Inverse association between body mass index and all-cause mortality in rural chinese adults: 15-year follow-up of the Anqing cohort study

ObjectiveTo investigate the association between body mass index (BMI) and all-cause mortality in a Chinese rural population.DesignProspective cohort study.SettingThis study was conducted from 2003 to 2018 in Anqing, Anhui Province, China.Participants17 851 participants aged 25–64 years (49.4% female) attending physical examinations and questionnaire were included in this study. The inclusion criterion was families having a minimum of three participating siblings. The exclusion criteria included participants without family number and BMI data at baseline.Outcome measuresThe outcome measure was all-cause mortality. Generalized estimating equation (GEE) regression analysis was performed to determine the association between baseline BMI and all-cause mortality.ResultsDuring a mean follow-up period of 14.1 years, 730 deaths (8.0%) occurred among men, and 321 deaths (3.6%) occurred among women. The mean BMI for males was 21.3±2.5 kg/m2, and for female it was 22.1±3.1 kg/m2. Baseline BMI was significantly inversely associated with all-cause mortality risk for per SD increase (OR, 0.79 (95% CI, 0.72 to 0.87) for males; OR, 0.88 (95% CI, 0.76 to 1.01) for females). When BMI was stratified with cut points at 20 and 24 kg/m2, compared with the low BMI group, a significantly lower risk of death was found in the high BMI group (BMI ≥24: OR, 0.57 (95% CI, 0.43 to 0.77) in males; 0.65 (95% CI, 0.46 to 0.93) in females) after adjustment for relevant factors.ConclusionsIn this relatively lean rural Chinese population, the risk of all-cause mortality decreased with increasing BMI. The excess risk of all-cause mortality associated with a high BMI was not seen among this rural population.

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P3781Prognostic impact of body mass index on mortality and its causes in patients with atrial fibrillation: the Fushimi AF Registry

European Heart Journal ◽

10.1093/eurheartj/ehz745.0630 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

Y An ◽

M Iguchi ◽

M Ishii ◽

N Masunaga ◽

Y Aono ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Body Mass ◽

Obesity Paradox ◽

Chronic Obstructive ◽

Inverse Association ◽

Community Based ◽

Increased Risk ◽

All Cause Mortality

Abstract Background Obesity has been shown to be related to an increased risk for incidence and progression of atrial fibrillation (AF). Meanwhile, the inverse association between body mass index (BMI) and mortality, so-called “obesity paradox”, is well-known among patients with AF, as well as other cardiovascular diseases. However, data regarding the relationship between BMI and specific causes of death in AF patients remain scarce. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto. The inclusion criterion for the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time. We started to enroll patients from March 2011, and baseline characteristics including BMI and follow-up data were available for 3,805 patients by the end of November 2018. Patients were categorized into 3 groups depending on the BMI value; underweight (<18.5 kg/m2; 419 patients), normal (18.5 to <25.0 kg/m2; 2,283 patients), overweight (≤25.0 kg/m2; 1,103 patients). Results In the entire population, the mean BMI level was 23.1±4.0 kg/m2. The lower BMI was associated with higher age (78.5±10.3, 74.0±10.3, and 71.3±10.9 years in Underweight, Normal, and Overweight, respectively; p<0.001) and with higher prevalence of various comorbidities and CHA2DS2-VASc scores (3.83±1.67, 3.43±1.70, and 3.29±1.64, p<0.001). Oral anticoagulants were less frequently prescribed in those with lower BMI (46%, 56%, and 58%, p<0.001). During a median follow-up of 1,464 days (interquartile range: 727–2,228 days), all-cause mortality was lower in accordance with higher BMI (14.3, 5.3, and 3.5 per 100 person-years, respectively; p<0.001). The proportion of infection as a cause of death was prominently higher in the Underweight group than the others (25.7%, 16.7%, and 13.4%, p<0.001) (Figure A). Furthermore, the mortality due to infection was consistently higher in Underweight than in the others in any of the age subgroups (Figure B). Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the BMI value for mortality, adjusted by age, sex, chronic kidney disease, anemia, chronic obstructive pulmonary disease, history of major bleeding, and other components of CHA2DS2-VASc score. Higher BMI was related to lower all-cause mortality (per 5 kg/m2 increase: HR 0.71 [95% CIs 0.63–0.78], p<0.001), and also lower mortality due to infection (per 5 kg/m2 increase: HR 0.48 [95% CIs 0.37–0.61], p<0.001). Figure 1 Conclusions In a Japanese community-based AF cohort, obesity paradox was also observed on all-cause mortality. In particular, lower BMI was strongly associated with the mortality due to infection regardless of age. Acknowledgement/Funding Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi-Sankyo, Novartis Pharma, MSD, Sanofi-Avent

