Abstract
BackgroundTo assess the association of body mass index with mortality in a population-based setting of older people in Thailand.MethodsBaseline data from the National Health Examination Survey III (NHES III) conducted in 2004 was linked to death records from vital registration for 2004-2007. Complete information regarding body mass index (BMI) (n = 15997) and mortality data were separately analysed by sex. The Cox Proportional Hazard Model was used to test the association between BMI and all-cause mortality controlling for demographic, socioeconomic, and health risk factors.ResultsDuring a mean follow-up time of 3.8 years (60545.8 person-years), a total of 1575 older persons, (936 men and 639 women) had died. A U-shaped and reverse J-shaped of association between BMI and all-cause mortality were observed in men and women, respectively. However there was no significant increased risk in the higher BMI categories. Compared to those with BMI 18.5-22.9 kg/m2, the adjusted hazard ratios (HR) of all-cause mortality for those with BMI <18.5, 23.0-24.9, 25.0-27.4, 27.5-29.9, 30.0-34.9, and ≥35.0 were 1.34 (95% CI, 1.14-1.58), 0.79 (95% CI, 0.65-0.97), 0.81 (95% CI, 0.65-1.00), 0.67 (95% CI, 0.48-0.94), 0.60 (95% CI, 0.35-1.03), and 1.87 (95% CI, 0.77-4.56), respectively, for men, and were 1.29 (95% CI,1.04-1.60), 0.70 (95% CI, 0.55-0.90), 0.79 (95% CI, 0.62-1.01), 0.57 (95% CI, 0.41-0.81), 0.58 (95% CI, 0.39-0.87), and 0.78 (95% CI, 0.38-1.59), respectively, for women.ConclusionsThe results of this study support the obesity paradox phenomenon in older Thai people, especially in women. Improvement in quality of mortality data and further investigation to confirm such association are needed in this population.
Highlights
To assess the association of body mass index with mortality in a population-based setting of older people in Thailand
A U-shaped and reverse J-shaped of association between body mass index (BMI) and all-cause mortality were observed in men and women, respectively
The major health consequences associated with obesity include diabetes mellitus (DM), hypertension (HT), dyslipidemia and cardiovascular diseases (CVDs) [2]
Summary
In the past two decades, Thailand, a rapidly economic growth country with the advent of an ageing population, the predominant cause of deaths is changing from infectious diseases to chronic non-communicable diseases including chronic diseases and cancer [5]. Such changes are likely to be attributable to urbanization and changes in lifestyle leading to the increases in cardiovascular risk factors such as hypertension, diabetes and obesity [6,7,8,9,10,11,12]
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