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Yuan Y, Liu K, Zheng M, Chen S, Wang H, Jiang Q, Xiao Y, Zhou L, Liu X, Yu Y, Wu J, Ding X, Yang H, Li X, Min X, Zhang C, Zhang X, He M, Zheng Y, Sun D, Qi L, Hemler EC, Wu S, Wu T, Pan A. Analysis of Changes in Weight, Waist Circumference, or Both, and All-Cause Mortality in Chinese Adults. JAMA Netw Open 2022; 5:e2225876. [PMID: 35939299 PMCID: PMC9361078 DOI: 10.1001/jamanetworkopen.2022.25876] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IMPORTANCE Although numerous studies have separately investigated the associations of changes in weight or waist circumference with mortality risk, few studies have examined the associations of concurrent changes in these 2 anthropometric parameters with all-cause mortality. OBJECTIVE To assess the associations of changes in body weight, waist circumference, or both, combined with all-cause mortality. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from 2 longitudinal cohort studies in Dongfeng-Tongji and Kailuan, China. Participants included 58 132 adults (aged 40 years and older) with measures of weight and waist circumference at baseline and follow-up visit. Statistical analysis was performed from June 2020 to September 2021. EXPOSURES Changes in weight and waist circumference between 2 visits (2008-2010 to 2013 in the Dongfeng-Tongji cohort, and 2006-2007 to 2010-2011 in the Kailuan study). Stable weight was defined as change in weight within 2.5 kg between the 2 visits and stable waist circumference was defined as changes within 3.0 cm. Changes were categorized as loss, stable, or gain for weight and waist circumference separately, and created a 9-category variable to represent the joint changes. MAIN OUTCOMES AND MEASURES All-cause mortality from follow-up visit (2013 in Dongfeng-Tongji cohort and 2010-2011 in Kailuan study) until December 31, 2018. Cox proportional hazard regression models were used to estimate the associations with adjustment for potential confounders. Results were obtained in the 2 cohorts separately and pooled via fixed-effect meta-analysis. RESULTS A total of 10 951 participants in the Dongfeng-Tongji cohort (median [IQR] age, 62 [56-66] years; 4203 [38.4%] men) and 47 181 participants in the Kailuan study (median [IQR] age, 51 [46-58] years; 36 663 [77.7%] men) were included in the analysis. During 426 072 person-years of follow-up, 4028 deaths (523 in the Dongfeng-Tongji cohort and 3505 in the Kailuan study) were documented. When changes in weight and waist circumference were examined separately, U-shape associations were found: both gain and loss in weight (weight loss: pooled hazard ratio [HR], 1.33; 95% CI, 1.23-1.43; weight gain: HR, 1.10; 95% CI, 1.02-1.19) or waist circumference (waist circumference loss: HR, 1.14; 95% CI, 1.05-1.24; waist circumference gain: HR, 1.11; 95% CI, 1.03-1.21) were associated with higher mortality risk compared with stable weight or waist group. When changes in weight and waist circumference were jointly assessed, compared with participants with stable weight and waist circumference (16.9% of the total population [9828 of 58 132] with 508 deaths), participants with different combinations of weight and waist circumference change all had higher mortality risks except for those with stable weight but significant loss in waist. Notably, those who lost weight but gained waist circumference (6.4% of the total population [3698 of 58 132] with 308 deaths) had the highest risk of all-cause mortality (HR, 1.69; 95% CI, 1.46-1.96; absolute rate difference per 100 000 person-years in the Dongfeng-Tongji cohort: 414; 95% CI, 116-819; and in the Kailuan study: 333; 95% CI, 195-492) among the joint subgroups. CONCLUSIONS AND RELEVANCE In this cohort study, weight loss with concurrent waist circumference gain was associated with a higher mortality risk in middle-aged and older Chinese adults. This study's findings suggest the importance of evaluating the changes in both body weight and waist circumference when assessing their associations with mortality.
