Body Mass Index Change and Hospitalization Risk in Elderly Hemodialysis Patients: Results from Japanese Dialysis Outcomes and Practice Patterns Study

2018 ◽  
Vol 47 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Keiichi Sumida ◽  
Shungo Yamamoto ◽  
Tadao Akizawa ◽  
Shunichi Fukuhara ◽  
Shingo Fukuma
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Practice Patterns ◽  
Baseline Period ◽  
Short Term ◽  
Cox Models ◽  
Hazard Ratios ◽  
Dialysis Outcomes ◽  
Gains And Losses

Background: Short-term weight gains and losses are associated with a lower and higher mortality risk, respectively, in patients undergoing hemodialysis (HD). However, little is known about their association with the risk of subsequent hospitalization. Methods: In a prospective cohort of 1,804 HD patients aged ≥65 years enrolled in the Japanese Dialysis Outcomes and Practice Patterns Study phases 3 (2005–2008) and 4 (2009–2011), we examined the associations between changes in body mass index (BMI) over a 4-month baseline period (<–3%, –3 to <–1%, –1 to <1% [reference], 1 to <3%, and ≥3%) and subsequent risk of all-cause, cardiovascular, and noncardiovascular hospitalization using Cox models with adjustment for potential confounders. Results: During a median follow-up of 1.2 years, we noted 1,028 incident hospitalizations for any cause, including 275 and 753 hospitalizations for cardiovascular and noncardiovascular causes, respectively. An L-shaped association was observed between BMI change and all-cause hospitalization. The multivariable-adjusted hazard ratios (HRs; 95% CI) of all-cause hospitalization associated with BMI changes of <–3%, –3 to <–1%, 1 to <3%, and ≥3% (vs. –1 to <1%) were 1.29 (1.01–1.65), 1.22 (0.98–1.51), 1.04 (0.83–1.29), and 1.10 (0.83–1.45), respectively. Qualitatively similar associations were present for cardiovascular-related hospitalization (corresponding HRs [95% CI]: 1.58 [1.06–2.37], 1.09 [0.75–1.58], 0.99 [0.72–1.36], and 0.91 [0.51–1.64], respectively) but not for noncardiovascular-related hospitalization (corresponding HRs [95% CI]: 1.19 [0.90–1.57], 1.26 [0.99–1.59], 1.06 [0.84–1.35], and 1.18 [0.86–1.63], respectively). Conclusions: Decreases in BMI over a relatively short-term period were independently associated with higher risk of subsequent hospitalization, particularly cardiovascular-related hospitalization, among elderly HD patients.

scholarly journals Discharge Body Mass Index, Not Illness Chronicity, Predicts 6-Month Weight Outcome in Patients Hospitalized With Anorexia Nervosa

2021 ◽  
Vol 12 ◽  
Author(s):  
Graham W. Redgrave ◽  
Colleen C. Schreyer ◽  
Janelle W. Coughlin ◽  
Laura K. Fischer ◽  
Allisyn Pletch ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Body Mass ◽  
Adult Women ◽  
Short Term ◽  
Illness Duration ◽  
Weight Restoration ◽  
The Impact

Proposed treatments for severe and enduring anorexia nervosa (SE-AN) focus on quality of life, and psychological and social functioning. By de-emphasizing weight restoration as a priority, however, premature diagnosis of SE-AN may reduce potential for recovery. The present study assessed the effect of weight restoration, illness duration, and severity on treatment outcome 6 months after discharge from an intensive, meal-based behavioral treatment program. Participants included hospitalized adult women (N = 191) with AN or underweight other specified feeding and eating disorder (OSFED). Participants were characterized as short-term (ill &lt;7 years; n = 74) or long-term ill (ill ≥ 7 years; n = 117). Compared with short-term ill, long-term ill patients were older, had lower lifetime body mass index (BMI), more prior admissions, and exhibited greater depression and neuroticism. Long-term vs. short-term ill patients gained weight at the same rate (~2 kg/wk) and were equally likely to be weight restored by discharge (&gt;75% reached BMI ≥ 19 kg/m2 in both groups). At 6-month follow-up (n = 99), both groups had equivalent self-reported BMI, and depression, drive for thinness, body dissatisfaction, and bulimia scores. The only predictor of BMI ≥ 19 kg/m2 at follow-up was discharge BMI. The likelihood of a BMI ≥ 19 kg/m2 at follow-up was 5-fold higher for those with discharge BMI ≥ 19 kg/m2. Few studies of long-term ill inpatients with AN have examined the impact of full weight restoration on short-term outcomes. This study supports the therapeutically optimistic stance that, regardless of illness duration, hospitalized patients with AN benefit from gaining weight to a BMI ≥ 19 kg/m2.

