Baseline Between Body Mass Index Research Articles

Prognostic value of body mass index for first-line chemoimmunotherapy combinations in advanced non-small cell lung cancer in Chinese population.

BackgroundFew studies have examined the correlation between body mass index (BMI) and effectiveness of first-line chemoimmunotherapy in patients with advanced non-small cell lung cancer (NSCLC); moreover, the conclusion remains elusive and no such studies have been conducted in the Chinese population. Our study aimed to validate the predictive significance of BMI in Chinese patients with advanced NSCLC receiving first-line chemoimmunotherapy combinations. MethodsData of patients with advanced NSCLC treated with first-line chemoimmunotherapy between June 2018 and February 2022 at three centers were retrieved retrospectively. The association between baseline BMI with progression-free survival (PFS) and overall survival (OS) was evaluated using the Kaplan–Meier method and Cox regression models. BMI was categorized according to the World Health Organization criteria. ResultsOf the included 805 patients, 5.3% were underweight, 63.4% had normal weight, 27.8% were overweight, and 3.5% were obese. Survival analysis showed that patients in the high BMI group had significantly better PFS (p=0.012) and OS (p=0.014) than those in the low BMI group. Further, patients in the overweight subgroup had better PFS (p=0.036) and OS (p=0.043) compared to the normal weight population. The results of Cox regression analysis confirmed the correlations between BMI and prognosis of advanced NSCLC patients receiving first-line chemoimmunotherapy combinations. ConclusionsBaseline BMI affected the clinical outcomes of first-line chemoimmunotherapy combinations in patients with advanced NSCLC, and was especially favorable for the overweight subgroup.

Natriuretic peptides, body mass index and heart failure risk: Pooled analyses of SAVOR-TIMI 53, DECLARE-TIMI 58 and CAMELLIA-TIMI 61.

N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations are lower in patients with obesity. The interaction between body mass index (BMI) and NT-proBNP with respect to heart failure risk remains incompletely defined. Data were pooled across three randomized clinical trials enrolling predominantly patients who were overweight or obese with established cardiometabolic disease: SAVOR-TIMI 53, DECLARE-TIMI 58 and CAMELLIA-TIMI 61. Hospitalization for heart failure (HHF) was examined across strata of baseline BMI and NT-proBNP. The effect of dapagliflozin versus placebo was assessed for a treatment interaction across BMI categories in patients with or without an elevated baseline NT-proBNP (≥125 pg/ml). Among 24 455 patients, the median NT-proBNP was 96 (interquartile range [IQR]: 43-225) pg/ml and the median BMI was 33 (IQR 29-37) kg/m2, with 68% of patients having a BMI ≥30 kg/m2. There was a significant inverse association between NT-proBNP and BMI which persisted after adjustment for all clinical variables (p < 0.001). Within any range of NT-proBNP, those at higher BMI had higher risk of HHF at 2 years (comparing BMI <30 vs. ≥40 kg/m2 for NT-proBNP ranges of <125, 125-<450 and ≥450 pg/ml: 0.0% vs. 0.6%, 1.3% vs. 4.0%, and 8.1% vs. 13.8%, respectively), which persisted after multivariable adjustment (adjusted hazard ratio [HRadj] 7.47, 95% confidence interval [CI] 3.16-17.66, HRadj 3.22 [95% CI 2.13-4.86], and HRadj 1.87 [95% CI 1.35-2.60], respectively). In DECLARE-TIMI 58, dapagliflozin versus placebo consistently reduced HHF across BMI categories in those with an elevated NT-proBNP (p-trend for HR across BMI = 0.60), with a pattern of greater absolute risk reduction (ARR) at higher BMI (ARR for BMI <30 to ≥40 kg/m2: 2.2% to 4.7%; p-trend = 0.059). The risk of HHF varies across BMI categories for any given range of circulating NT-proBNP. These findings showcase the importance of considering BMI when applying NT-proBNP for heart failure risk stratification, particularly for patients with low-level elevations in NT-proBNP (125-<450 pg/ml) where there appears to be a clinically meaningful absolute and relative risk gradient.

