Body-Mass Index and Mortality in Korean Men and Women

Jee, Sun Ha; Sull, Jae Woong; Park, Jungyong; Lee, Sang-Yi; Ohrr, Heechoul; Güallar, Eliseo; Samet, Jonathan M.

doi:10.1056/nejmoa054017

Cited by 781 publications

(657 citation statements)

References 34 publications

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“…Overweight and obesity are associated with increased risks of cardiovascular morbidity and mortality in the general population [8][9][10][11][12][24][25][26][27], but only a few previous studies of type 2 diabetic patients have addressed the topic, and with somewhat conflicting results [13][14][15][16][28][29][30][31]. Our large observational study clearly shows an increased risk of fatal/non-fatal CHD (15%), stroke (11%), CVD (13%) and total mortality (27%) with a 5 unit increase in BMI at baseline after adjustment for age, sex, diabetes duration, type of hypoglycaemic treatment and smoking (model 1), and the risks were attenuated, but remained significant (except for stroke), when also adjusted for additional cardiovascular risk factors (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…It is well established that patients with diabetes are at high risk of cardiovascular disease (CVD) and that risk-factor control is of great importance in reducing this risk [4][5][6][7]. The association between overweight/obesity and the increased risk of cardiovascular disease is well established in the general population, in both men and women [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients

et al. 2008

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Aims/hypothesis The aim of this study of type 2 diabetic patients in the Swedish National Diabetes Register was to study the associations of BMI, overweight (BMI 25-29.9 kg/m 2 ) and obesity (BMI≥30 kg/m 2 ) with cardiovascular disease in type 2 diabetes, as these associations have not previously been clarified. Methods Patients aged 30-74 years with no previous CHD or stroke (N=13,087) were followed for a mean of 5.6 years until 2003 for fatal or non-fatal CHD, stroke, cardiovascular disease (CHD or stroke) and total mortality. In total, 1,922 cardiovascular-disease events occurred, based on 64,864 person-years.Results The relative risks of CHD, stroke, cardiovascular disease and total mortality for a 5 unit increase in BMI at baseline were 15%, 11%, 13% and 27%, respectively, using Cox regression analysis, after adjusting for age, sex, diabetes duration, hypoglycaemic treatment and smoking (model 1), and were 9%, 4% (not significant), 7% and 20%, respectively, when adjusting also for HbA 1c , blood pressure, antihypertensive drugs, lipid-reducing drugs and microalbuminuria (model 2). Adjusted hazard ratios (model 1) for CHD, cardiovascular disease and total mortality with overweight were 1.27 (95% CI 1.09-1.48), 1.24 (1.09-1.41) and 1.16 (0.94-1.45), respectively, and 1.49 (1.27-1.76), 1.44 (1.26-1.64) and 1.71 (1.36-2.14) with obesity, as compared with normal weight. Significant hazard ratios were attenuated when adjusted according to model 2. For a 1 unit increase in BMI during follow-up, the relative risk of CHD (model 2) was 1.13 (1.04-1.23; p=0.005). Conclusions/interpretation Both overweight and obesity independently increased the risk of CHD and cardiovascular disease in patients with type 2 diabetes. The CHD risk was higher with increasing BMI than with stable or decreasing BMI during the study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients

et al. 2008

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“…The data used in this study is directly available via the NHIS database registration system. A number of previous studies have used this NHIS database for epidemiological studies, and its validity has been described in detail elsewhere 22, 23…”

Section: Methodsmentioning

confidence: 99%

Effect of smoking cessation on the risk of dementia: a longitudinal study

Choi

Park

2018

Ann Clin Transl Neurol

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ObjectiveTo determine the risk of developing dementia in relation to duration of smoking cessation by using a nationwide health claims database.MethodsThis cohort study included 46,140 men aged 60 years or older from Korean National Health Insurance System – National Health Screening Cohort, a population‐based national health screening program from 2002 to 2013. The changes in smoking habit from a questionnaire during the first (2002 and 2003) and second (2004 and 2005) health examination periods, participants were divided into continual smokers, short‐term (less than 4 years) quitters, long‐term (4 years or more) quitters, and never smokers. Participants were followed‐up for 8 years from January 1, 2006 for the development of overall dementia, Alzheimer's disease, and vascular dementia.ResultsCompared to continual smokers, long‐term quitters and never smokers had decreased risk of overall dementia (hazard ratio, HR 0.86 95% CI, confidence interval 0.75–0.99 and HR: 0.81; 95% CI: 0.71–0.91, respectively). Never smokers had decreased risk of Alzheimer's disease (HR: 0.82; 95% CI: 0.70–0.96) compared to continual smokers. Finally, both long‐term quitters (HR: 0.68; 95% CI: 0.48–0.96) and never smokers (HR: 0.71; 95% CI: 0.54–0.95) had decreased risk of vascular dementia compared to continual smokers.InterpretationSmoking was associated with increased risk of dementia. Smokers who quit for a prolonged period of time may benefit from reduced risk of dementia. Therefore, smokers should be encouraged to quit in order to reduce the risk of developing dementia, especially in the elderly population who are already at risk.

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“…30 In our population, it was not possible to determine precisely the cause of death as invasive explorations were rarely performed for ethical reasons.…”

Section: Denutrition and Prognosismentioning

confidence: 96%

Aortic stiffness, inflammation, denutrition and prognosis in the oldest people

et al. 2011

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Observational studies have shown that some of the classic CV risk factors, namely hypertension or hypercholesterolemia, become nebulous, or even act in the reverse direction, in the oldest people. We investigated whether in the elderly, increased aortic stiffness was associated with higher mortality risk, before and after adjustments on common geriatric confounders. In a cohort of 331 (86 men) subjects aged 470 years (mean age ( ± s.d.): 85 ± 7 years), aortic stiffness was assessed by carotid-femoral pulse wave velocity (PWV). Classical CV risk factors were determined simultaneously, in association with inflammation and denutrition parameters. One hundred and ten subjects died during a 2-year follow-up period. In crude analysis, a positive non-significant trend was observed between PWV and mortality risk. Multivariate Cox regression analysis showed that five parameters entered the prediction model: two were positively related to mortality risk, PWV (P ¼ 0.008) and orosomucoide (P ¼ 0.045), and three were related negatively, total cholesterol (P ¼ 0.006), albumin (P ¼ 0.026) and body weight (P ¼ 0.035). Interaction analysis revealed that the effect of PWV on mortality was increased in the presence of renal dysfunction and increased inflammation. In conclusion, although marginally significant in crude analysis, PWV is a powerful determinant of prognosis in the oldest people taking into account inflammation and denutrition.

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Body-Mass Index and Mortality in Korean Men and Women

Abstract: Underweight, overweight, and obese men and women had higher rates of death than men and women of normal weight. The association of BMI with death varied according to the cause of death and was modified by age, sex, and smoking history.

Cited by 781 publications

References 34 publications

Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients

Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients

Effect of smoking cessation on the risk of dementia: a longitudinal study

Aortic stiffness, inflammation, denutrition and prognosis in the oldest people

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