scholarly journals Body-Mass Index and Progression of Hepatitis B: A Population-Based Cohort Study in Men

2008 ◽  
Vol 26 (34) ◽  
pp. 5576-5582 ◽  
Author(s):  
Ming-Whei Yu ◽  
Wei-Liang Shih ◽  
Chih-Lin Lin ◽  
Chun-Jen Liu ◽  
Jhih-Wei Jian ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Hepatitis B ◽  
Body Mass ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Excess Body Weight ◽  
Biochemical Tests ◽  
Hazard Ratios

Purpose To determine prospectively whether body-mass index (BMI) is associated with liver-related morbidity and mortality among male hepatitis B virus (HBV) carriers. Patients and Methods We performed a prospective study of 2,903 male HBV surface antigen–positive government employees who were free of cancer at enrollment between 1989 and 1992. Main outcome measures included ultrasonography, biochemical tests, incident hepatocellular carcinoma (HCC), and liver-related death. Results During mean follow-up of 14.7 years, 134 developed HCC and 92 died as a result of liver-related causes. In Cox proportional hazards models adjusting for age, number of visits, diabetes, and use of alcohol and tobacco, the hazard ratios for incident HCC were 1.48 (95% CI, 1.04 to 2.12) in overweight men (BMI between 25.0 and 29.9 kg/m2) and 1.96 (95% CI, 0.72 to 5.38) in obese men (BMI ≥ 30.0 kg/m2), compared with normal-weight men (BMI between 18.5 and 24.9 kg/m2). Liver-related mortality had adjusted hazard ratios of 1.74 (95% CI, 1.15 to 2.65) in overweight men and 1.50 (95% CI, 0.36 to 6.19) in obese men. Excess BMI was also associated with the occurrence of fatty liver and cirrhosis detected by ultrasonography, as well as elevated ALT and γ-glutamyltransferase (GGT) activity during follow-up. The association of BMI with GGT was stronger than with ALT, and elevated GGT activity and cirrhosis were the strongest predictors for incident HCC and liver-related death. Conclusion This longitudinal cohort study indicates that excess body weight is involved in the transition from healthy HBV carrier state to HCC and liver-related death among men.

scholarly journals Vegetarian diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Tammy Y.N. Tong ◽  
Paul N. Appleby ◽  
Aurora Perez-Cornago ◽  
Timothy J. Key
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Hip Fractures ◽  
Cox Regression ◽  
Dietary Intakes ◽  
Site Specific ◽  
Main Site ◽  
Hazard Ratios ◽  
Prospective Cohorts