Baseline BMI is associated with clinical symptom improvements in first-episode schizophrenia: a longitudinal study.

Background: There is sufficient evidence of the high prevalence of obesity in schizophrenia (SZ) compared to the general population. Previous studies have reported that weight gain correlated with the response to antipsychotics in patients with SZ. Nonetheless, the relationship between body mass index (BMI) and therapeutic benefits remains unclear. This study was designed to investigate the association between baseline BMI and improvements in clinical symptoms after treatment with antipsychotics in first-episode and medication-naïve SZ (FEMNS). Methods: A total of 241 FEMNS patients were enrolled and received risperidone over 12weeks. The severity of symptoms was assessed by the Positive and Negative Syndrome Scale (PANSS) and BMI was measured at baseline and 12-week follow-up. Results: We found that risperidone treatment raised the body weight of FEMNS patients and baseline BMI was negatively correlated with the improvement in negative symptoms (r = -0.14, p = 0.03) after 12-week treatment. Linear regression analysis indicated that baseline BMI was an independent predictor of response to risperidone in the early stage of SZ. Conclusion: The current study suggests a close relationship between baseline BMI and improvement in negative symptoms in SZ.

Association between body mass index and cognitive impairment in Chinese older adults

BackgroundThe association between body mass index (BMI) and the risk of cognitive impairment remains uncertain. Relatively few studies have analyzed the dose–response relationship between BMI and cognitive impairment. This article utilized nationally representative longitudinal data to assess the association between BMI and cognitive impairment in Chinese older adults.ObjectiveThe present study aimed to analyze the association between BMI and cognitive impairment in Chinese older people, including an investigation of gender differences and the dose–response relationship.MethodsData were obtained from the China Health and Retirement Longitudinal Study database in 2015 and 2018. The present study used logistic regression to analyze the relationship between baseline BMI and cognitive impairment, and adopted a restricted cubic spline model to plot dose–response curves for baseline BMI and prevalence of risk of cognitive impairment.ResultsThe mean BMI of the survey population was 23.48 ± 3.66 kg/m2, and the detection rate of cognitive impairment was 34.2%. Compared to the normal weight group (18.5 ≤ BMI &amp;lt; 23.9 kg/m2), the odds ratio (OR) for cognitive impairment was 1.473 (95% CI: 1.189–1.823) in the underweight group (BMI &amp;lt; 18.5 kg/m2), whereas the corresponding OR was 0.874 (95% CI: 0.776–0.985) for the overweight or obese group (BMI ≥ 24.0 kg/m2) after adjusting for confounders. Gender subgroup analysis showed that overweight or obese older women were less likely to develop cognitive impairment (OR = 0.843; 95% CI: 0.720–0.987). The results of the restricted cubic spline analysis revealed a curvilinear L-shaped relationship between BMI and the risk of cognitive impairment (P non-linearity &amp;lt;0.05). In particular, the risk of cognitive impairment was higher at a lower baseline BMI. In contrast, BMI in the range of 23.2–27.8 kg/m2 was associated with a decreased risk of cognitive impairment.ConclusionBMI is a dose-dependent related factor for cognitive impairment in Chinese older adults. Being underweight is a risk factor for the development of cognitive impairment, while being overweight or obese is less likely to have cognitive impairment, particularly in female older people. Keeping BMI ranging from 23.2–27.8 kg/m2 in older adults can help maintain cognitive function.

Impact of body mass index and its change on survival outcomes in patients with early breast cancer: A pooled analysis of individual-level data from BCIRG-001 and BCIRG-005 trials.

