Abstract
The association of fluctuations in body mass index with cardiovascular risk in long-term is not well understood. This study aimed to investigate cardiovascular outcomes of weight fluctuation. Total of 67,101 obese adults from the Korean National Health Insurance Service who received health examinations in three separate biennial periods were included. Participants were followed up from January 1, 2008 to the date of cardiovascular disease, death, or December 31, 2015, and categorized into 9 distinctive groups according to the BMI. Continuous weight gain showed an increased risk of overall cardiovascular disease (hazard ratio [HR], 2.36; P = 0.007), whereas weight loss after weight maintenance (HR, 0.91; P = 0.016) and weight maintenance after weight loss (HR, 0.91; P = 0.004) were ameliorative compared to the no weight change group. As for coronary heart disease, weight maintenance after weight gain was unfavorable (HR, 1.25; P = 0.004) while weight loss after weight maintenance (HR, 0.82; P < 0.001), weight cycling (HR, 0.83; P = 0.043), and weight maintenance after weight loss (HR, 0.88; P = 0.012) were beneficial. Weight maintenance after weight loss is beneficial for obese adults in terms of cardiovascular risks. In addition, weight loss is in part related to reduced risk of coronary heart disease despite weight cycling.
Highlights
Cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, is the most common noncommunicable disease worldwide, responsible for 17.8 million deaths in 2 0171
As a number of researchers pointed that it may be due to inaccuracy of body mass index (BMI) for measurement of total adiposity because it is a height-normalized sum of fat mass and fat-free mass, effects of BMI on cardiovascular risk are c ontroversial[7]
Weight maintenance after weight gain significantly reduced CHD-free survival (HR, 1.25; 95% confidence interval (CI), 1.08–1.46; P = 0.004), whereas it was prolonged in weight loss after weight maintenance (HR, 0.82; 95% CI, 0.73–0.92; P < 0.001), weight cycling (HR, 0.83; 95% CI, 0.70–0.99; P = 0.043), weight maintenance after weight loss (HR, 0.88; 95% CI, 0.80–0.97; P = 0.012) groups
Summary
Cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, is the most common noncommunicable disease worldwide, responsible for 17.8 million deaths in 2 0171. A positive association was reported between body mass index (BMI) and cardiovascular risk, including morbidity and mortality[2]. Weight loss maintenance was reported to have ameliorative effect to cardiovascular risk factors, including triglyceride and blood pressure, whereas BMI variability was found a risk factor for CVD risk[11,12,13]. Effects of circumstances of weight per BMI maintenance on cardiovascular outcomes in obese population remain unclear. We conducted the present study to further explore the impact of weight maintenance status in morbidity and mortality of CVD in Korean adults with obesity aged 40 and over
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