Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity

Khan, Sadiya S.; Ning, Hongyan; Wilkins, John T.; Allen, Norrina B.; Carnethon, Mercedes R.; Berry, Jarett D.; Sweis, Ranya; Lloyd‐Jones, Donald M.

doi:10.1001/jamacardio.2018.0022

Cited by 728 publications

(531 citation statements)

References 55 publications

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“…In the United States, the Centers for Disease Control and Prevention reports a mean BMI in women aged 40‐59 years of 29.7 kg/m 2 over 2011 and 2012 . Since an increased BMI is one of the classical cardiovascular risk factors, a healthy BMI negatively influences the cardiovascular risk burden in women with POI, resulting in a lower risk of developing CVD. The mixed model analyses were corrected for BMI, to account for BMI‐related differences in CAC between the two study populations.…”

Section: Discussionmentioning

confidence: 90%

Coronary artery calcification in middle‐aged women with premature ovarian insufficiency

Gunning

Meun

Rijn

et al. 2019

Clinical Endocrinology

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Objective Women with premature ovarian insufficiency (POI) enter menopause before age 40. Early menopause was associated with increased risk for coronary artery disease (CAD), death from cardiovascular disease and all‐cause mortality. We compared the prevalence of CAD between middle‐aged women on average 10 years following the initial POI diagnosis, with a population‐based cohort. Design Cross‐sectional case‐control study. Participants Women from two Dutch University Medical Centers above 45 years of age previously diagnosed with POI (n = 98) were selected and compared with age‐ and race‐matched controls from the Multi‐Ethnic Study of Atherosclerosis (MESA). Measurements The primary outcome was detectable coronary artery calcium (CAC) determined by coronary computed tomography (CCT). Results Women with POI had significantly higher blood pressure, cholesterol and glucose, despite lower BMI compared to controls. Similar proportions of detectable CAC (CAC score >0 Agatston Units) were observed in women with POI and controls (POI n = 16 (16%), controls n = 52 (18%), P = 0.40 and Padj = 0.93). In women with POI separately, we were not able to identify associations between CVD risk factors and CAC. The following CVD risk factors in controls were positively associated with CAC: age, diabetes mellitus, hypertension and LDL cholesterol. HRT use was negatively associated with CAC in controls. Conclusions The presence of CAC did not differ significantly in women with POI around 50 years of age, compared to an age‐ and race‐matched control group. We observe no increased calcified coronary disease in POI patients, despite the presence of unfavourable cardiovascular risk factors in these women.

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Section: Discussionmentioning

confidence: 90%

Coronary artery calcification in middle‐aged women with premature ovarian insufficiency

Gunning

Meun

Rijn

et al. 2019

Clinical Endocrinology

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“…Although it is the most common measure of obesity, BMI is not the best reflection of the fat distribution because it cannot differentiate easily between lean and fat mass. However, BMI levels correlate with future health risks (both morbidity and death) Therefore, BMI can be an appropriate measure to screen obesity and classify the patients according to the health risks in clinical practice. Anyhow, we found similar results using waist circumference than BMI in a subset of patients.…”

Section: Discussionmentioning

confidence: 99%

The effects of metabolic status on non‐alcoholic fatty liver disease‐related outcomes, beyond the presence of obesity

Ampuero¹,

Aller²,

Gallego‐Durán³

et al. 2018

Aliment Pharmacol Ther

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Summary Background Metabolically healthy obesity (MHO) shows a reduced risk compared with obese patients with adverse metabolic conditions. Lean people suffering some metabolic derangements also have non‐alcoholic fatty liver disease (NAFLD)‐related outcomes compared with non‐obese subjects with a few metabolic risks. Aim To define the impact of the metabolic status on the NAFLD‐related outcomes, beyond the presence of obesity. Methods We designed a multicentre cross‐sectional study, including 1058 biopsy‐proven NAFLD patients. Metabolically healthy status was strictly defined by the lack of metabolic risk factors (diabetes mellitus, low HDL, hypertriglyceridemia, arterial hypertension). Non‐alcoholic steatohepatitis (NASH) and significant fibrosis (F2‐F4) were identified by liver biopsy. Chronic kidney disease epidemiology collaboration equation was calculated for kidney function and the atherogenic index of plasma (AIP) for cardiovascular risk. Results Metabolically healthy (OR 1.88; P = 0.050) and unhealthy obesity (OR 3.47: P < 0.0001), and unhealthy non‐obesity (OR 3.70; P < 0.0001) were independently associated with NASH together with homeostatic model assessment (HOMA), ALT, and platelets. Significant fibrosis was more frequently observed in the presence of adverse metabolic conditions in obese (OR 3.89; P = 0.003) and non‐obese patients (OR 3.92; P = 0.002), and independently associated with platelets, albumin, ALT, HOMA, and age. The number of metabolic factors determined the risk of NASH and significant fibrosis. Glomerular filtration rate was lower in unhealthy (91.7 ± 18) than healthy metabolism (95.6 ± 17) (P = 0.007). AIP was higher in adverse metabolic conditions (P = 0.0001). Metabolically unhealthy non‐obesity showed higher liver damage (NASH 55.8% vs 42.4%; P < 0.05; significant fibrosis 31.7% vs 11.4%; P < 0.0001) and cardiovascular risk (P < 0.0001) than healthy obesity. Conclusions Metabolic unhealthy status showed a greater impact on NASH, significant fibrosis, kidney dysfunction, and atherogenic profile than obesity. However, metabolically healthy obesity was not a full healthy condition. We should focus our messages especially on patients with adverse metabolic conditions.

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“…Obesity is an important risk factor for many adverse health outcomes, including cardiovascular events, progression of type 2 diabetes, and surgical complications . In health services research based on health care administrative data, the validity of overweight/obesity and body mass index (BMI) coding may be relevant for cohort selection or confounding adjustment in the context of a comparative study.…”

Section: Introductionmentioning

confidence: 99%

Validation of body mass index (BMI)‐related ICD‐9‐CM and ICD‐10‐CM administrative diagnosis codes recorded in US claims data

Ammann

Kalsekar

Yoo

et al. 2018

Pharmacoepidemiology and Drug

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Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity

Cited by 728 publications

References 55 publications

Coronary artery calcification in middle‐aged women with premature ovarian insufficiency

Coronary artery calcification in middle‐aged women with premature ovarian insufficiency

The effects of metabolic status on non‐alcoholic fatty liver disease‐related outcomes, beyond the presence of obesity

Validation of body mass index (BMI)‐related ICD‐9‐CM and ICD‐10‐CM administrative diagnosis codes recorded in US claims data

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