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Effects of Initial Body Mass Index and Weight Change on All-Cause Mortality: A 10-Year Cohort Study in Korea

Asia Pacific Journal of Public Health ◽

10.1177/1010539518756981 ◽

2018 ◽

Vol 30 (3) ◽

pp. 217-226 ◽

Cited By ~ 4

Author(s):

Susan Park ◽

Sunmi Pi ◽

Jinseub Hwang ◽

Jae-Heon Kang ◽

Jin-Won Kwon

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Weight Change ◽

Baseline Body Mass Index ◽

Healthy Weight ◽

Risk Of Death ◽

Hazard Ratios ◽

Increased Risk ◽

All Cause Mortality ◽

Baseline Bmi

We evaluated the effects of baseline body mass index (BMI) and its changes over 4 years on all-cause mortality in Korean population. We analyzed 351 735 participants whose BMI was measured in both 2002/2003 and 2006/2007. Mortality was assessed until 2013. Multivariate hazard ratios for all-cause mortality were estimated. Underweight and severe obesity with BMI >30 kg/m2 were significantly associated with higher mortality. Similarly, >5% decrease or >10% increase of BMI for 4 years was associated with the increased risk of death. Comparing the results between baseline BMI and BMI change, the BMI change showed more stable associations with mortality than the baseline BMI in subgroup analysis such as nonsmokers and healthy participants. This study suggests that BMI change could be a useful health indicator along with obesity level by BMI. In addition, maintaining a healthy weight is needed for longevity, but rapid weight change should be carefully monitored.

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Body mass index and risk of COVID-19 diagnosis, hospitalisation, and death: a cohort study of 2 524 926 Catalans

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab546 ◽

2021 ◽

Author(s):

Martina Recalde ◽

Andrea Pistillo ◽

Sergio Fernandez-Bertolin ◽

Elena Roel ◽

Maria Aragon ◽

...

Keyword(s):

Body Mass Index ◽

Cohort Study ◽

Body Mass ◽

Potential Effect ◽

Population Based ◽

Risk Of Death ◽

Hazard Ratios ◽

Catalan Population ◽

Wide Testing

Abstract Context A comprehensive understanding of the association between body mass index (BMI) and COVID-19 is still lacking. Objective To investigate associations between BMI and risk of COVID-19 diagnosis, hospitalisation with COVID-19, and death after a COVID-19 diagnosis or hospitalisation (subsequent death), accounting for potential effect modification by age and sex. Design Population-based cohort study. Setting Primary care records covering >80% of the Catalan population, linked to region-wide testing, hospital, and mortality records from March to May 2020. Participants Adults (≥18 years) with at least one measurement of weight and height. Main outcome measures Hazard ratios (HR) for each outcome. Results We included 2 524 926 participants. After 67 days of follow-up, 57 443 individuals were diagnosed with COVID-19, 10 862 were hospitalised with COVID-19, and 2467 had a subsequent death. BMI was positively associated with being diagnosed and hospitalised with COVID-19. Compared to a BMI of 22kg/m 2, the HR (95%CI) of a BMI of 31kg/m 2 was 1.22 (1.19-1.24) for diagnosis, and 1.88 (1.75-2.03) and 2.01 (1.86-2.18) for hospitalisation without and with a prior outpatient diagnosis, respectively. The association between BMI and subsequent death was J-shaped, with a modestly higher risk of death among individuals with BMIs ≤19kg/m 2 and a more pronounced increasing risk for BMIs ≥40kg/m 2. The increase in risk for COVID-19 outcomes was particularly pronounced among younger patients. Conclusions There is a monotonic association between BMI and COVID-19 diagnosis and hospitalisation risks, but a J-shaped one with mortality. More research is needed to unravel the mechanisms underlying these relationships.