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Affiliation(s)
- Yu Yuan
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kang Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Mengyi Zheng
- Graduate School of North China University of Science and Technology, Tangshan, China
| | - Shuohua Chen
- Health Department of Kailuan Group, Tangshan, China
| | - Hao Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qin Jiang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Xiao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lue Zhou
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuezhen Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanqiu Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiachen Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiong Ding
- Graduate School of North China University of Science and Technology, Tangshan, China
| | - Handong Yang
- Department of Cardiovascular Diseases, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Xiulou Li
- Department of Cardiovascular Diseases, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Xinwen Min
- Department of Cardiovascular Diseases, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Ce Zhang
- Department of Cardiovascular Diseases, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meian He
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, Human Phenome Institute and School of Life Sciences, Fudan University, Shanghai, China
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Elena C. Hemler
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Huang Y, Ruan Z, Lin W, Chen Z, Zhang L, Li Z. Association Between Weight Change and Increased Likelihood of Abdominal Aortic Calcification Among Men. J Endocr Soc 2022; 6:bvac067. [PMID: 35528824 PMCID: PMC9071313 DOI: 10.1210/jendso/bvac067] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE We aimed to explore the effect of weight change on abdominal aortic calcification (AAC) among men. METHODS Data were obtained from the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES). Self-reported cardiovascular disease patients were excluded. Lateral spine images were used to quantify AAC score and severe AAC was defined as a AAC score greater than 6. Weight change over a 10-year period was defined as long-term weight change, and weight change over a 1-year period was defined as short-term weight change. The relationship between long-term and short-term weight change with AAC grade was estimated by using multivariable regression analysis and subgroup analysis. RESULTS After adjusting for covariates, weight gain, especially severe weight gain (> 10 kg), was associated with increased likelihood of AAC and severe AAC both in the short term (1 year) and long term (10 years) among men when compared to stable weight change, while long-term weight loss could also lead to an increased likelihood of AAC and severe AAC. CONCLUSION Stable body weight might be a predictor of a lower risk of AAC and severe AAC among men in the long term and short term.
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Affiliation(s)
- Yanting Huang
- Shantou University Medical College, Shantou, Guangdong 515041, P. R. China
| | - Zhijie Ruan
- Shantou University Medical College, Shantou, Guangdong 515041, P. R. China
| | - Weizhao Lin
- Shantou University Medical College, Shantou, Guangdong 515041, P. R. China
- Department of Cardiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P. R. China
| | - Zhichao Chen
- Shantou University Medical College, Shantou, Guangdong 515041, P. R. China
- Department of Cardiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P. R. China
| | - Liling Zhang
- Shantou University Medical College, Shantou, Guangdong 515041, P. R. China
- Endocrinology Department, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P. R. China
| | - Zhi Li
- Shantou University Medical College, Shantou, Guangdong 515041, P. R. China
- Department of Cardiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P. R. China
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Mandry D, Girerd N, Lamiral Z, Huttin O, Filippetti L, Micard E, Ncho Mottoh MPB, Böhme P, Chemla D, Zannad F, Rossignol P, Marie PY. Arterial and Cardiac Remodeling Associated With Extra Weight Gain in an Isolated Abdominal Obesity Cohort. Front Cardiovasc Med 2021; 8:771022. [PMID: 34805324 PMCID: PMC8602697 DOI: 10.3389/fcvm.2021.771022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction: This study aims to assess the changes in cardiovascular remodeling attributable to bodyweight gain in a middle-aged abdominal obesity cohort. A remodeling worsening might explain the increase in cardiovascular risk associated with a dynamic of weight gain. Methods: Seventy-five middle-aged subjects (56 ± 5 years, 38 women) with abdominal obesity and no known cardiovascular disease underwent MRI-based examinations at baseline and at a 6.1 ± 1.2-year follow-up to monitor cardiovascular remodeling and hemodynamic variables, most notably the effective arterial elastance (Ea). Ea is a proxy of the arterial load that must be overcome during left ventricular (LV) ejection, with increased EA resulting in concentric LV remodeling. Results: Sixteen obese subjects had significant weight gain (>7%) during follow-up (WG+), whereas the 59 other individuals did not (WG-). WG+ and WG- exhibited significant differences in the baseline to follow-up evolutions of several hemodynamic parameters, notably diastolic and mean blood pressures (for mean blood pressure, WG+: +9.3 ± 10.9 mmHg vs. WG-: +1.7 ± 11.8 mmHg, p = 0.022), heart rate (WG+: +0.6 ± 9.4 min-1 vs. -8.9 ± 11.5 min-1, p = 0.003), LV concentric remodeling index (WG: +0.08 ± 0.16 g.mL-1 vs. WG-: -0.02 ± 0.13 g.mL-1, p = 0.018) and Ea (WG+: +0.20 ± 0.28 mL mmHg-1 vs. WG-: +0.01 ± 0.30 mL mmHg-1, p = 0.021). The evolution of the LV concentric remodeling index and Ea were also strongly correlated in the overall obese population (p < 0.001, R2 = 0.31). Conclusions: A weight gain dynamic is accompanied by increases in arterial load and load-related concentric LV remodeling in an isolated abdominal obesity cohort. This remodeling could have a significant impact on cardiovascular risk.
