Association between body mass index and all-cause mortality among oldest old Chinese

Objectives

To examine the association between BMI and all-cause mortality in the oldest old (≥80 years).

Design

The study used a prospective cohort study design.

Setting

Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 1998/99 and 2011.

Population

8026 participants aged 80 years and older were followed every two to three years.

Measurements

Body weight and knee height were measured. Height was calculated based on knee height using a validated equation. Deaths were ascertained from family members during follow-up.

Results

The mean BMI was 19.8 (SD 4.5) kg/m². The prevalence of underweight, overweight and obese was 37.5%, 10.2% and 4.4%, respectively. There were 5962 deaths during 29503 person-years of follow-up. Compared with normal weight, underweight was associated with a higher mortality risk (HRs: 1.20 (95%CI 1.13-1.27) but overweight (HR 0.89 (95%CI 0.81-0.99)) were associated with a lower risk. Obesity had a HR 0.91 (95%CI 0.78-1.05) for mortality.

Conclusion

Among oldest old Chinese, underweight is associated with an increased risk of all-cause mortality but overweight is associated with a reduced risk. Interventions to reduce undernutrition should be given priority among the oldest old Chinese.

     

Association of body mass index and weight change with all-cause mortality in the elderly

The authors explored the relation of body mass index (BMI; weight (kg)/height (m)(2)) and weight change to all-cause mortality in the elderly, using data from a large, population-based California cohort study, the Leisure World Cohort Study. They estimated relative risks of mortality associated with self-reported BMI at study entry, BMI at age 21 years, and weight change between age 21 and study entry. Participants were categorized as underweight (BMI <18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9), or obese (BMI >or=30). Of 13,451 participants aged 73 years (on average) at study entry (1981-1985), 11,203 died during 23 years of follow-up (1981-2004). Relative to normal weight, being underweight (relative risk (RR) = 1.51, 95% confidence interval (CI): 1.38, 1.65) or obese (RR = 1.25, 95% CI: 1.13, 1.38) at study entry was associated with increased mortality. People who were either overweight or obese at age 21 also had increased mortality (RR = 1.17, 95% CI: 1.09, 1.25). Participants who lost weight between age 21 and study entry had increased mortality regardless of their BMI category at age 21. Obesity was significantly associated with increased mortality only among persons under age 75 years and among never or past smokers. This study highlights the influence on older-age mortality risk of being overweight or obese in young adulthood and underweight or obese in later life.     

体重指数与儿童青少年体能指数关联性研究

目的 探讨体重指数(BMI)与儿童青少年体能指数(PFI)之间的关联.方法 以安徽省参加2010年全国学生体质健康调查的7～18岁汉族学生共8941人为研究对象.按性别、年龄分层后,将研究对象依据BMI百分位数分为5组:很低(BMI＜P5)、较低(P5≤BMI＜P15)、正常(P15≤BMI＜ P85)、较高(P85≤BMI＜P95)、很高(BMI≥P95).对各体能测试成绩进行标准化,将其Z分相加算出PFI.用方差分析比较不同BMI组PFI的差异.用线性回归模型分析不同性别不同学龄段学生BMI与PFI的关联.结果 8941名学生中BMI很低、较低、正常、较高、很高组的PF1分别为-1.77、-0.91、0.32、-0.17、-0.54,呈倒“U”形分布;BMI正常组的PFI显著高于其他各组(P值均＜0.05).回归分析显示PFI与BMI呈正相关,与BMI2呈负相关,表明PFI是BMI的二次函数,随着BMI的增高PFI呈现先上升后下降的抛物线变化趋势.结论 BMI与儿童青少年PFI呈现抛物线变化趋势.     