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Associations of Body Mass Index and Anthropometric Indicators of Fat Mass and Fat Free Mass with All-cause Mortality among Women in the First and Second National Health and Nutrition Examination Surveys Follow-up Studies

Annals of Epidemiology ◽

10.1016/s1047-2797(02)00417-9 ◽

2003 ◽

Vol 13 (4) ◽

pp. 286-293 ◽

Cited By ~ 61

Author(s):

S Zhu

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Fat Mass ◽

National Health ◽

Fat Free Mass ◽

Anthropometric Indicators ◽

Health And Nutrition ◽

Follow Up Studies ◽

All Cause Mortality

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Body Mass Index and Its Change from Adolescence to Adulthood Are Closely Related to the Risk of Adult Metabolic Syndrome in China

International Journal of Endocrinology ◽

10.1155/2021/8888862 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Bingyang Liu ◽

Yue Li ◽

Jiamei Guo ◽

Yuting Fan ◽

Ling Li ◽

...

Keyword(s):

Metabolic Syndrome ◽

Body Mass Index ◽

Body Mass ◽

Glycosylated Hemoglobin ◽

Early Adulthood ◽

Study Groups ◽

Relationship Of ◽

Baseline Bmi ◽

The Relationship

Aims. To investigate the influence of body mass index (BMI) and its change from adolescence to adulthood (ΔBMI) on the risk of metabolic syndrome (MetS) in early adulthood. Methods. We selected 931 students from 12 to 16 years of age in Liaoyang City, China. Ninety-three participants from 18 to 22 years of age with complete baseline data were available for follow-up after 5 years. Statistical analysis determined the relationship of MetS at follow-up with baseline BMI (BMIb), ΔBMI, and follow-up BMI (BMIf). Results. ΔBMI was positively correlated with the change of waist circumference (ΔWC), systolic blood pressure (ΔSBP), triglycerides (ΔTG), uric acid, and glycosylated hemoglobin (ΔHbA1c) in follow-up ( p < 0.05 ). For every 1 kg/m2 increase in BMIb, ΔBMI, and BMIf, the risk of MetS at follow-up increased 1.201-fold, 1.406-fold, and 1.579-fold, respectively. Both BMIb and ΔBMI were predictive of MetS at follow-up, with prediction thresholds of 23.47 kg/m2 and 1.95 kg/m2. The participants were divided by the predicted BMIb and ΔBMI threshold values into four study groups. Interestingly, the group with lower BMI but a higher increase in BMI presented the same metabolic derangements and Mets% of the group with higher BMI but lower Δ BMI. Conclusion. Both BMI of adolescence and ΔBMI were predictive of MetS and cardiovascular risk factors in adulthood. Control of both variables in adolescents would be more effective in decreasing the risk of MetS in young adults than control of BMI alone.

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Associations of Body Mass Index and Waist Circumference with 3-Year All-Cause Mortality Among the Oldest Old: Evidence from a Chinese Community-Based Prospective Cohort Study

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2018.03.015 ◽

2018 ◽

Vol 19 (8) ◽

pp. 672-678.e4 ◽

Cited By ~ 9

Author(s):

Yue-Bin Lv ◽

Simin Liu ◽

Zhao-Xue Yin ◽

Xiang Gao ◽

Virginia Byers Kraus ◽

...

Keyword(s):

Body Mass Index ◽

Cohort Study ◽

Waist Circumference ◽

Body Mass ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Oldest Old ◽

Community Based ◽

All Cause Mortality ◽

Old Evidence

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The association of dialysis adequacy, body mass index, and mortality among hemodialysis patients

BMC Nephrology ◽

10.1186/s12882-019-1570-0 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Woong-pyo Hong ◽