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Affiliation(s)
- Damien Mandry
- Department of Radiology, CHRU-Nancy, Université de Lorraine, Nancy, France.,INSERM, UMR-1254, Université de Lorraine, Nancy, France
| | - Nicolas Girerd
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, France.,CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France
| | - Zohra Lamiral
- CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France
| | - Olivier Huttin
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, France
| | - Laura Filippetti
- Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, France
| | - Emilien Micard
- CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France
| | | | - Philip Böhme
- Department of Endocrinology, Diabetology, Nutrition, CHRU-Nancy, Nancy, France
| | - Denis Chemla
- Explorations Fonctionnelles, Hôpital Kremlin Bicêtre, APHP, Paris, France.,INSERM, UMR- 999, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - Faïez Zannad
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, France.,CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France
| | - Patrick Rossignol
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,CHRU-Nancy, INSERM, CIC 1433, Université de Lorraine, Nancy, France.,FCRIN INI-CRCT, Nancy, France
| | - Pierre-Yves Marie
- INSERM, UMR-1116, Université de Lorraine, Nancy, France.,CHRU-Nancy, Université de Lorraine, Nuclear Medicine & Nancyclotep Platform, Nancy, France
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12
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Lee CH, Han KD, Kim DH, Kwak MS. Continuing regular physical activity and maintaining body weight have a synergistic interaction in improving survival: a population-based cohort study including 6.5 million people. Eur J Prev Cardiol 2021; 29:547-555. [PMID: 34792138 DOI: 10.1093/eurjpc/zwab190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/14/2021] [Accepted: 10/29/2021] [Indexed: 01/21/2023]
Abstract
AIMS Continuing physical activity (PA) and maintaining body weight are tightly intertwined; however, no study investigated whether these two factors have interactions in terms of the mortality. The aim of this study is to elucidate whether continuing regular PA and maintaining body weight have interactions in terms of all-cause mortality risk. METHODS AND RESULTS Participants with health screening from both 2009 and 2011 without underlying cancer or cardiovascular disease were included. Physical activity change was grouped as remained active, inactive-to-active, active-to-inactive, or remained inactive. Body weight change was categorized as stable (weight change < 5%), weight gain, or loss. Outcome included all-cause mortality. Of 6 572 984 total participants, 91 347 deaths occurred during a median 7.4-year follow-up. Compared with the remained active and stable weight group, most other groups had a higher mortality risk. The weight loss and remained inactive group [adjusted hazard ratio (aHR), 2.30; 95% confidence interval (CI), 2.22-2.38] and the weight gain and remained inactive group (aHR, 2.17; 95% CI, 2.09-2.25) showed the highest mortality risks. Among stable weight participants, the ranking of the groups from highest to lowest in terms of mortality risk was as follows: remained inactive (aHR, 1.46; 95% CI, 1.41-1.50), active-to-inactive (aHR, 1.24; 95% CI, 1.19-1.29), inactive-to-active (aHR, 1.15; 95% CI, 1.11-1.20), and remained active (reference). Remaining active and maintaining a stable body weight had a synergistic interaction on decreasing all-cause mortality risk (multiplicative P for interaction < 0.001; relative excess risk due to interaction, 0.38; 95% CI, 0.31-0.46; attributable proportion, 0.18; 95% CI, 0.15-0.22). CONCLUSIONS Continuing regular PA as recommended and maintaining body weight have multiplicative and additive interactions on reducing all-cause mortality. Healthcare providers should emphasize the importance of both regular PA and body weight maintenance for the general public.