成人腰围、体重指数与高三酰甘油血症的关系

目的探讨体重指数（BMI）、腰围（WC）与三酰甘油水平之间的关系,并用受试者工作特征（ROC）凹线评价BMI和WC对诊断高三酰甘油血症的价值。方法以2008年7至9月在我院进行常规体检的1093人（男性707人、女性386人）为研究对象,检测身高、体重、腰围和血三酰甘油水平。比较三酰甘油正常组与异常组BMI和WC的差异。建立BMI和WC的ROC曲线,获得曲线下面积及曲线上各界值点的灵敏度和特异度。结果男女性三酰甘油异常率分别为33．5％和8．3％。三酰甘油异常者的BMI和WC明显大于三酰甘油正常者（P〈0．01）。以BMI诊断高三酰甘油血症的ROC曲线下面积：男性为0．728±0．041、女性为0．708±0．021,最佳界值点：男性为24．5、女性为22．5;以WC诊断高三酰甘油血症的ROC曲线下面积：男性为0．790±0．042,女性为0．714±0．020,最佳界值点：男性为86cm,女性为77cm。结论BMI和WC与三酰甘油水平均相关。BMI和WC是预测高三酰甘油血症较为理想的指标。     

Associations between body mass index and health-related quality of life among Australian adults

Objectives  

To assess the relationship between body mass index (BMI) and health-related quality of life (HQoL), as measured by the Short Form Health Survey (SF-36) within a sample with broad population coverage.     

Effects of low body mass index and smoking on all-cause mortality among middle-aged and elderly Japanese

To investigate effects of low body mass index (BMI) and smoking on all-cause mortality among middle-aged and elderly Japanese, we conducted a community-based prospective study. A mail survey was conducted in 1987-1990 in four towns, western Japan. A cohort of 7,301 Japanese men and 8,825 Japanese women was followed up from the date of the mail survey to 1995 in three of the towns and 1998 in the fourth town. We investigated the effect of BMI and smoking on all-cause mortality by using Cox's proportional hazards model. The relationship between BMI and all-cause mortality was a reverse J-shape with minimal mortality in 24 < or = BMI < 26 in men and a U-shape with minimal mortality in 22 < or = BMI < 24 in women, after adjusting for age and smoking. The lowest BMI category (BM < 20) had the highest all-cause mortality in men and also in women. Taking only never-smokers, the highest risk for all-cause mortality was observed in the lowest BMI category for men and for women. This does not seem to be explained by smoking and pre-existing diseases. More attention should be paid to persons with low BMI.     

北京市中老年人体质指数与死亡的关系

目的：探讨北京市中老年人体质指数（BMI）与死亡的关系，方法：采用前瞻队列研究方法，于1991年对北京市40岁以上的自然人群共6209人进行基线危险因素调查后，并随访至1999年12月，对在随访期间发生的所有死亡病例按ICD－9编码进行登记，并在个体水平对BMI与总死亡及几种主要死因的关系进行分析。结果：近10年北京市中老年人前5位主要死因依次为心脑血管疾病，肺心病，消化道肿瘤，不明原因突然死亡，肺癌，其死亡构成比分别为33．3％，13．8％，11．2％，7．4％，5．6％，人群总死亡率及不吸烟者总死亡率均以BMI值23．6－26．2组最小，以此BMI组为参照，BMI＜21．2组上述二组人群总死亡的RR值分别为1．7和1．9，在BMI≥26．2组以上二组人群总死亡的RR值分别为1．3和1．5，BMI与心血管病死亡呈正关联，BMI≥26.2组较BMI＜21．2组心血管病死亡的RR值为1．2，BMI与肺心病，消化道肿瘤，肺癌，肺炎及不明原因突然死亡分别均呈U型关系，均以BMI值23．6－26．2组死亡率最低，与此BMI组相比，BMI＜21．2组因上述5种疾病死亡的RR值分别为14．8，1．1，5．6，2．4和2．6，BMI≥26．2组因上述5种疾病死亡的RR值分别为3．0，1．9，3．7，2．2和1．5，各BMI组均以心血管病死亡构成比最大（28．0％－54．8％），结论：北京市中老年人体质指数与总死亡呈U型关系；心脑血管疾病仍是目前影响人们健康的最主要疾病，其死亡危险性随BMI的增加而增加。     

