To evaluate the association between body mass index (BMI) and all-cause mortality and cardiovascular disease (CVD) in an 80-year-old population.
Six hundred ninety-seven of 1,282 (54.4%) 80-year-old candidate individuals.
The dates and causes of all deaths were followed up for 4 years.
The relative hazard ratios (HRs) for all-cause mortality were lower in overweight subjects (BMI > or= 25.0) than in underweight (BMI<18.5) or normal-weight (BMI 18.5-24.9) subjects. Similarly, the HRs for mortality due to CVD in overweight subjects were 78% less (HR=0.22, 95% confidence interval (CI)=0.06-0.77) than those in underweight subjects, and those in normal weight subjects were 78% less (HR=0.22, 95% CI=0.08-0.60) than those in underweight subjects. Mortality due to CVD was 4.6 times (HR 4.64, 95% CI=1.68-12.80) as high in underweight subjects as in normal-weight subjects, and mortality due to cancers was 88% lower (HR=0.12, 95% CI=0.02-0.78) in the overweight group than in the underweight group. There were no differences in mortality due to pneumonia.
Overweight status was associated with longevity and underweight with short life, due to lower and higher mortality, respectively, from CVD and cancer.
"Several independent predictors of all-cause and cardiovascular mortality have been suggested for older adults          such as body mass index (BMI)  ; sarcopenia ; cigarette smoking ; biomarkers such as the serum concentrations of adiponectin , C-reactive protein (CRP) , interleukin 6 , tumor necrosis factor α , and fibrinogen ; and leukocyte count . Adiponectin is the most abundant secretory adipocyte-derived protein and is known as an insulin-sensitizing, anti-inflammatory, and antiatherogenic adipokine . "
[Show abstract][Hide abstract] ABSTRACT: Background:
The relationship between adiponectin concentration and mortality is unclear. We examined whether serum adiponectin concentration is associated with all-cause and cardiovascular mortality in elderly Asians.
We analyzed the data for community-dwelling adults ≥65 years of age (439 men and 561 women) who were enrolled in the Korean Longitudinal Study on Health and Aging (KLoSHA) cohort in prospective manner. The baseline serum total and high molecular weight adiponectin were measured using an enzyme-linked immunosorbent assay. Using Cox regression, we determined the associations between serum adiponectin concentration and all-cause and cardiovascular mortality after adjusting for well-known cardiovascular risk factors.
Over a mean follow-up time of 6.2 years, 222 individuals died, and 52 deaths (23.4%) were by cardiovascular disease. After adjusting confounding factors, elevated baseline serum adiponectin concentration was independently associated with all-cause mortality (adjusted hazard ratio [HR] 1.38; 95% confidence interval [CI] 1.17-1.64) and cardiovascular mortality (HR 1.50; 1.06-2.14). We evaluated the effect modification by baseline body mass index (BMI). High serum adiponectin and low BMI were synergistically associated with increased all-cause mortality (HR 6.25; 3.08-12.71) and cardiovascular mortality (HR 13.94; 1.82-106.58).
Higher serum adiponectin concentration was associated with increased all-cause and cardiovascular mortality in community-dwelling elderly Asian population. Our data supported the recent theory so called "adiponectin paradox". This relationship was strengthened when combined with low BMI. We suggest that measurement of adiponectin concentration and BMI together could be an additional predictive marker of survival among elderly adults.
International Journal of Cardiology 03/2015; 183. DOI:10.1016/j.ijcard.2015.01.057 · 4.04 Impact Factor
"Studies indicated a variation in the mortality risk depending on age
. Some observed a higher risk associated with underweight among older participants
[3,48], which we could not confirm (Figure
1B). In our sample, younger participants were at increased odds of being underweight (Additional file
1: Table S5). "
[Show abstract][Hide abstract] ABSTRACT: In contrast to obesity, information on the health risks of underweight is sparse. We examined the long-term association between underweight and mortality by considering factors possibly influencing this relationship.
We included 31,578 individuals aged 25-74 years, who participated in population based health studies between 1977 and 1993 and were followed-up for survival until 2008 by record linkage with the Swiss National Cohort (SNC). Body Mass Index (BMI) was calculated from measured (53% of study population) or self-reported height and weight. Underweight was defined as BMI < 18.5kg/m2. Cox regression models were used to determine mortality Hazard Ratios (HR) of underweight vs. normal weight (BMI 18.5- < 25.0kg/m2). Covariates were study, sex, smoking, healthy eating proxy, sports frequency, and educational level.
Underweight individuals represented 3.0% of the total study population (n = 945), and were mostly women (89.9%). Compared to normal weight, underweight was associated with increased all-cause mortality (HR: 1.37; 95%CI: 1.14-1.65). Increased risk was apparent in both sexes, regardless of smoking status, and mainly driven by excess death from external causes (HR: 3.18; 1.96-5.17), but not cancer, cardiovascular or respiratory diseases. The HR were 1.16 (0.88-1.53) in studies with measured BMI and 1.59 (1.24-2.05) with self-reported BMI.
The increased risk of dying of underweight people was mainly due to an increased mortality risk from external causes. Using self-reported BMI may lead to an overestimation of mortality risk associated with underweight.
BMC Public Health 04/2014; 14(1):371. DOI:10.1186/1471-2458-14-371 · 2.26 Impact Factor
"However, Phung et al. did not find that obesity was significantly associated with pneumonia risk. Takata et al. indicated that mortality risk was not different between obese pneumonia patients and normal weight patients. However, other studies reported that obese subjects with pneumonia had lower mortality compared to normal weight subjects [26-28]. "
[Show abstract][Hide abstract] ABSTRACT: It is unclear whether an 'obesity survival paradox' exists for pneumonia. Therefore, we conducted a meta-analysis to assess the associations between increased body mass index (BMI), pneumonia risk, and mortality risk.
Cohort studies were identified from the PubMed and Embase databases. Summary relative risks (RRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random effects model.
Thirteen cohort studies on pneumonia risk (n = 1,536,623), and ten cohort studies on mortality (n = 1,375,482) were included. Overweight and obese individuals were significantly associated with an increased risk of pneumonia (RR = 1.33, 95% CI 1.04 to 1.71, P = 0.02, I2 = 87%). In the dose-response analysis, the estimated summary RR of pneumonia per 5 kg/m2 increase in BMI was 1.04 (95% CI 1.01 to 1.07, P = 0.01, I2 = 84%). Inversely, overweight and obese subjects were significantly associated with reduced risk of pneumonia mortality (RR = 0.83, 95% CI 0.77 to 0.91, P < 0.01, I2 = 34%). The estimated summary RR of mortality per 5 kg/m2 increase in BMI was 0.95 (95% CI 0.93 to 0.98, P < 0.01, I2 = 77%).
This meta-analysis suggests that an 'obesity survival paradox' exists for pneumonia. Because this meta-analysis is based on observational studies, more studies are required to confirm the results.
BMC Medicine 04/2014; 12(1):61. DOI:10.1186/1741-7015-12-61 · 7.25 Impact Factor
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