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Affiliation(s)
- Chang-Hoon Lee
- Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Sangdo-ro, Dongjak-gu, Seoul 06978, Republic of Korea
| | - Da Hye Kim
- Department of Biomedicine and Health Science, Catholic University of Korea, Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
| | - Min-Sun Kwak
- Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, 39FL., Gangnam Finance Center 737, Yeoksam-Dong, Gangnam-gu, Seoul 06236, Republic of Korea
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13
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Zhang J, Hayden K, Jackson R, Schutte R. Associations of weight changes with all-cause, cancer and cardiovascular mortality: A prospective cohort study. PUBLIC HEALTH IN PRACTICE 2021; 2:100065. [PMID: 36101609 PMCID: PMC9461596 DOI: 10.1016/j.puhip.2020.100065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/20/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives Previous studies suggest that changes in body weight can lead to an increased risk of mortality in the general population, although the results are controversial. The current study sought to investigate this association further using data from the UK Biobank. Study design This is a large prospective population-based cohort study. Data were derived from the UK Biobank, with the initial assessments commencing between 2006 and 2010. Methods Proportional hazard models were used to assess the association between self-reported weight change and risk of all-cause, cancer and cardiovascular mortality. The effect of gender was also investigated. Results Of 433,829 participants with data for self-reported weight change, the mean age was 56 (standard deviation [SD]: 8.1) years and 55% were female. In total, 55% of participants reported no weight change, 28% gained weight, 15% lost weight, 2% did not know and 0.1% preferred not to give an answer. The median follow-up was 7.1 (interquartile range [IQR]: 6.4–7.8) years. Compared with participants with no weight change, those with weight loss had an increased risk of all-cause mortality (adjusted hazard ratio [HR] 1.25, 95% confident interval [CI] 1.18–1.32), cancer death (HR 1.17, 95% CI 1.08–1.27) and cardiovascular death (HR 1.26, 95% CI 1.12–1.43). Similarly, participants reporting weight gain also had an increased risk of all-cause mortality (HR 1.08, 95% CI 1.02–1.13), cancer death (HR 1.14, 95% CI 1.07–1.22) and cardiovascular death (HR 1.27, 95% CI 1.14–1.42). Participants who had a response ‘do not know’ or ‘prefer not to answer’ showed an increased risk of all-cause and cardiovascular mortality, particularly in men. Conclusions The results of this study highlight the importance of maintaining a stable weight in middle-aged adults. Further studies are needed to understand the pathophysiology of weight change and its effects on mortality.
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Affiliation(s)
- Jufen Zhang
- Medical School, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Karen Hayden
- Medical School, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Ruth Jackson
- Medical School, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Rudolph Schutte
- Medical School, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
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Murayama H, Liang J, Shaw BA, Botoseneanu A, Kobayashi E, Fukaya T, Shinkai S. Short-, Medium-, and Long-term Weight Changes and All-Cause Mortality in Old Age: Findings From the National Survey of the Japanese Elderly. J Gerontol A Biol Sci Med Sci 2021; 76:2039-2046. [PMID: 33626135 DOI: 10.1093/gerona/glab052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recent studies, predominantly in Western populations, suggest that both weight loss and weight gain are associated with an increased mortality risk in old age. However, evidence of this association in older Asian populations remains sparse. This study aimed to examine the association between weight change and all-cause mortality in a nationally representative sample of community-dwelling older Japanese people. METHODS Data were obtained from the National Survey of the Japanese Elderly, which included 4869 adults aged ≥60 years. Participants were followed for up to 30 years. We considered 3 indicators of weight change according to the follow-up interval: short-term (3 years), medium-term (6-7 years), and long-term (12-13 years). Weight change was classified as loss ≥ 5%, loss 2.5%-4.9%, stable (±2.4%), gain 2.5%-4.9%, and gain ≥ 5%. Cox proportional hazards models were used to calculate the relative mortality risk of each weight change category. RESULTS Weight loss ≥ 5% for all intervals was associated with higher mortality than stable weight and the effects were largely similar across all 3 intervals (hazard ratio [95% confidence interval]: 1.36 [1.22-1.51] for short-term, 1.36 [1.22-1.51] for medium-term, and 1.31 [1.11-1.54] for long-term). A similar pattern of results was observed among the young-old and old-old, and among men and women. The effect of weight loss on higher mortality was greater among those with a lower body mass index at baseline. CONCLUSIONS These findings could inform clinical and public health approaches to body-weight management aimed at improving the health and survival of older adults, particularly in Asian populations.
