Change in Weight and Body Mass Index Associated With All-Cause Mortality in Korea: A Nationwide Longitudinal Study

Kim, Yang Hyun; Kim, Seon Mee; Han, Kyungdo; Son, Jang Won; Lee, Seongsu; Oh, Sang Woo; Lee, Won Young; Yoo, Soon Jib

doi:10.1210/jc.2017-00787

Cited by 45 publications

(44 citation statements)

References 50 publications

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“…A nationwide longitudinal study in more than 11 million South Korean subjects showed that weight loss across all BMI categories was associated with increased mortality. 29 …”

Section: Discussionmentioning

confidence: 99%

Obesity and weight loss are inversely related to mortality and cardiovascular outcome in prediabetes and type 2 diabetes: data from the ORIGIN trial

Doehner

Gerstein

Ried

et al. 2020

European Heart Journal

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Aims The association of body weight and weight change with mortality and cardiovascular (CV) outcome in patients with diabetes mellitus (DM) is not clearly established. We assessed the relationship between weight, weight change, and outcomes in patients with established CV risk factors and type 2 DM or pre-diabetes. Methods and results A total of 12 521 participants from the ORIGIN trial were grouped in BMI categories of low body weight [body mass index (BMI) < 22 kg/m2] normal (22–24.9), overweight (25–29.9), obesity Grades 1–3 (30–34.9, 35–39.9, ≥40 kg/m2, respectively). Outcome variables included total and CV mortality and composite outcomes of CV death, non-fatal stroke, or myocardial infarction plus revascularization or heart failure hospitalization. Follow-up was 6.2 years (interquartile range 5.8–6.7 years). After multivariable adjustment, lowest risks were seen in patients with overweight and mild obesity for total mortality [overweight: hazard ratio (HR) 0.80 (95% confidence interval (CI) 0.69–0.91); obesity Grade 1: HR 0.82 (0.71–0.95), both P < 0.01)] and CV mortality [overweight: HR 0.79 (0.66–0.94); obesity Grade 1: 0.79 (0.65–0.95), all compared to patients with normal BMI, P < 0.05]. Obesity of any severity was not associated with higher mortality. Low body weight was related to higher mortality [HR 1.28 (1.02–1.61); CV mortality: HR 1.34 (1.01–1.79), P < 0.05]. A continued 2-year weight loss was associated with higher risk of mortality [HR 1.32 (1.18–1.46), P < 0.0001] and CV mortality [HR 1.18 (1.02–1.35), compared to patients without weight loss, P < 0.05]. In turn, weight gain was not related to any adverse outcome. Conclusion Obesity in patients with DM or pre-diabetes and CV risk profile was not associated with higher mortality or adverse CV outcome. The lowest mortality risk was seen in patients with overweight and moderate obesity (BMI 25–35 kg/m2). Weight loss was an independent risk factor for higher mortality compared to no weight loss.

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“…A nationwide longitudinal study in more than 11 million South Korean subjects showed that weight loss across all BMI categories was associated with increased mortality. 29 …”

Section: Discussionmentioning

confidence: 99%

Obesity and weight loss are inversely related to mortality and cardiovascular outcome in prediabetes and type 2 diabetes: data from the ORIGIN trial

Doehner

Gerstein

Ried

et al. 2020

European Heart Journal

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“…After excluding those who were diagnosed with diabetes mellitus prior to enrollment, 51,405 subjects were finally included and followed until the development of diabetes or the end of 2013. The patients who had developed diabetes during the study period were identified based on the prescription of antidiabetic medication under the World Health Organization (WHO) International Classification of Diseases (ICD)-10 codes E11-14 or fasting glucose level ≥126 mg/dL 15 .…”

Section: Methodsmentioning

confidence: 99%

“…The subjects’ socioeconomic status was categorized into two groups based on income level, which was dichotomized at lower 20% (<20% vs. ≥20%). Hypertension was defined based on ICD-10 codes (I10–13, I15), the list of prescribed medicine, or blood pressure above 140/90 mmHg 15 . Hyperlipidemia was defined based on at least one of the following criteria: a claim under ICD-10 code (E78), the list of prescribed lipid lowering agents, or serum TC above 240 mg/dL 15 .…”

Section: Methodsmentioning

confidence: 99%

Impact of weight changes on the incidence of diabetes mellitus: a Korean nationwide cohort study