AbstractIntroductionIt has been speculated that vegetarians or vegans may have higher risks of fractures than meat eaters, but there is limited evidence from prospective cohorts. We aimed to assess the risks of total and site-specific fractures in people of different diet groups, in a prospective cohort with a large proportion of non-meat eaters.Materials and methodsIn EPIC-Oxford, dietary information was collected at baseline (1993–2001) and at follow-up around 14 years later (≈2010). Participants were categorised into five diet groups (≈20,106 regular meat eaters: ≥ 50 g of meat per day, ≈9,274 low meat eaters: < 50 g of meat per day, ≈8,037 fish eaters, ≈15,499 vegetarians and ≈1,982 vegans, with minor variations in numbers for each outcome after pre-specified exclusions) at both time points. Using multivariable Cox regression adjusted for socio-demographic, lifestyle, and physiological confounders, we estimated the risks of total and site-specific fractures (arm, wrist, hip, leg, ankle, and other main sites i.e. clavicle, rib and vertebra) in the different diet groups, with outcomes identified through record linkage.ResultsOver an average of 17.6 years of follow-up, we observed 3,941 cases of total fractures, 566 arm fractures, 889 wrist fractures, 945 hip fractures, 366 leg fractures, 520 ankle fractures, and 467 other main site fractures. Compared with meat eaters, vegetarians had marginally higher risks of total fractures (hazard ratios and 95% confidence intervals: 1.10; 1.00–1.20) and arm fractures (1.28; 1.01–1.63), while vegans had significantly higher risks of total fractures (1.44; 1.21–1.72) and leg fractures (2.06; 1.22–3.47), and marginally higher risks of arm fractures (1.60, 1.01–2.54). For hip fractures, the risks were higher in fish eaters (1.28; 1.03–1.59), vegetarians (1.27; 1.05–1.55) and vegans (2.35; 1.67–3.30, p-heterogeneity < 0.0001) than regular meat eaters. There were no significant differences in risks of wrist, ankle or other main site fractures by diet groups. Overall, the significant associations appeared stronger without adjustment for body mass index (e.g. 1.52; 1.27–1.81 in vegans for total fractures), and were slightly attenuated with additional adjustment for total protein (1.41; 1.17–1.69) or dietary calcium (1.32; 1.10–1.59).DiscussionIn conclusion, non-meat eaters, especially vegans, had higher risks of either total or some site-specific fractures, particularly hip fractures. The higher risks might be partly explained by the lower body mass index in these diet groups, but differences in dietary intakes of protein and calcium are likely relevant as well. Given the observational design of this study, causality and potential mechanisms should be further investigated.

scholarly journals Body mass index, sitting time, and risk of Parkinson disease

Neurology ◽  
2018 ◽  
Vol 90 (16) ◽  
pp. e1413-e1417 ◽  
Author(s):  
Elin Roos ◽  
Alessandra Grotta ◽  
Fei Yang ◽  
Rino Bellocco ◽  
Weimin Ye ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Parkinson Disease ◽  
Body Mass ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Sitting Time ◽  
Anthropometric Measures ◽  
Hazard Ratios ◽  
Incident Cases

ObjectiveCauses of Parkinson disease are largely unknown, but recent evidence suggests associations with physical activity and anthropometric measures.MethodsWe prospectively analyzed a cohort of 41,638 Swedish men and women by detailed assessment of lifestyle factors at baseline in 1997. Complete follow-up until 2010 was achieved through linkage to population-based registers. We used multivariable Cox proportional hazards models to estimate hazard ratios with 95% confidence intervals (CIs).ResultsWe identified 286 incident cases of Parkinson disease during follow-up. Multivariable adjusted hazard ratios were 1.06 (95% CI 0.76–1.47) for sitting time ≥6 vs <6 hours per day; and 1.13 (95% CI 0.60–2.12) for body mass index ≥30 vs <25 kg/m2. Results did not differ by sex.ConclusionsNo association between prolonged sitting time per day or obesity and risk of Parkinson disease was found.

scholarly journals Relationship between Body Mass Index Reference and All-Cause Mortality: Evidence from a Large Cohort of Thai Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Vasoontara Yiengprugsawan ◽  
Cathy Banwell ◽  
Jiaying Zhao ◽  
Sam-ang Seubsman ◽  
Adrian C. Sleigh
Keyword(s):  
Body Mass Index ◽  
Confidence Intervals ◽  
Body Mass ◽  
Large Cohort ◽  
Mortality Data ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Using Data ◽  
Normal Adults

We investigate variation in body mass index (BMI) reference and 5-year all-cause mortality using data from 87151 adult Open University students nationwide. Analyses focused on BMI reference bands: “normal” (≥18.5 to <23), “lower normal” (≥18.5 to <20.75), “upper normal” (≥20.75 to <23), and “narrow Western normal” (≥23 to <25). We report hazard ratios (HR) and 95% Confidence Intervals adjusting for covariates. Compared to lower normal, adults aged 35–65 years who were obese (BMI ≥ 30) were twice as likely to die during the follow-up (HR 2.37; 1.01–5.70). For the same group, when using narrow Western normal as the reference, the results were similar (HR 3.02; 1.26–7.22). However, different combinations of BMI exposure and reference band produce quite different results. Older age persons belonging to Asian overweight BMI category (≥23 to <25) were relatively protected from mortality (HR 0.57; 0.34–0.96 and HR 0.49; 0.28–0.84) when assessed using normal (≥18.5 to <23) and upper normal (≥20.75 to <23) as reference bands. Use of different “normal” reference produced varying mortality relationships in a large cohort of Thai adults. Caution is needed when interpreting BMI-mortality data.