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Affiliation(s)
- Hiroshi Murayama
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Jersey Liang
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, USA
| | - Benjamin A Shaw
- Department of Health Policy, Management and Behavior, School of Public Health, State University of New York at Albany, Rensselaer, USA
| | - Anda Botoseneanu
- Department of Health and Human Services, University of Michigan-Dearborn, USA
| | - Erika Kobayashi
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Taro Fukaya
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
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15
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Suh J, Cho YJ, Kim HJ, Choi SS. Age-Related Difference in Weight Change and All-Cause Mortality in Middle-Aged and Older Korean Populations: Korean Longitudinal Study of Aging. Korean J Fam Med 2021; 42:297-302. [PMID: 34320797 PMCID: PMC8321903 DOI: 10.4082/kjfm.20.0170] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Obesity is associated with increased mortality as a significant risk factor for chronic diseases, including cardiovascular diseases and cancer. Several people believe that weight gain is harmful, and weight loss helps maintain health. However, some studies have shown that weight loss, particularly among older adults, is more likely to increase the risk of mortality than weight gain. Methods We used data for the cohort of the Korean Longitudinal Study of Aging, which is a nationwide stratified multi-stage sample of adults aged 45 years. The all-cause mortality risk was assessed using the survival status and the number of months of survival calculated from 2006 (baseline year) to 2016. Cox proportional hazard regression were used to study the causal link between weight change and all-cause mortality risk. Results The results showed interactive associations between weight loss and mortality among middle-aged and older adults. The hazard ratio was 1.62 (95% confidence interval [CI], 1.10–2.40) for the participants aged 45–65 years with weight losses greater than 5 kg and 1.56 (95% CI, 1.29–1.89) for those older than 65 years with weight losses greater than 5 kg. The results for the group with weight gain above 5 kg were not significant. Middle-aged and older men showed an increase in all-cause mortality associated with weight loss of more than 5 kg, but only the older women showed significant results. Conclusion This large-scale cohort study in Korea showed a relationship between weight loss and all-cause mortality in middle-aged and older individuals.
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Affiliation(s)
- Jungki Suh
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Hyun Ji Kim
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Seong Soo Choi
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
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16
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Zhu Y, Zheng R, Hu C, Qin G, Wang B, Wang T, Yu X, Tang X, Hu R, Su Q, Zhang J, Zhang Y, Zhao Z, Xu Y, Li M, Chen Y, Wang S, Shi L, Wan Q, Chen G, Dai M, Zhang D, Gao Z, Wang G, Shen F, Luo Z, Qin Y, Chen L, Huo Y, Li Q, Ye Z, Zhang Y, Liu C, Wang Y, Wu S, Yang T, Deng H, Chen L, Zhao J, Mu Y, Yan L, Wang W, Ning G, Bi Y, Lu J, Xu M. Association of early adulthood weight and subsequent weight change with cardiovascular diseases: Findings from REACTION study. Int J Cardiol 2021; 332:209-215. [PMID: 33667580 DOI: 10.1016/j.ijcard.2021.02.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/07/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Excessive adiposity in adulthood is positively associated with the risk of cardiovascular disease (CVD). However, it is less studied how the risk is separately explained by early adulthood weight and later weight change, especially in Asian ancestries. METHODS This study included 121160 participants in a large population-based cohort in China. Body weight at 20 and 40 years of age wase self-reported. Information on CVD history was obtained through standard questionnaires. RESULTS The odds ratios (ORs) were 1.20 (95% CI, 1.10-1.31) for coronary heart disease (CHD), 1.74 (95% CI, 1.36-2.22) for myocardial infarction (MI), 1.14 (95% CI, 0.99-1.32) for stroke and 1.21 (95% CI, 1.12-1.31) for total CVD among individuals with early overweight, and became more prominent for early obesity. Meanwhile, A moderate weight gain of 2.5 kg between early adulthood and midlife significantly increased the risk of CHD (OR: 1.18, 95% CI: 1.05-1.32), stroke (OR: 1.19, 95% CI: 1.03-1.38) and total CVD (OR: 1.15, 95% CI: 1.04-1.27), and the risk escalated with higher amounts of weight gain. Conversely, a weight loss of 2.5 kg conferred lower risk of CVD compared with a stable weight. In further cross-analysis, participants with early adulthood overweight or obesity and significant weight gain afterwards exhibited the greatest risk of CVD. CONCLUSIONS High early adulthood BMI and subsequent weight gain had both independent and combined effect on the risk of CVD after midlife. Therefore, weight management should start before early adulthood, and emphasized throughout adulthood for CVD prevention.
