Association Of Baseline Body Mass Index Research Articles

Associations of body size with all-cause and cause-specific mortality in healthy older adults

In the general population, body mass index (BMI) and waist circumference are recognized risk factors for several chronic diseases and all-cause mortality. However, whether these associations are the same for older adults is less clear. The association of baseline BMI and waist circumference with all-cause and cause-specific mortality was investigated in 18,209 Australian and US participants (mean age: 75.1 ± 4.5 years) from the ASPirin in Reducing Events in the Elderly (ASPREE) study, followed up for a median of 6.9 years (IQR: 5.7, 8.0). There were substantially different relationships observed in men and women. In men, the lowest risk of all-cause and cardiovascular mortality was observed with a BMI in the range 25.0–29.9 kg/m2 [HR25-29.9 vs 21–24.9 kg/m2: 0.85; 95% CI, 0.73–1.00] while the highest risk was in those who were underweight [HRBMI <21 kg/m2 vs BMI 21–24.9 kg/m2: 1.82; 95% CI 1.30–2.55], leading to a clear U-shaped relationship. In women, all-cause mortality was highest in those with the lowest BMI leading to a J-shaped relationship (HRBMI <21 kg/m2 vs BMI 21–24.9 kg/m2: 1.64; 95% CI 1.26–2.14). Waist circumference showed a weaker relationship with all-cause mortality in both men and women. There was little evidence of a relationship between either index of body size and subsequent cancer mortality in men or women, while non-cardiovascular non-cancer mortality was higher in underweight participants. For older men, being overweight was found to be associated with a lower risk of all-cause mortality, while among both men and women, a BMI in the underweight category was associated with a higher risk. Waist circumference alone had little association with all-cause or cause-specific mortality risk.Trial registration ASPREE https://ClinicalTrials.gov number NCT01038583.

Body mass index and 2‐year change of in vivo Alzheimer's disease pathologies in cognitively normal older adults

AbstractBackgroundMultiple studies supported that low body mass index (BMI) or underweight status in late‐life was associated with increased risk of dementia. We tried to test the hypothesis that lower late‐life BMI is related with greater increase of in vivo AD pathology including Aβ and tau deposition for two years in cognitively healthy individuals. Additionally, we explored the same relationship in each sex separately, considering previous reports that showed prominent sex differences for the relationship between BMI and AD dementia risk.MethodTotal 194 cognitive normal older adults from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE) were included. All participants underwent comprehensive clinical assessment including BMI measurement, [11C] Pittsburg compound B and [18F] AV‐1451 PET at baseline. The same brain imaging scans were repeated at a year follow‐up assessment. The association of baseline BMI with longitudinal changes of AD biomarkers were analyzed using linear mixed effect models.ResultLower BMI at baseline was significantly associated with greater increase of tau deposition in AD‐signature region for 2 years. In contrast, BMI was not related with 2‐year change of global Aβ deposition. In additional exploratory analysis for each sex, lower baseline BMI was associated with greater increase of both Aβ and tau deposition in male, whereas neither Aβ nor tau change was not related with baseline BMI in female.ConclusionThe present study suggest that lower late‐life BMI may accelerate the accumulation of AD pathology in the brain, especially in male. To prevent AD, more attention is needed to be paid to avoiding underweight in old age and maintaining an appropriate BMI status.

Body mass index trajectories and their predictors in undergraduate students from Canada: Results from the GENEiUS study

Objective: To explore the patterns and predictors of body mass index (BMI) change among undergraduate students from Ontario (Canada). Participants: 68 undergraduate students were followed longitudinally for 3 years with anthropometric data collected bi-annually. Methods: BMI measurements were plotted to generate individual BMI trajectory curves, which were categorized, based on the observed trajectory pattern. Within and between group comparisons of BMI were conducted via nonparametric paired tests. The association of baseline BMI, sex, and ethnicity with BMI trajectory type was assessed using multinomial logistic regression. Results: Four BMI trajectory types were observed: “stable weight” (n = 15, 22.1%), “weight gain” (n = 30, 44.1%), “weight loss” (n = 12, 17.6%), and “weight cycling” (n = 11, 16.2%) trajectories. Higher baseline BMI was significantly associated with the “weight gain,” “weight loss,” and the “weight cycling” trajectories as compared to the “stable weight” trajectory type. Conclusions: Our findings demonstrate an association between high baseline BMI and “nonstable” subsequent BMI change patterns among Canadian students.