Body Mass Index Trajectory and Incident Hypertension: Results From a Longitudinal Cohort of Chinese Children and Adolescents, 2006–2016

2020 ◽  
Vol 110 (11) ◽  
pp. 1689-1695
Author(s):  
Xijie Wang ◽  
Bin Dong ◽  
Sizhe Huang ◽  
Yinghua Ma ◽  
Zhiyong Zou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Body Mass ◽  
Transition Period ◽  
Population Level ◽  
Chinese Children ◽  
Hazard Ratios ◽  
Bmi Trajectories ◽  
The Mean

Objectives. To identify body mass index (BMI) trajectories in Chinese children and to compare the risk of incident high blood pressure (HBP) across trajectory groups. Methods. A total of 9286 children were included. The mean age at baseline was 8.9 years; age at endpoint ranged between 16 and 18 years. At least 8 measurements were obtained from each involved child. We used group-based trajectory modeling to identify BMI trajectory groups in each sex. We used blood pressure from each measurement to define HBP. Results. We identified 4 BMI trajectories for each sex. Compared with the low trajectory group, the hazard ratios of HBP in the higher trajectory groups ranged from 1.17 (95% confidence interval [CI] = 1.11, 1.23) to 2.00 (95% CI = 1.78, 2.27) during follow-up, and HBP risk at late adolescence ranged from 1.36 (95% CI = 1.22, 1.52) to 3.63 (95% CI = 3.12, 4.21). All trend P values across trajectories were less than .001. In terms of population level, overweight started 3 years earlier than HBP. Conclusions. Children of higher BMI trajectories had a higher risk of HBP during adolescence. The transition period from overweight to HBP onset could be critical for HBP prevention.

scholarly journals Associations Between Physical Activity and Incident Hypertension Across Strata of Body Mass Index: A Prospective Investigation in a Large Cohort of French Women

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Conor‐James MacDonald ◽  
Anne‐Laure Madika ◽  
Martin Lajous ◽  
Nasser Laouali ◽  
Fanny Artaud ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Mass ◽  
High Body Mass Index ◽  
Healthy Weight ◽  
Cox Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Diet History Questionnaire ◽  
Diet History

Background High body mass index (BMI) and low physical activity are associated with increased risk of hypertension. Few studies have assessed their joint impact or the relation of physical activity and hypertension among individuals within a healthy BMI range. The objective of this study was to investigate the associations between physical activity and hypertension across strata of BMI. Methods and Results We used data from the E3N (Etude Epidémiologique de femmes de la Mutuelle Générale de l´Education) cohort, a French prospective study of women aged 40 to 65 years. We included participants who completed a diet history questionnaire and who did not have prevalent hypertension at baseline, resulting in a total of 41 607 women. Questionnaires assessed time spent undertaking various types of physical activity. Hypertension cases were self‐reported. Cox models were used to calculate hazard ratios (HRs) for physical activity. Associations were assessed over strata of BMI. Among the 41 607 included women, 10 182 cases of hypertension were identified in an average follow‐up time of 14.5 years. Total physical activity was associated with a lower hypertension risk in women within the high‐normal BMI range (BMI, 22.5–24.9) (HR Quartile 1–Quartile 4 , 0.89; 95% CI, 0.79–0.99). An inverse relationship was observed between sports (HR sports >2 hours , 0.87; 95% CI, 0.83–0.93), walking (HR walk >6.5 hours , 0.94; 95% CI, 0.90–1.00), and gardening (HR gardening >2.5 hours , 0.94; 95% CI, 0.89–0.99). Sports were associated with a reduced risk of hypertension in women with a healthy weight, but evidence was weaker in overweight/obese or underweight women. Conclusions Women with a healthy weight were those who could benefit most from practicing sports, and sports provided the largest risk reduction compared with other types of activity.

scholarly journals Intra-Dialytic Hemoglobin Changes and Cardiovascular Events: A Cohort Study on Dialysis Outcomes and Practice Patterns in Japan

