Analysis of Changes in Weight, Waist Circumference, or Both, and All-Cause Mortality in Chinese Adults

Yuan, Yu; Liu, Kang; Zheng, Mengyi; Chen, Shuohua; Wang, Hao; Jiang, Qin; Xiao, Yang; Zhou, Lue; Liu, Xuezhen; Yu, Yanqiu; Wu, Jinglan; Ding, Xiong; Yang, Handong; Li, Xiulou; Min, Xinwen; Zhang, Ce; Zhang, Xiaomin; He, Meian; Zheng, Yan; Sun, Dianjianyi; Qi, Lü; Hemler, Elena C; Wu, Shouling; Wu, Tangchun; Pan, An

doi:10.1001/jamanetworkopen.2022.25876

Cited by 26 publications

(19 citation statements)

References 40 publications

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“…Accordingly, WC showed superior predicting value for predicting insulin resistance and diagnosis of adult MetS when compared with BMI [ 2 , 8 , 49 , 50 ]. Besides, the WC was not only significantly associated with the development of complications under the MetS [ 51 , 52 ] but also linked to the mortality risk in the general population [ 48 , 53 – 56 ]. Furthermore, compared with other obesity-related indicators, the WHtR index was validated to present significantly better prediction power for cardiometabolic health and mortality, especially among the diabetes population [ 57 – 59 ].…”

Section: Discussionmentioning

confidence: 99%

Association between triglyceride-glucose related indices with the all-cause and cause-specific mortality among the population with metabolic syndrome

Wei,

Min,

Song

et al. 2024

Cardiovasc Diabetol

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Background Triglyceride-glucose (TyG) index has been determined to play a role in the onset of metabolic syndrome (MetS). Whether the TyG index and TyG with the combination of obesity indicators are associated with the clinical outcomes of the MetS population remains unknown. Method Participants were extracted from multiple cycles of the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018 years. Three indicators were constructed including TyG index, TyG combining with waist circumference (TyG-WC), and TyG combining with waist-to-height ratio (TyG-WHtR). The MetS was defined according to the National Cholesterol Education Program (NCPE) Adult Treatment Panel III. Kaplan-Meier (KM) curves, restricted cubic splines (RCS), and the Cox proportional hazard model were used to evaluate the associations between TyG-related indices and mortality of the MetS population. The sensitive analyses were performed to check the robustness of the main findings. Results There were 10,734 participants with MetS included in this study, with 5,570 females and 5,164 males. The median age of the study population was 59 years old. The multivariate Cox regression analyses showed high levels of TyG-related indices were significantly associated with the all-cause mortality of MetS population [TyG index: adjustedhazard ratio (aHR): 1.36, 95%confidence interval (CI): 1.18–1.56, p < 0.001; TyG-WHtR index: aHR = 1.29, 95%CI: 1.13–1.47, p < 0.001]. Meanwhile, the TyG-WC and TyG-WHtR index were associated with cardiovascular mortality of the MetS population (TyG-WC: aHR = 1.45, 95%CI: 1.13–1.85, p = 0.004; TyG-WHtR: aHR = 1.50 95%CI: 1.17–1.92, p = 0.002). Three TyG-related indices showed consistent significant correlations with diabetes mortality (TyG: aHR = 4.06, 95%CI: 2.81–5.87, p < 0.001; TyG-WC: aHR = 2.55, 95%CI: 1.82–3.58, p < 0.001; TyG-WHtR: aHR = 2.53 95%CI: 1.81–3.54, p < 0.001). The RCS curves showed a non-linear trend between TyG and TyG-WC indices with all-cause mortality (p for nonlinearity = 0.004 and 0.001, respectively). The sensitive analyses supported the positive correlations between TyG-related indices with mortality of the MetS population. Conclusion Our study highlights the clinical value of TyG-related indices in predicting the survival of the MetS population. TyG-related indices would be the surrogate biomarkers for the follow-up of the MetS population.

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Section: Discussionmentioning

confidence: 99%

Association between triglyceride-glucose related indices with the all-cause and cause-specific mortality among the population with metabolic syndrome

Wei,

Min,

Song

et al. 2024

Cardiovasc Diabetol

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“…Considering waist circumference significantly predicted CVD, independent of BMI. 20 Both BMI and waist circumference should be considered in the obesity-related study. 21 Waist circumference was adjusted in the Cox regression model and even BMI was a LE8 component.…”