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Affiliation(s)
- Yuanyue Zhu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruizhi Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunyan Hu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guijun Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bin Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuefeng Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xulei Tang
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Qing Su
- Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lixin Shi
- Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Qin Wan
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Gang Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Meng Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengnan Gao
- Dalian Municipal Central Hospital, Dalian, China
| | - Guixia Wang
- The First Hospital of Jilin University, Changchun, China
| | - Feixia Shen
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Chen
- Qilu Hospital of Shandong University, Jinan, China
| | - Yanan Huo
- Jiangxi Provincial People's Hospital, Nanchang University, Nanchang, China
| | - Qiang Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Yinfei Zhang
- Central Hospital of Shanghai Jiading District, Shanghai, China
| | - Chao Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - Youmin Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shengli Wu
- Karamay Municipal People's Hospital, Xinjiang, China
| | - Tao Yang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huacong Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiajun Zhao
- Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yiming Mu
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Cheng YJ, Chen ZG, Wu SH, Mei WY, Yao FJ, Zhang M, Luo DL. Body mass index trajectories during mid to late life and risks of mortality and cardiovascular outcomes: Results from four prospective cohorts. EClinicalMedicine 2021; 33:100790. [PMID: 33778436 PMCID: PMC7985466 DOI: 10.1016/j.eclinm.2021.100790] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Our understanding of the weight-outcome association mainly comes from single-time body mass index (BMI) measurement. However, data on long-term trajectories of within-person changes in BMI on diverse study outcomes are sparse. Therefore, this study is to determine the associations of individual BMI trajectories and cardiovascular outcomes. METHODS The present analysis was based on data from 4 large prospective cohorts and restricted to participants aged ≥45 years with at least two BMI measurements. Hazard ratios (HR) and 95% confidence intervals(95%CI) for each outcome according to different BMI trajectories were calculated in Cox regression models. FINDINGS The final sample comprised 29,311 individuals (mean age 58.31 years, and 77.31% were white), with a median 4 BMI measurements used in this study. During a median follow-up of 21.16 years, there were a total of 10,192 major adverse cardiovascular events (MACE) and 11,589 deaths. A U-shaped relation was seen with all study outcomes. Compared with maintaining stable weight, the multivariate adjusted HR for MACE were 1.53 (95%CI 1.40-1.66), 1.26 (95%CI 1.16-1.37) and 1.08 (95%CI 1.02-1.15) respectively for rapid, moderate and slow weight loss; 1.01 (95%CI 0.95-1.07), 1.13 (95%CI 1.05-1.21) and 1.29 (95%CI 1.20-1.40) respectively for slow, moderate and rapid weight gain. Identical patterns of association were observed for all other outcomes. The development of BMI differed markedly between the outcome-free individuals and those who went on to experience adverse events, generally beginning to diverge 10 years before the occurrence of the events. INTERPRETATION Our findings may signal an underlying high-risk population and inspire future studies on weight management. FUNDING National Natural Science Foundation of China, Guangdong Natural Science Foundation.
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Affiliation(s)
- Yun-Jiu Cheng
- From the Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510700, China
- From Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
- Corresponding authors.
| | - Zhen-Guang Chen
- From the Department of Thoracic Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Su-Hua Wu
- From the Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510700, China
- From Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Wei-Yi Mei
- From the Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510700, China
- From Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Feng-Juan Yao
- From the Department of Medical Ultrasonics, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ming Zhang
- From the Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Dong-Ling Luo
- From the Department of Cardiology, the Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen 518033, China
- Corresponding authors.
