scholarly journals Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Li Weng ◽  
Junning Fan ◽  
Canqing Yu ◽  
Yu Guo ◽  
Zheng Bian ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
Population Based ◽  
Chinese Adults ◽  
Related Mortality

scholarly journals Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Barbara Iyen ◽  
Stephen Weng ◽  
Yana Vinogradova ◽  
Ralph K. Akyea ◽  
Nadeem Qureshi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
World Health ◽  
Obese Adults ◽  
Bmi Trajectories ◽  
The Impact

Abstract Background Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8 kg/m2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06 kg/m2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had hazards ratios (HR) of 3.26 (95% CI 2.98–3.57) for heart failure, HR of 2.72 (2.58–2.87) for all-cause mortality and HR of 3.31 (2.84–3.86) for CVD-related mortality, after adjusting for baseline demographic and cardiovascular risk factors. Conclusion The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.

scholarly journals BODY MASS INDEX TRAJECTORY BEFORE DEATH IN COMMUNITY-DWELLING OLDER ADULTS. POPULATION-BASED COHORT STUDY

2021 ◽  
Author(s):  
Hari Venkatesh Pai ◽  
Martin C Gulliford
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
High Body Mass Index ◽  
Population Based ◽  
Community Dwelling ◽  
Housing Tenure ◽  
Age Related ◽  
Community Dwelling Older Adults

Background and objective: Both low and high body mass index (BMI) have been associated with greater mortality in older adults. This study evaluated the trajectory of BMI in the final years of life. Design: Population-based cohort study. Setting: Community-dwelling adults in the English Longitudinal Study of Ageing between 1998 and 2012. Measurements: Body mass index, years before death and all-cause mortality. Analyses were adjusted for age, gender, educational level, housing tenure and social class. Results: Data were analysed for 16,924 participants with 31,857 BMI records; mean age at study start, 61.6 (SD 10.9) years; mean BMI, 27.5 (4.7) Kg/m2. There were 3,686 participants (4,794 BMI records) who died and 13,238 participants (27,063 BMI records) who were alive at last follow-up. Mean BMI increased with age to 60-69 years but then declined, but the age-related decline was more rapid in decedents. At ages 80-89 years, mean BMI in decedents was 26.1 (4.7) compared with 27.1 (4.4) Kg/m2 in survivors. After adjusting for age and covariates, mean BMI declined in the five years before death. From 9 to 5 years before death or end of study, adjusted mean BMI was 0.51 (95% confidence interval 0.24 to 0.78) Kg/m2 lower for decedents than survivors; and from four to zero years before death, 1.55 (1.26 to 1.84) Kg/m2 lower in decedents. Conclusions: In community-dwelling older adults, mean body mass index enters an accelerating decline during five years before death. Reverse causation may account for the association of lower BMI with mortality.

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