Section: Discussionmentioning

confidence: 99%

Life’s Essential 8 and Risk of Stroke: A Prospective Community-Based Study

Wang

et al. 2023

Stroke

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BACKGROUND: Data are lacking regarding cardiovascular health (CVH) with Life’s Essential 8 approach and future stroke risk. We sought to elucidate whether the CVH score constructed by the Life’s Essential 8 metrics predicted stroke risk in 2 Chinese ongoing cohorts. METHODS: This included 41 043 participants of the Kailuan I study and 27 842 participants of the Kailuan II study who were free of cardiovascular disease or cancer in 2014. CVH score (ranged from 0 to 100) was assessed using the Life’s Essential 8 metrics (body mass index, cigarette smoking, diet quality, physical activity, sleep health, lipid, blood glucose, and blood pressure). A composite of incident stroke events (ischemic stroke and hemorrhagic stroke) was identified via review of medical records. The follow-up period was calculated from the finishing date of the 2014 survey to either the date of stroke occurrence, death, loss to follow-up, or the end of follow-up (December 31, 2020). We also examined the longitudinal association between the CVH score and arterial stiffness status, as assessed by brachial-ankle pulse wave velocity, in 25 922 participants free of cardiovascular disease during the follow-up. We performed a meta-analysis to assess the association between CVH, based on the 2010 American Heart Association recommendation, and stroke integrating the results of current study and previous studies. RESULTS: During a median follow-up of 5.65 years (interquartile range, 5.20–6.09), a total of 1750 incident stroke events were identified in the pooled Kailuan study. The pooled hazard ratios were 0.33 (95% CI, 0.20–0.54) for ideal versus poor health category of CVH ( P trend <0.0001). Higher CVH scores were also associated with lower brachial-ankle pulse wave velocity values at baseline and slower increments of brachial-ankle pulse wave velocity during follow-up ( P trend ≤0.001 for both). Arterial stiffness mediated 9.07% (95% CI, 5.83%–15.0%) of the total association between CVH and incident stroke. The pooled hazard ratio comparing 2 extreme CVH categories for stroke was 0.45 (95% CI, 0.35–0.59) when including 10 published studies and the current study. CONCLUSIONS: The CVH score as assessed by the Life’s Essential 8 metrics significantly predicted future stroke risk and arterial stiffness status.

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“…In the longitudinal analysis, we calculated the incidence density of all-cause death (per 1,000 person-years) and cancer (per 10,000 person-years) across each baseline LE8 status. Cox proportional hazards regression, modeling with age as a time scale since age dramatically impacts the progression of cancer and death [ 22 , 23 ], was conducted to calculate the hazard ratio (HR) and 95% confidential intervals (CIs) for the association of baseline LE8 with cancer and mortality. Numeric values were assigned to the LE8 level and analyzed as a continuous variable in the adjusted model to examine the trend.…”

Section: Methodsmentioning

confidence: 99%

Association of Life's Essential 8 with all-cause mortality and risk of cancer: a prospective cohort study

Jiang,

Ning,

Liu

et al. 2024

BMC Public Health

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Background No study has concentrated on the association of LE8 with cancer risk and death. We aim to examine the association of LE8 with death and cancer. Methods A total of 94733 adults aged 51.42 ± 12.46 years and 77551 participants aged 54.09±12.06 years were enrolled in longitudinal and trajectory analysis respectively. Baseline LE8 was divided into three groups based on the American Heart Association criteria and three trajectory patterns by latent mixture models. We reviewed medical records and clinical examinations to confirm incident cancer during the period from 2006 to 2020. Death information was collected from provincial vital statistics offices. Cox models were used. Results 12807 all-cause deaths and 5060 cancers were documented during a 14-year follow-up. Relative to participants with high LE8 at baseline, participants with lower levels of LE8 have a significantly increased risk of mortality and incident cancer. All these risks have an increasing trend with LE8 level decreasing. Meanwhile, the trajectory analysis recorded 7483 all-cause deaths and 3037 incident cancers after approximately 10 years. The associations of LE8 with death and cancer were identical to the longitudinal study. In the subtype cancer analysis, LE8 has a strong effect on colorectal cancer risk. Moreover, the cut point is 56.67 in the association between LE8 and death, while the cut point altered to 64.79 in the association between LE8 and incident cancers. These associations were enhanced among younger adults. Conclusions There was a significant association of LE8 with death and cancer risk, especially for the young population.

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Analysis of Changes in Weight, Waist Circumference, or Both, and All-Cause Mortality in Chinese Adults

Cited by 26 publications

References 40 publications

Association between triglyceride-glucose related indices with the all-cause and cause-specific mortality among the population with metabolic syndrome

Association between triglyceride-glucose related indices with the all-cause and cause-specific mortality among the population with metabolic syndrome

Life’s Essential 8 and Risk of Stroke: A Prospective Community-Based Study

Association of Life's Essential 8 with all-cause mortality and risk of cancer: a prospective cohort study

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