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Kisanuki K, Muraki I, Yamagishi K, Kokubo Y, Saito I, Yatsuya H, Sawada N, Iso H, Tsugane S. Weight change during middle age and risk of stroke and coronary heart disease: The Japan Public Health Center-based Prospective Study. Atherosclerosis 2021; 322:67-73. [PMID: 33743510 DOI: 10.1016/j.atherosclerosis.2021.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 02/13/2021] [Accepted: 02/18/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS The impact of weight changes in middle age on the incidence of cardiovascular disease has not been well elucidated. We investigated whether a 5-year weight change was associated with risk of stroke and coronary heart disease (CHD) in middle-aged individuals. METHODS We analyzed data of 74,928 participants aged 40-69 years who provided responses to the baseline and 5-year follow-up questionnaires in the Japan Public Health Center-based Prospective Study. Weight change was calculated by subtracting self-reported weight at baseline from that at 5-year follow-up. Stroke and CHD events were confirmed by reviewing hospital records. RESULTS During 997,406 person-years of follow-up, we documented 3,975 stroke and 914 CHD events. The multivariable HRs of stroke for losing ≥5 kg compared to stable weight (change ≤2 kg) was 1.17 (95% CI, 1.01-1.37) in men versus 1.33 (1.13-1.57) for losing ≥5 kg and 1.61 (1.36-1.92) for gaining ≥5 kg in women (U-shaped association). These associations did not change after the exclusion of early events. The multivariable HR of CHD for gaining ≥5 kg was 1.22 (0.95-1.58) in men. After exclusion of early events within another 5 years, that positive association became stronger [multivariable HR 1.34 (1.00-1.82)]. CONCLUSIONS Weight gain during middle age was associated with an increased risk of stroke in women and an increased risk of CHD in men. Weight loss was associated with an increased risk of stroke in both men and women.
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Affiliation(s)
- Koichi Kisanuki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University, Toyoake, Aichi, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Public Health Medicine, Faculty of Medicine and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan.
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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19
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Huang YY, Jiang CQ, Xu L, Zhang WS, Zhu F, Jin YL, Thomas GN, Cheng KK, Lam TH. Adiposity change and mortality in middle-aged to older Chinese: an 8-year follow-up of the Guangzhou Biobank Cohort Study. BMJ Open 2020; 10:e039239. [PMID: 33277280 PMCID: PMC7722382 DOI: 10.1136/bmjopen-2020-039239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To examine the associations of change in body mass index (BMI) and waist circumference (WC) over an average of 4 years with subsequent mortality risk in middle-aged to older Chinese. DESIGN Prospective cohort study based on the Guangzhou Biobank Cohort Study. SETTING Community-based sample. PARTICIPANTS 17 773 participants (12 956 women and 4817 men) aged 50+ years. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measure was all-cause mortality. Secondary outcome measures were cardiovascular disease (CVD) and cancer mortality. Causes of death were obtained via record linkage, and coded according to the International Classification of Diseases (tenth revision). RESULTS 1424 deaths (53.4% women) occurred in the 17 773 participants (mean age 61.2, SD 6.8 years) during an average follow-up of 7.8 (SD=1.5) years, and 97.7% of participants did not have an intention of weight loss . Compared with participants with stable BMI, participants with BMI loss (>5%), but not gain, had a higher risk of all-cause mortality (HR=1.49, 95% CI 1.31 to 1.71), which was greatest in those who were underweight (HR=2.45, 95% CI 1.31 to 4.59). Similar patterns were found for WC. In contrast, for participants with a BMI of ≥27.5 kg/m2, BMI gain, versus stable BMI, was associated with 89% higher risk of all-cause mortality (HR=1.89, 95% CI 1.25 to 2.88), 72% higher risk of CVD mortality (HR=1.72, 95% CI 0.80 to 3.72) and 2.27-fold risk of cancer mortality (HR=2.27, 95% CI 1.26 to 4.10). CONCLUSION In older people, unintentional BMI/WC loss, especially in those who were underweight was associated with higher mortality risk. However, BMI gain in those with obesity showed excess risks of all-cause and cancer mortality, but not CVD mortality. Frequent monitoring of changes in body size can be used as an early warning for timely clinical investigations and interventions and is important to inform appropriate health management in older Chinese.