Kim

Jeong

Han

et al. 2018

Sci Rep

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Obesity is a well-known risk factor for type 2 diabetes, but few data exist on the association between weight changes and diabetes risk in non-obese subjects. This study aimed to investigate the effect of weight changes on the incidence of type 2 diabetes in Korea, using 51,405 non-diabetic subjects. Individuals who developed type 2 diabetes were more likely to be older and male, to have high body mass index (BMI), blood pressure, fasting blood glucose, and total cholesterol, to be current smokers and frequent drinkers, to be hypertensive and hyperlipidemic, and to have a family history of diabetes, compared to those without type 2 diabetes. Compared with the consistently non-obese group, there was a higher hazard ratio for incident diabetes (95% confidence interval) in subjects becoming obese [1.49 (1.26–1.77)] and remaining obese [2.56 (2.34–2.81)] after adjustment for confounding factors. Decreased BMI was significantly associated with lower risks for incident diabetes and the trends were more evident in the non-obese group. However, overall there was no significant association of increased BMI with incident diabetes. In conclusion, weight loss was significantly associated with lower risk for diabetes both in non-obese and obese Koreans, but particularly in the non-obese.

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“…Their subgroup analysis showed that BMI change better predicted mortality than a single measure. Using the National Health Insurance System health checkup data, Kim et al 1) reported the association between weight change and subsequent mortality, demonstrating a reverse J-shaped all-cause mortality curve for weight change; furthermore, weight loss was associated with a higher risk of mortality than was weight gain. However, these studies measured BMI just twice (at baseline and later) in a short period and included a relatively young population.…”

Section: Discussionmentioning

confidence: 99%

“…The association of weight change with mortality is frequently shown as a reverse J-shaped curve. 1 , 2 ) Weight loss in overweight or obese people and weight gain in underweight people have beneficial effects on health. 1 ) However studies have reported conflicting results depending on ethnicity and age groups.…”

Section: Introductionmentioning

confidence: 99%

Trajectories of Body Mass Index and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging

Kong

Park

Lee

et al. 2020

Ann Geriatr Med Res

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Weight change is an important risk factor for mortality. The association of weight change with mortality is frequently shown as a reverse J-shaped curve. 1,2) Weight loss in overweight or obese people and weight gain in underweight people have beneficial effects on health. 1) However studies have reported conflicting results depending on ethnicity and age groups. While some studies reported that weight loss and weight gain increased mortality, 3,4) others found no associations. 5) Instead of using baseline body mass index (BMI) as in previous Background: Weight change is a known risk factor for mortality. Previous Korean studies only considered mortality consequences of weight change between two time points over relatively short periods. This study investigated whether body mass index (BMI) trajectory patterns were associated with all cause-mortality based on continuous BMI observations during a 10-year follow-up period among Korean older adults. Method: This study analyzed data from the 2006-2016 Korean Longitudinal Study of Aging database. The participants included in this study were 3,478 people aged 65 years or older who have measured BMI more than once. A trajectory model was developed to classify different homogeneous trajectory subgroups according to BMI, and Cox proportional hazards models were used to investigate the association of BMI trajectory with allcause mortality. Result: We identified four trajectory groups: obese (OG); overweight (OWG); high normal weight (HNWG); and low normal weight (LNWG). The LNWG and HNWG experienced continuous weight loss during the study period. Trajectories with higher BMI were associated with lower mortality. The adjusted hazard ratios (95% confidence intervals) for all-cause mortality in the LNWG, HNWG, and OWG were 2.40 (1.69-3.40), 1.75 (1.26-2.45), and 1.38 (0.99-1.96), respectively, compared with those in the OG. Conclusion: We found that the lower the BMI of the weight trajectory group, the higher the mortality over 10 years in Korean older adults. This result suggested that baseline obesity status and degree of weight loss during follow-up contributed to mortality in later life.

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Change in Weight and Body Mass Index Associated With All-Cause Mortality in Korea: A Nationwide Longitudinal Study

Abstract: Weight change over 4 years showed a reverse J-shaped all-cause mortality curve, independent of BMI status. Weight loss was associated with a greater risk of mortality than was weight gain.

Cited by 45 publications

References 50 publications

Obesity and weight loss are inversely related to mortality and cardiovascular outcome in prediabetes and type 2 diabetes: data from the ORIGIN trial

Obesity and weight loss are inversely related to mortality and cardiovascular outcome in prediabetes and type 2 diabetes: data from the ORIGIN trial

Impact of weight changes on the incidence of diabetes mellitus: a Korean nationwide cohort study

Trajectories of Body Mass Index and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging

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