Body mass index and all-cause mortality in patients with cardiogenic shock: A systematic review and meta-analysis

Meng, Fanqi; Guo, Fei-yan; Abulimiti, Burebiguli; Zhao, Kai-di; Dong, Ying; Ma, Xiang; Fu, Zhen-Yan; Ma, Yun

doi:10.1016/j.ajem.2021.01.003

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…The link between BMI and mortality, on the other hand, has sparked a lot of debate, since epidemiological studies have discovered numerous forms of U-shaped, J-shaped, and linear relationships between BMI and mortality (3)(4)(5)(6)(7)(8). In several studies, being overweight, for example, was linked to an increased risk of mortality (9), while others found that overweight persons had the lowest death rate and that mortality increased with decreased BMI (10,11). The phenomenon has been described as "obesity paradox" (12).…”

Section: Introductionmentioning

confidence: 99%

Obesity paradox and aging: Visceral Adiposity Index and all-cause mortality in older individuals: A prospective cohort study

Wang

Zhong

2022

Front. Endocrinol.

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BackgroundThe relationship between body mass index (BMI) and mortality in older adults diminished. It is necessary to examine other factors that may accurately predict mortality in older adults. The visceral adiposity index (VAI) is an uncomplicated marker specific to the gender that incorporates anthropometric data and lipid profiles. VAI has been proposed as a marker of visceral adipose tissue dysfunction and of the related cardiometabolic risk. The aim of this study was to evaluate the link of VAI with all-cause mortality among the elderly.MethodsThe present prospective cohort study included data from 1999 to 2014 provided by the National Health and Nutrition Examination Survey (NHANES) in the United States. NHANES participants at or above the age of 65 were included. Data collection was carried out by taking face-to-face interviews, mobile-physical examinations, and lab tests. From the start of the survey to the end of December 2015, mortality-related follow-up statistics are available. The shape of the link between VAI and all-cause mortality was investigated using a restricted cubic spline model. Univariate- and multivariate-adjusted Cox proportional hazard models were estimated for VAI, and the results were presented as regression coefficients and 95% confidence intervals (CI).ResultsThe 82,091 NHANES participants represented 442.2 million non-institutionalized residents of the United States. A total of 11,173 older individuals (representing 23.3 million; aged 73.4 ± 5.8 years; 56.3% women, 82.7% non-Hispanic Whites, 6.8% non-Hispanic Blacks, and 3.3% Mexican Americans) were included in the study. During the 80-month follow-up period, 4466 fatalities were reported, including 825 deaths from cancer, 867 from heart disease, and 211 from cerebrovascular disease. The restricted cubic spline model demonstrated a robust J-shaped link between VAI and all-cause mortality, revealing a significant decrease in risk within the lower range of VAI, which attained the lowest risk close to 1.7. With VAI greater than 1.7, the risk of mortality increased with the increase of VAI (P for non-linearity = 0.025). In the multivariate-adjusted model, the risk of all-cause mortality was 0.73 (0.56-0.97) and 1.05 (1.01-1.09) in participants with VAI less than 1.7 and VAI greater than or equal to 1.7, respectively.ConclusionThis investigation is a population-based cohort study with high sample sizes and a long-term in older individuals follow-up that showed a J-shaped link between VAI levels and all-cause mortality. Understanding the independent roles of VAI in the relationship between BMI and mortality is crucial to understanding the obesity paradox phenomenon.

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Section: Introductionmentioning

confidence: 99%

Obesity paradox and aging: Visceral Adiposity Index and all-cause mortality in older individuals: A prospective cohort study

Wang

Zhong

2022

Front. Endocrinol.

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“…While the obesity paradox is firmly established in several cardiovascular diseases, its association with outcomes of patients with cardiogenic shock is still unclear. In the previous meta-analysis of three studies, Meng et al [ 13 ] noted no difference in all-cause mortality between obese and non-obese patients with cardiogenic shock (OR = 0.88, 95%CI: 0.71-1.08, I 2 = 96%). In a sub-group analysis, they found that cardiogenic shock mortality was lower in developed countries (United States), but higher in developing countries (Pakistan).…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, this research question has been systematically analyzed by only one review to date. Meng et al [ 13 ] in a recently published meta-analysis pooled data from three studies to assess the association between high BMI and mortality after cardiogenic shock. An important limitation of their review was that two of the three studies were from the same database with a considerable overlap of data.…”

Section: Introductionmentioning

confidence: 99%

Body mass index and outcomes of patients with cardiogenic shock: A systematic review and meta-analysis

Tao¹,

Qian²,

Li³

et al. 2022

World J Clin Cases

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BACKGROUND Cardiogenic shock continues to be a highly morbid complication that affects around 7%-10% of patients with acute myocardial infarction or heart failure. Similarly, obesity has become a worldwide epidemic. AIM To analyze the impact of higher body mass index (BMI) on outcomes of patients with cardiogenic shock. METHODS A systematic and comprehensive search was undertaken on the electronic databases of PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar for all types of studies comparing mortality outcomes of patients with cardiogenic shock based on BMI. All studies defined overweight or obese patients based on the World Health Organization BMI criteria. The data were then extracted and assessed on the basis of the Reference Citation Analysis ( ). RESULTS Five studies were included. On pooled analysis of multivariable-adjusted ratios, we noted a statistically significantly reduced risk of mortality in overweight/obese vs normal patients (three studies; odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.85-0.98, I 2 = 85%). On meta-analysis, we noted that crude mortality rates did not significantly differ between overweight/obese and normal patients after cardiogenic shock (OR = 0.95, 95%CI: 0.79-1.15, I 2 = 99%). The results were not stable on sensitivity analysis and were associated with substantial heterogeneity. CONCLUSION Current evidence on the association between overweight/obesity and mortality after cardiogenic shock is scarce and conflicting. The obesity paradox might exist in patients with cardiogenic shock but could be confounded by the use of mechanical circulatory support. There is a need for further studies to clarify this relationship.

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The impact of body mass index on mortality rates of hip fracture patients: a systematic review and meta-analysis

Wang

et al. 2022

Osteoporos Int

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Body mass index and all-cause mortality in patients with cardiogenic shock: A systematic review and meta-analysis

Cited by 6 publications

References 16 publications

Obesity paradox and aging: Visceral Adiposity Index and all-cause mortality in older individuals: A prospective cohort study

Obesity paradox and aging: Visceral Adiposity Index and all-cause mortality in older individuals: A prospective cohort study

Body mass index and outcomes of patients with cardiogenic shock: A systematic review and meta-analysis

The impact of body mass index on mortality rates of hip fracture patients: a systematic review and meta-analysis

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