Zhi-Bing Li1, Man-Liu Wang2, Sheng-Yong Dong3, Ban-Ruo Sun1, Xin-Yu Miao1, Fu-Sheng Fang4, Zheng-Xue Dai3, Chun-Lin Li1, Hui Tian5. 1. Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China. 2. Center of Biomedical Analysis, Tsinghua University, Beijing, China. 3. Healthcare Department, Agency for Offices Administration of PLA, Beijing, China. 4. Department of Health Care, Chinese PLA General Hospital, Beijing, China. 5. Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China. Electronic address: tianhui@medmail.com.cn.
Abstract
OBJECTIVES: To assess the effect of baseline body mass index (BMI) status and weight change on mortality in older men with impaired glucose regulation (IGR). METHODS: Eight hundred eighty-five men with IGR aged 60 to 90 were included. Baseline and endpoint weight were measured. All-cause and cardiovascular mortality were observed during a median follow-up period of 10years. Multivariate Cox regressions were used to estimate associations between BMI, weight change and mortality. RESULTS: Relative to normal weight, overweight was associated with lower all-cause mortality (hazard ratios, HRs [95% confidence interval, 95% CI]: 0.57 [0.41, 0.78]) and cardiovascular mortality (0.52 [0.29, 0.93]), whereas obesity did not significantly decrease or increase the mortality risk. Furthermore, compared to weight stability, all types of weight change led to increased mortality risk, except small weight gain. Specifically, after adjustment for covariates and the initial weight, the HRs (95% CI) of large weight loss were 1.64 (1.15, 2.34) for all-cause mortality and 1.85 (1.10, 3.14) for cardiovascular mortality, and the HRs (95% CI) of large weight gain were 1.55 (1.01, 2.40) for all-cause mortality and 2.11 (1.04, 4.30) for cardiovascular mortality. Similar associations were observed when weight change was redefined in sensitivity analyses. CONCLUSIONS: Both BMI at baseline and weight change have independent U-shaped associations with all-cause and cardiovascular mortality among older men with IGR. The present study suggests that older men with IGR may ensure their best survival by being overweight at baseline or by maintaining their weight regardless of their baseline weight status.
OBJECTIVES: To assess the effect of baseline body mass index (BMI) status and weight change on mortality in older men with impaired glucose regulation (IGR). METHODS: Eight hundred eighty-five men with IGR aged 60 to 90 were included. Baseline and endpoint weight were measured. All-cause and cardiovascular mortality were observed during a median follow-up period of 10years. Multivariate Cox regressions were used to estimate associations between BMI, weight change and mortality. RESULTS: Relative to normal weight, overweight was associated with lower all-cause mortality (hazard ratios, HRs [95% confidence interval, 95% CI]: 0.57 [0.41, 0.78]) and cardiovascular mortality (0.52 [0.29, 0.93]), whereas obesity did not significantly decrease or increase the mortality risk. Furthermore, compared to weight stability, all types of weight change led to increased mortality risk, except small weight gain. Specifically, after adjustment for covariates and the initial weight, the HRs (95% CI) of large weight loss were 1.64 (1.15, 2.34) for all-cause mortality and 1.85 (1.10, 3.14) for cardiovascular mortality, and the HRs (95% CI) of large weight gain were 1.55 (1.01, 2.40) for all-cause mortality and 2.11 (1.04, 4.30) for cardiovascular mortality. Similar associations were observed when weight change was redefined in sensitivity analyses. CONCLUSIONS: Both BMI at baseline and weight change have independent U-shaped associations with all-cause and cardiovascular mortality among older men with IGR. The present study suggests that older men with IGR may ensure their best survival by being overweight at baseline or by maintaining their weight regardless of their baseline weight status.
Authors: Ji-Bin Li; Sheng Luo; Martin C S Wong; Cai Li; Li-Fen Feng; Jian-Hong Peng; Jing-Hua Li; Xi Zhang Journal: BMC Cancer Date: 2019-11-11 Impact factor: 4.430