Yu-Ji Lee

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Mortality Risk ◽

Cox Regression ◽

Target Range ◽

Dialysis Adequacy ◽

Cox Regression Analysis ◽

Increased Risk ◽

All Cause Mortality ◽

High Bmi

Abstract Background Although hemodialysis (HD) adequacy, single-pool Kt/Vurea (spKt/V), is inversely correlated with body size, each is known to affect patient survival in the same direction. Therefore, we sought to examine the relationship between HD adequacy and mortality according to body mass index (BMI) in HD patients and explore a combination effect of BMI and HD adequacy on mortality risk. Methods We retrospectively reviewed patient data from the Korean Society of Nephrology registry, a nationwide database of medical records of HD patients, from January 2001 to June 2017. We included patients ≥18 years old who were receiving maintenance HD. Patients were categorized into three groups according to baseline BMI (< 20 (low), 20 to < 23 (normal), and ≥ 23 (high) kg/m2). Baseline spKt/V was divided into six categories. Results Among 18,242 patients on HD, the median follow-up duration was 5.2 (IQR, 1.9–8.9) years. Cox regression analysis showed that, compared to the reference (spKt/V 1.2–1.4), lower and higher baseline spKt/V were associated with greater and lower risks for all-cause mortality, respectively. However, among patients with high BMI (n = 5588), the association between higher spKt/V and lower all-cause mortality was attenuated in all adjusted models (Pinteraction < 0.001). Compared to patients with normal BMI and spKt/V within the target range (1.2–1.4), those with low BMI had a higher risk for all-cause mortality at all spKt/V levels. However, the gap in mortality risk became narrower for higher values of spKt/V. Compared to patients with normal BMI and spKt/V in the target range, those with high BMI and spKt/V < 1.2 were not at increased risk for mortality despite low dialysis adequacy. Conclusions The association between spKt/V and mortality in HD patients may be modified by BMI.

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Blood-based-inflammation-markers, body mass index, and survival of nonmetastatic esophageal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.324 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 324-324

Author(s):

Wanning Wang ◽

Joelle Soriano ◽

Tyler Soberano ◽

Katrina Hueniken ◽

M. Catherine Brown ◽

...

Keyword(s):

Body Mass Index ◽

Esophageal Cancer ◽

Body Mass ◽

Cox Regression ◽

Locally Advanced ◽

Continuous Variables ◽

Inflammation Markers ◽

Lymphocyte Ratio ◽

Risk Of Death ◽

High Bmi

324 Background: Blood-based-inflammation-markers (BBIM) and Body Mass Index (BMI) have been associated with overall survival (OS) in a number of cancers. Inflammation and obesity have biological interactions. We evaluated the role of Neutrophil-to-Lymphocyte-Ratio (NLR), Platelet-to-Lymphocyte-Ratio (PLR) and Systemic-Inflammation-Index (SII) in conjunction with BMI as predictors of OS in localized/locally-advanced-esophageal cancer (LEC/LAEC). Methods: LEC/LAEC patients treated from 2006-2014 had the following variables analyzed both as continuous and categorical: BMI (low <25 kg/m2, high ≥25 kg/m2), NLR (low <4, high ≥4), PLR (low <232, high ≥232), and SII (low <1375, high ≥1375), with OS. Univariate (UVA) and Multivariate analysis (MVA) were analyzed using Cox regression (adjusted hazard ratios, aHR; 95% Confidence Intervals, CI). MVA models of OS were built, assessing different categorical combinations of BBIM factors with and without BMI. Results: Of 411 pts, 79% were males, median age was 63.5 years, 67% were adenocarcinomas; Stage I/II/III: 14%, 28%, 59%; Median BMI was 26.5kg/m2 and BMI distribution was: 3% underweight, 40% normal weight, 37% overweight and 20% obese. After a median follow-up of 87 months, 204 pts recurred, and 257 died. In MVA, BMI alone had no impact on OS (aHR 0.89, CI 0.7-1.1, p=0.15); individually as continuous variables, higher SII (p=0.03) and higher NLR (p=0.006) were inversely associated with OS whereas higher PLR was not (p=0.10). In an MVA of categorical combinations of BMI and BBIM on OS, patients in the high-BMI/low-PLR group were at lower risk of death when compared to all other groups (aHR=0.65, 95%CI:0.5-0.8, p=0.007). Similar non-statistically significant trends were shown when SII and NLR were individually combined with BMI (aHR=0.77, 95%CI:0.6-1.0, p=0.09; aHR=0.74, 95%CI:0.5-1.0, p=0.05, respectively). Conclusions: Our results suggest that in LEC/LAEC pts, high BMI and low PLR together are associated with improved OS when compared to pts with low BMI and/or high PLR. NLR and SII alone were associated with OS. Further studies evaluating the underlying mechanisms of BBMI, in particular PLR and inflammation/obesity are warranted.

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