2019 ◽  
Vol 50 (4) ◽  
pp. 272-280
Author(s):  
Takashi Hara ◽  
Miho Kimachi ◽  
Tatsuyoshi Ikenoue ◽  
Tadao Akizawa ◽  
Shunichi Fukuhara ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Events ◽  
Primary Outcome ◽  
Practice Patterns ◽  
Cox Model ◽  
Hemoglobin Concentration ◽  
Major Adverse Cardiovascular Events ◽  
Hazard Ratios ◽  
Dialysis Outcomes

Background: Ultrafiltration during hemodialysis (HD) causes hemoconcentration. Little is known about the relationships between intra-dialytic changes in hemoglobin concentration and cardiovascular events. Thus, this study aimed to elucidate the relationships between intra-dialytic changes in hemoglobin concentration and cardiovascular events among HD patients. Methods: This prospective cohort study was based on the Japanese Dialysis Outcomes and Practice Pattern Study phases 4 and 5. The predictor was the ratio of post-dialysis hemoglobin concentration to pre-dialysis hemoglobin concentration (post-Hb/pre-Hb) at baseline. The primary outcome was major adverse cardiovascular events (MACEs). Hazard ratios (HRs) were estimated using a Cox model for the association between post-Hb/pre-Hb and MACEs, adjusting for potential confounders. Results: A total of 865 patients were enrolled. During a median follow-up of 2.6 years, 145 (16.8%) patients developed MACEs. Patients were divided into 4 categories according to baseline post-Hb/pre-Hb (<1.0, ≥1.0 to <1.1, ≥1.1 to <1.2, and ≥1.2). The multivariable-adjusted HRs for MACEs were 1.69 (95% CI 1.36–2.10), 1.29 (95% CI 1.10–1.51), and 1.31 (95% CI 1.02–1.68) in patients with post-Hb/pre-Hb ratios of <1.0, ≥1.0 to <1.1, and ≥1.2, respectively, compared with the reference post-Hb/pre-Hb ratio of ≥1.1 to <1.2. Cubic spline analyses revealed a U-shaped association between post-Hb/pre-Hb and MACEs. Conclusion: High and low intra-dialytic changes in hemoglobin concentration are associated with a high risk of MACEs in patients undergoing HD.

Combined effect of fasting glucose and body mass index on mortality by age and sex in over 15 million adults: a cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Jung ◽  
S.W Yi ◽  
S.J An ◽  
S.H Ihm
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Proportional Hazards ◽  
Fasting Glucose ◽  
Fasting Blood Glucose ◽  
Cox Proportional Hazards ◽  
Younger Adults ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios

Abstract Background We aimed to elucidate whether synergic combined association of body mass index (BMI) and fasting blood glucose (FBG) on mortality exist and to identify FBS-BMI subgroups with higher mortality according to sex and age. Methods A total of 15,149,275 Korean adults participated in health examinations during 2003–2006 and were followed up until December 2018. Hazard ratios (HRs) of 40 BMI-FBG combined groups for mortality were assessed by Cox proportional hazards models. Results During mean 13.7 years of follow-up, 1,213,401 individuals died. The association between hyperglycemia and mortality was stronger in leaner than more obese individuals and these effects were more prominent in younger than older adults. Compared with overweight (BMI 25–27.4kg/m2) normoglycemic (FBG 80–94mg/dL), age, sex-adjusted HRs of leanest (BMI &lt;20kg/m2) normoglycemic, overweight diabetes (FBG ≥180mg/dL), and leanest diabetes were 1.66, 2.17, and 4.77, respectively. Corresponding HRs in those aged 18–44 years were 1.29, 2.59, and 11.18, respectively, while corresponding HRs in those aged 75–99 years were 1.56, 1.72, and 2.87, respectively (Figure 1). The interpretation of BMI-FBG subgroups associated with higher mortality was not straightforward. For example, prediabetes (FBG 110–125 mg/dL) with BMI 20–22.4 kg/m2 had similar or higher mortality than low diabetes (FBG 126–179 mg/dL) with BMI ≥22.5 kg/m2. In non-diabetic women aged &lt;45 years, BMI ≥27.5 kg/m2 was associated with the highest mortality, whereas the leanest had the worst mortality in each given FBG level in other age-sex groups. Conclusions Leanness and hyperglycemia interact together to increase mortality supra-multiplicatively, especially in younger adults, while complex interaction of BMI, FBG, sex and age on mortality exist. Figure 1 Funding Acknowledgement Type of funding source: None

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