Abstract P251: Weight Change is Associated With Risk of Cardiovascular Mortality Among Singapore Chinese

Abstract

Introduction: While epidemiologic studies have established overweight and obesity as risk factors of cardiovascular disease (CVD) mortality, findings on the relationship of change in body weight with CVD mortality are inconsistent. Hypothesis: We assessed the hypothesis that weight change was related to CVD mortality among middle-aged to elderly Chinese in Singapore. Methods: We used prospective data from the Singapore Chinese Health Study, a population-based cohort of 63,257 Chinese men and women aged 45-74 years at recruitment (1993-1998). After 5.7 [standard deviation (SD) 1.4] years, we conducted a follow-up interview (1999-2004) among 52,322 surviving subjects in the cohort. Body weight and height were self-reported among 42,328 participants at both baseline and follow-up interviews. Weight change was computed by percentage difference in weight at both assessments relative to weight at baseline, and categorized as moderate-to-large loss (≥10%), small loss (5.1 to 9.9%), stable (±5%), small gain (5.1-9.9%), and moderate-to-large gain (≥10%). Cox proportional hazards regression model was applied to estimate hazard ratio (HR) after controlling for age, gender, dialect group, dietary pattern, smoking status, alcohol consumption, physical activity, hours of sleep and history of diabetes and hypertension. Results: A total of 1,805 CVD deaths were identified during the follow-up until December 31, 2013 [follow-up duration of 11.5 (SD 2.9) years]. Compared to participants with stable weight, those with moderate-to-large weight loss had a 42% higher risk of CVD mortality (HR: 1.42; 95% CI: 1.25-1.61), while those with moderate-to-large weight gain had a 19% higher risk (HR: 1.19; 95% CI: 1.02-1.37). The HR (95% CI) for stroke mortality was 1.77 (1.44-2.18) for moderate-to-large weight loss, and 1.42 (1.12-1.80) for moderate-to-large weight gain. Conversely, for coronary heart diseases (CHD) mortality, only moderate-to-large weight loss was associated with an increased risk (HR: 1.24; 95% CI: 1.05-1.47). The associations were not different by gender or age-group. When stratified by BMI at baseline using 23 kg/m 2 as cutoff for overweight, moderate-to-large weight loss was associated with increased risks of CHD and stroke mortality in both BMI groups. In contrast, moderate-to-large weight gain was only associated with increased risk of stroke mortality but not with CHD mortality in both BMI groups. Conclusions: In conclusion, this study suggested that both moderate-to-large weight loss and weight gain significantly increased risk of CVD mortality among middle-aged to elderly Chinese. This study emphasizes the importance of maintaining stable body weight in middle-aged and elderly populations.