Relationship of body mass index with efficacy of exenatide twice daily added to insulin glargine in patients with type 2 diabetes.

This post hoc analysis assessed the evidence behind common reimbursement practices by evaluating the relationship of body mass index (BMI) ranges (<30, 30–35 and >35 kg/m2) with treatment effects of exenatide twice daily among patients with type 2 diabetes. Patients received exenatide twice daily added to insulin glargine in two 30‐week studies (exenatide twice daily vs insulin lispro, n = 627; exenatide twice daily vs placebo, n = 259). No association of baseline BMI with changes in efficacy variables was observed. Glycated haemoglobin (HbA1c) reductions were significant (p < 0.0001) and similar across BMI range groups in the lispro‐comparator study and greater for exenatide versus placebo in the placebo‐controlled study. Significant weight loss occurred with exenatide across BMI range groups (p < 0.0001), while weight increased with both comparators. Achievement of HbA1c <7.0% (<53 mmol/mol) without weight gain was greater for exenatide versus comparators. Systolic blood pressure decreased across BMI range groups with exenatide in the lispro‐comparator study (p < 0.0001); changes in lipids were not clinically meaningful. Minor hypoglycaemia was less frequent for exenatide versus insulin lispro. These findings suggest that BMI alone should not limit clinical decision‐making or patient access to medication.

SNP-by-fitness and SNP-by-BMI interactions from seven candidate genes and incident hypertension after 20 years of follow-up: the CARDIA Fitness Study

The association of SNPs from seven candidate genes, including genotype-by-baseline fitness and genotype-by-baseline body mass index (BMI) interactions, with incident hypertension over 20 years was investigated in 2663 participants (1301 blacks, 1362 whites) of the Coronary Artery Risk Development in Young Adults Study (CARDIA) Study. Baseline cardiorespiratory fitness was determined from duration of a modified Balke treadmill test. A total of 98 SNPs in blacks and 89 SNPs in whites from seven candidate genes were genotyped. Participants that became hypertensive (295 blacks and 146 whites) had significantly higher blood pressure and BMI (both races), and lower fitness (blacks only) at baseline than those who remained normotensive. Markers at the PPARGC1A and BDKRB2 genes were nominally associated with greater risk of hypertension, while one marker each at the BDKRB2 and NOS3 genes were nominally associated with lower risk. The association of baseline fitness with risk of hypertension was nominally modified by genotype at markers within the ACE, AGT, BDKRB2, and NOS3 genes in blacks and the BDKRB2, EDN1, and PPARGC1A genes in whites. BDKRB2 rs4900318 showed nominal interactions with baseline fitness on the risk of hypertension in both races. The association of baseline BMI with risk of hypertension was nominally modified by GNB3 rs2301339 genotype in whites. None of the above associations were statistically significant after correcting for multiple testing. We found that SNPs in these candidate genes did not modify the association between baseline fitness or BMI and risk of hypertension in CARDIA participants.

Body mass index and risk of lung cancer in no-smoking women: A prospective cohort study in urban Shanghai

Objective:To investigate the association between BMI(Body Mass Index) and risk of lung cancer in non-smoking women in urban Shanghai.Methods:A total of 74 942 female residents aged 40 to 70 years in urban Shanghai were recruited in a prospective cohort from 1997 to 2000.They were actively followed up every two years.Until December in 2007,271 incident cases of lung cancer in no-smoking women were identified in the cohort.COX regression model was used to estimate the adjusted relative risks(RR) and 95% confidence intervals(95% CI).Results:After adjustment for age,education level,menopause status and other potential confounding factors,there were no association of baseline BMI and 20-year BMI with risk of lung cancer.The highest quartiles of baseline BMI group experienced 0.95 fold risk(95%CI:0.67-1.34) of lung cancer compared with their counterpart with lowest quartile.Compared with those with lowest quartile of BMI when aged 20 years,women who with the highest quartiles experienced 0.77 fold decreased risk(95%CI:0.52-1.15).Similar results were obtained after stratified analysis on the association of baseline BMI with risk of lung cancer in non-smoking women.Conclusion:BMI was not associated with the risk of lung cancer in no-smoking women older than 40 years in urban Shanghai.