北京市中老年人体质指数与死亡的相关关系

目的探讨北京市中老年人体质指数(BMI)与死亡的相关关系.方法采用前瞻对列研究方法,于1991年对北京市40岁以上的自然人群共6 209人进行基线危险因素调查后,并随访至1999年12月.对在随访期间发生的所有死亡病例按ICD-9编码进行登记,并在个体水平对BMI与总死亡及几种主要死因进行相关分析.结果近10年北京市中老年人前5位主要死因依次为心脑血管疾病、肺心病、消化道肿瘤、不明原因突然死亡、肺癌,其死亡构成比分别为33.3%、13.8%、11.2%、7.4%、5.6%.人群总死亡率及不吸烟者总死亡率均以BMI值23.6～26.2组最小,以此BMI组为参照,BMI＜21.2组上述二组人群总死亡的RR值分别为1.7和1.9,在BMI≥26.2组以上二组人群总死亡的RR值分别为1.3和1.5.BMI与心血管病死亡呈正相关,BMI≥26.2组较BMI＜21.2组心血管病死亡的RR值为1.2;BMI与肺心病、消化道肿瘤、肺癌、肺炎及不明原因突然死亡分别均呈U型关系,均以BMI值23.6～26.2组死亡率最低,与此BMI组相比,BMI＜21.2组因上述5种疾病死亡的RR值分别为14.8、1.1、5.6、2.4和2.6,BMI≥26.2组因上述5种疾病死亡的RR值分别为3.0、1.9、3.7、2.2和1.5.各BMI组均以心血管病死亡构成比最大(28.0%～54.8%).结论北京市中老年人体质指数与总死亡呈U型相关;心脑血管疾病仍是目前影响人们健康的最主要疾病,其死亡危险性随BMI的增加而增加.     

Body mass index and measures of adiposity among elderly adults

OBJECTIVE: To evaluate the nutritional status of elderly persons and to compare the correlation between the body mass index (BMI=kg/m2) with measures of adiposity and fat distribution among elderly and middle-aged adults. METHODS: Elderly persons (N=699; 60 years or older) and middle-aged adults (N=1,306; 40-59.9 years) participating in a population-based survey conducted in 1996 in the municipality of Rio de Janeiro were evaluated as to body mass index, arm, waist, and hip circumferences, skinfolds, and arm fat and muscle areas using standardized procedures. The cutoff points proposed by the World Health Organization for waist circumference, waist-to-hip ratio, and body mass index were used. Analyses were performed using the Spearman correlation coefficient and linear regression adjusted for age. RESULTS: About 50% of elderly subjects were classified as overweight and more than 50% of women in all age groups had waist circumference and waist-to-hip ratio outside the normal range. Among men, these percentages were about 40% for waist circumference and 20% for waist-to-hip ratio. Among elderly subjects, the partial correlation (adjusted for age) between body mass index and measures of adiposity (waist circumference, skinfolds, and arm fat area) ranged from 0.45 to 0.85 for men and 0.55 to 0.86 for women. Weight and waist circumference were the variables more strongly correlated with body mass index among both elderly persons and adults. CONCLUSIONS: The prevalence of overweight among elderly persons was high for both men and women. Body mass index shows a similar relationship with adiposity regardless of ageing.     

Association between body composition and body mass index in young Japanese women

The National Nutrition Survey of Japan indicated a trend toward a decreasing body mass index (BMI; kg/m2) among young Japanese women. Current studies suggest that not-high BMI often does not correlate with not-high body fat percentage. Recently, the classification of BMI in adult Asians was proposed by the International Obesity Task Force. The addition of an "at risk of overweight" category, BMI as 23.0-24.9, was intended to prevent chronic diseases. We investigated the association between body fat percentage (BF%) and BMI to evaluate the screening performance of BMI focused on individual preventive medicine. The subjects consisted of 605 female college students. The subjects' ages (y), heights (cm), body weights (kg), BMIs, and BF percents with underwater weighing expressed as the means +/- SD were 19.6 +/- 0.5, 158.7 +/- 5.6, 53.8 +/- 7.2, 21.3 +/- 2.4, and 24.9 +/- 4.9, respectively. We defined high BF% as +/- 85th percentile of BF% (29.8%). High-BF% individuals are often not classified into BMI > or = 23.0 because their BMI readings are very broad (18.4-31.7). In comparison to the screening performances (specificity and sensitivity), BMI > or = 23.0 (85.3% and 52.1%, respectively), rather than BMI > or = 25.0 (96.7% and 29.8%, respectively), is recommended for the mass evaluation of fatness. For this reason, the BMI "at risk of overweight" category is characterized as the threshold of increasing the appearance ratio of high-BF% individuals. In conclusion, the BMI > or = 25.0 kg/m2 category is determined as high BF%, regardless of body composition measurement for mass evaluation as a result of quite high specificity. Even so, body composition measurement is necessitated by the individual evaluation of fatness focused on preventive medicine because BMI performed a poor representation of body composition, especially BMI < 25.0 kg/m2 individuals.     