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Affiliation(s)
- Ying Yue Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chao Qiang Jiang
- Molecular Epidemiology Research Centre, Guangzhou No.12 Hospital, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, the University of Hong Kong, Hong Kong, China
| | - Wei Sen Zhang
- Molecular Epidemiology Research Centre, Guangzhou No.12 Hospital, Guangzhou, China
| | - Feng Zhu
- Molecular Epidemiology Research Centre, Guangzhou No.12 Hospital, Guangzhou, China
| | - Ya Li Jin
- Molecular Epidemiology Research Centre, Guangzhou No.12 Hospital, Guangzhou, China
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tai Hing Lam
- Molecular Epidemiology Research Centre, Guangzhou No.12 Hospital, Guangzhou, China
- School of Public Health, the University of Hong Kong, Hong Kong, China
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20
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Chen C, Ye Y, Zhang Y, Pan XF, Pan A. Weight change across adulthood in relation to all cause and cause specific mortality: prospective cohort study. BMJ 2019; 367:l5584. [PMID: 31619383 PMCID: PMC6812615 DOI: 10.1136/bmj.l5584] [Citation(s) in RCA: 139] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To investigate the association between weight changes across adulthood and mortality. DESIGN Prospective cohort study. SETTING US National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2014. PARTICIPANTS 36 051 people aged 40 years or over with measured body weight and height at baseline and recalled weight at young adulthood (25 years old) and middle adulthood (10 years before baseline). MAIN OUTCOME MEASURES All cause and cause specific mortality from baseline until 31 December 2015. RESULTS During a mean follow-up of 12.3 years, 10 500 deaths occurred. Compared with participants who remained at normal weight, those moving from the non-obese to obese category between young and middle adulthood had a 22% (hazard ratio 1.22, 95% confidence interval 1.11 to 1.33) and 49% (1.49, 1.21 to 1.83) higher risk of all cause mortality and heart disease mortality, respectively. Changing from obese to non-obese body mass index over this period was not significantly associated with mortality risk. An obese to non-obese weight change pattern from middle to late adulthood was associated with increased risk of all cause mortality (1.30, 1.16 to 1.45) and heart disease mortality (1.48, 1.14 to 1.92), whereas moving from the non-obese to obese category over this period was not significantly associated with mortality risk. Maintaining obesity across adulthood was consistently associated with increased risk of all cause mortality; the hazard ratio was 1.72 (1.52 to 1.95) from young to middle adulthood, 1.61 (1.41 to 1.84) from young to late adulthood, and 1.20 (1.09 to 1.32) from middle to late adulthood. Maximum overweight had a very modest or null association with mortality across adulthood. No significant associations were found between various weight change patterns and cancer mortality. CONCLUSIONS Stable obesity across adulthood, weight gain from young to middle adulthood, and weight loss from middle to late adulthood were associated with increased risks of mortality. The findings imply that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, is important for preventing premature deaths in later life.
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Affiliation(s)
- Chen Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yi Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yanbo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Impact of weight variability on mortality among Korean men and women: a population based study. Sci Rep 2019; 9:9543. [PMID: 31266987 PMCID: PMC6606749 DOI: 10.1038/s41598-019-46037-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 06/12/2019] [Indexed: 01/07/2023] Open
Abstract
The health consequences of weight fluctuation have been controversial and little-studied within Asian populations. We aimed to determine the effect of weight variability on mortality using Korean National Health Insurance Service – National Health Screening Cohort. Weight variability was defined as the average successive variability of body mass index (BMI) of the first (2002 and 2003), second (2004 and 2005), and third (2006 and 2007) health examinations. Then, we used Cox regression models to estimate the effect of weight variability on mortality. Compared to participants within the first quintile (lowest) of weight variability, those within the fifth quintile (highest) had increased the risk of death from all causes (hazard ratio, HR 1.33, 95% confidence interval, CI 1.26–1.41), cardiovascular disease (HR 1.31, 95% CI 1.12–1.53), cancer (HR 1.11, 95% CI 1.02–1.22), and other causes (HR 1.58, 95% CI 1.45–1.73). The risk-increasing effect of weight variability on mortality was preserved after excluding past and current smokers as well as those with pre-existing cardiovascular disease or cancer. In conclusion, high weight variability may lead to elevated risk of death even among healthy never smokers. Therefore, maintaining a steady weight should be recommended to benefit from reduced risk of death.
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