Predictors of body mass index among low-income community-dwelling older adults

This study investigated demographic, behavioral, and functional predictors of overweight and obesity, using secondary data from 705 community-dwelling individuals aged 65 years and older receiving or seeking Medicaid personal care services. Half of the participants were obese, while an additional 28% were overweight. The relationships between body mass index (BMI) levels and selected independent variables were analyzed. Females were more likely to be obese, while those who were older (75 years or older), more cognitively impaired, and smoked were less likely to obese. Comparing obesity with being overweight, being female and reporting more pain symptoms increased the odds of being obese, whereas being older (75 years or older) and being more cognitively impaired decreased the odds. The especially high rates of obesity in Texas have a profound impact on personal health and may result in increased health care costs that threaten public programs as well.     

围青春期女生身体成分与体质量指数协同变化关系

探索围青春期女生身体成分与体质量指数(BMI)的关系,为有针对性进行肥胖预防提供理论基础.方法 以2015年1-12月天津市体质检测中心测试的10~16岁中小学女生2 023名为研究对象,测试其基本形态指标和身体成分.结果 10~ 16岁女生的BMI与体脂、体脂/身高2、体重、体脂百分比呈中高度相关(r值分别为0.905,0.891,0.844和0.878,P值均<0.01);BMI与去脂体重、去脂体重/身高2呈低到中度相关(r值分别为0.507,0.636,P值均<0.01).11~16岁各年龄组体重、去脂体重均高于10岁时的体重、去脂体重,差异均有统计学意义(P值均<0.05).12~ 16岁各年龄组的脂肪重量均高于10岁时的脂肪重量,差异均有统计学意义(P值均<0.05).13,15,16岁时的BMI、体脂重量/身高2值高于10岁时的BMI、体脂重量/身高2;12,15,16岁时的去脂体重/身高2高于10岁时的去脂体重/身高2,差异均有统计学意义(P值均<0.05).结论 围青春期尤其是12~13岁女生体质量指数和身体成分变动幅度大.应为不同年龄段的女生制定不同的体力活动及营养健康计划.     

上海市某社区老年人体质指数与代谢异常关系的调查

[目的] 了解上海市湖南社区老年人体质指数(BMI)的分布情况及与高血压、高血糖、血脂紊乱、高尿酸、代谢综合征等患病情况的关系,以便更好地进行干预。[方法] 对社区中60岁以上老人进行体检,询问病史,测定身高、体重、血压、空腹血糖、血脂、血尿酸等。[结果] 639名资料齐全的老人平均BMI为24.15±3.38,其中男性为24.11±3.15,女性为24.18±3.53。超重、肥胖比例达51.64%,高于体重正常组,男性60～69岁组肥胖比例最高。60岁以上老人高血压检出率在超重和肥胖人群中高达83.40%和87.01%,明显高于体重正常组。血脂紊乱检出率在超重和肥胖人群中高达67.98%和75.33%,高于低体重组和正常体重组;正常体重组女性血脂紊乱检出率高达66.86%,高于同组男性的50.42%。代谢综合征检出率在超重、肥胖人群中分别为35.97%、61.04%,明显高于低体重组和正常体重组。高尿酸血症在肥胖组中达36.36%,高于另3组。高血糖检出率以超重和肥胖组为高。[结论] 应加强健康教育,提前控制体重等心脑血管疾病危险因素,以利提高老年人的生存质量。     

体质指数与总死亡率关系的Meta分析

目的采用Meta分析方法定量综合国内外前瞻性研究中不同水平体质指数(body mass index,BMI)与总死亡率关系。方法以体质指数、超重、肥胖、死亡率、队列研究、前瞻性研究及随访研究为主题词和关键词联合检索PubMed和中国期刊网全文数据库(CNKI),查找相关文献。合格的文献限定于探讨普通人群BMI与总死亡率关系的前瞻性研究,BMI分组数≥6,且报道了各组死亡的相对危险度(RR)及95%可信区间(95%CI)。结果共纳入32篇文献,含54个队列研究(总人数:7 910 932人,死亡数:1 376 997人)。男女合并发现,BMI和总死亡风险呈U形关系,总死亡风险最低时的BMI为23.0~24.9 kg/m2。与此对照,其他BMI组总死亡风险RR(95%CI)分别为:<18.5 kg/m2:1.53(1.49~1.57);18.5~20.9 kg/m2:1.09(1.07~1.11);21.0~22.9 kg/m2:1.06(1.04~1.08);25.0~26.9 kg/m2:1.01(1.00~1.03);27.0~29.9 kg/m2:1.11(1.10~1.12);30.0~34.9 kg/...     

Cognitive function,body mass index and mortality in a rural elderly Chinese cohort

Background

Previous studies have shown that poor cognition and low body mass index were associated with increased mortality. But few studies have investigated the association between cognition and mortality across the entire cognitive spectrum while adjusting for BMI. The objective of this study is to examine the associations between cognitive function, BMI and 7-year mortality in a rural elderly Chinese cohort.

Methods

A prospective cohort of 2,000 Chinese age 65 and over from four rural counties in China were followed for 7-years. Cognitive function, BMI and other covariate information were obtained at baseline. Cox’s proportional hazard models were used to determine the effects of cognitive function and BMI on mortality risk.

Results

Of participants enrolled, 473 (23.7%) died during follow-up. Both lower cognitive function (HR = 1.48, p = 0.0049) and lower BMI (HR = 1.6, p < 0.0001) were independently associated with increased mortality risk compared to individuals with average cognitive function and normal weight. Higher cognitive function was associated with lower mortality risk (HR = 0.69, p = 0.0312). We found no significant difference in mortality risk between overweight/obese participants and those with normal weight.

Conclusions

Cognitive function and BMI were independent predictors of mortality risk. Intervention strategies for increasing cognitive function and maintaining adequate BMI may be important in reducing morality risk in the elderly population.     

Relation between body mass index and mortality in an unusually slim cohort

STUDY OBJECTIVE: To investigate the relation between body mass index and mortality in an unusually slim cohort. DESIGN: Prospective cohort study. SETTING: United Kingdom. PARTICIPANTS: About 11,000 non-meat eaters and their meat eating friends and relatives, with a median age of 33 years were recruited between 1980 and 1984. More than 20% of the cohort had a self reported BMI below 20 kg/m(2) at recruitment. There were 195,000 person years of observation after a mean of 18.0 years of follow up. MAIN RESULTS: The characteristics of participants with a BMI below 18 kg/m(2) were favourable to a lower risk of cardiovascular disease. Nevertheless, these participants had an increased all cause death rate ratio (2.07, 95% CI 1.58 to 2.70) in comparison with participants who had a BMI between 20 and 22 kg/m(2). The death rate ratio for the slimmest category was also significantly increased for circulatory diseases (including ischaemic heart disease and cerebrovascular disease), respiratory diseases, and all other causes combined excluding all malignant neoplasms. This finding was consistent across a range of subgroups. CONCLUSIONS: Lean men and women (BMI <18 kg/m(2)) experience increased all cause mortality compared with those with a BMI between 20 and 22 kg/m(2). This pattern is not seen for cancer mortality, but is found for cardiovascular and respiratory diseases. It is important that public health messages regarding healthy eating are aimed at maintaining a healthy body weight rather than just "losing weight".     

成人体重指数、腰围与血脂异常的相关性研究

目的研究体重指数、腰围与血脂水平及血脂异常率之间的关系。方法采用整群抽样的方法,对3 911例体检人群的身高、体重、腰围进行测量,对其血脂水平进行实验室检测,对体重指数、腰围和血脂水平、血脂异常率的关系进行统计分析。结果随着体重指数、腰围的增加,TG、TC和LDL-C水平逐渐升高,HDL-C水平逐渐降低,差异有统计学意义(P0.05)。随着体重指数、腰围的增加,血脂异常率逐渐升高,差异有统计学意义(P0.05)。结论肥胖是血脂异常的危险因素。