The relationships between body mass index (BMI) and survival rates are complex, and have not been thoroughly investigated in breast cancer patients who received adjuvant chemotherapy. We collected data on 2394 patients from two randomized, phase III clinical trials that investigated adjuvant chemotherapy in breast cancer identified in Project Data Sphere. The objective was to examine the effect of baseline BMI, BMI after adjuvant chemotherapy, and BMI change from baseline to post-adjuvant chemotherapy on disease-free survival (DFS) and overall survival (OS). Restricted cubic splines were used to examine potential non-linear associations between continuous BMI value and survival. Stratified analyses involved chemotherapy regimens. Severe obesity (BMI≥40.0kg/m2) at baseline was independently associated with worse DFS (hazard ration [HR]=1.48, 95% confidence interval [CI] 1.02-2.16, P=0.04) and OS (HR=1.79, 95%CI 1.17-2.74, P=0.007) compared with underweight/normal weight (BMI≤24.9kg/m2). A BMI loss >10% was also an independent prognostic factor for adverse OS (HR=2.14, 95%CI 1.17-3.93, P=0.014). Stratified analyses revealed that severe obesity adversely affected DFS (HR=2.38, 95%CI 1.26-4.34, P=0.007) and OS (HR=2.90, 95%CI 1.46-5.76, P=0.002) in the docetaxel-based group, but not in the non-docetaxel-based group. Restricted cubic splines revealed a "J-shaped" association of baseline BMI with risk of recurrence or all-cause death, and this relationship was more pronounced in the docetaxel-based group. In early breast cancer patients treated with adjuvant chemotherapy, baseline severe obesity was significantly linked to worse DFS and OS, and a BMI loss over 10% from baseline to post-adjuvant chemotherapy also negatively affected OS. Moreover, the prognostic role of BMI might differ between docetaxel-based and non-docetaxel-based groups.

Influence of body mass index on recurrence of atrial fibrillation after electrical cardioversion.

Several studies have shown an independent relationship between body mass index (BMI) and the incidence of atrial fibrillation (AF). However, little is known about the influence of BMI on AF recurrence after electrical cardioversion (ECV). We selected 1121 patients who reverted to sinus rhythm after scheduled ECV and were included in three prospective Spanish registries of ECV in persistent AF. The patients were classified according to baseline BMI into three categories (normal weight, overweight, obesity). We assessed the influence of BMI on the rate of AF recurrence at 3 months. We identified 538 patients (48%) who had AF recurrence in the first 3 months after successful ECV. The patients who suffered AF recurrence had a higher BMI than those who remained in sinus rhythm (29.66±4.57 vs. 28.87±4.64 Kg/m2, respectively; p = 0.004). We observed a higher incidence of AF recurrence in the overweight and obese patients (BMI ≥25 kg/m2) than in those classified as normal weight (50.5% vs. 35.6%, respectively; p<0,001). BMI≥25 Kg/m2 was shown to be independently related to of AF recurrence in the multivariate analysis (OR = 1.75, 95% confidence interval = 1.20-2.58; p = 0.004). Increased BMI is independently related to AF recurrence after ECV. BMI should also be taken into account when making decisions about the indication for ECV in persistent AF.

Lower Body Mass Index at Baseline Is Related to Steeper Cognitive Decline in the Alzheimer's Disease Neuroimaging Initiative Cohort.

Midlife obesity is a risk factor for dementia, whereas obesity in older age may be protective of cognition, a phenomenon known as the "obesity paradox." The mechanisms underlying this phenomenon and the relationship between body mass index (BMI) and cognitive function over time remain unclear. In 1399 adults with and without mild cognitive impairment (median age 73.6 years) from the Alzheimer's Disease Neuroimaging Initiative, we modeled the effects of baseline BMI on within-person trajectories of cognitive decline using Latent Growth Curve Modeling. We also tested if the effects of BMI on cognitive decline are global or specific to memory, executive function, or language. Higher baseline BMI was associated with better memory ( βBMI = 0.06, p < .05) and worse executive function ( βBMI = -0.05, p < .05) and not associated with language. Independent of baseline diagnosis, higher baseline BMI was associated with slower rate of decline in executive function, memory, and language ( βBMI = 0.13, 0.12, and 0.12, respectively; p < .01). Higher BMI was not associated with the intercept ( βBMI = 0.04, p = .059) or change ( βBMI = 0.04, p = .415) in a global cognitive factor. We found that higher baseline BMI was associated with slower cognitive decline in participants with and without mild cognitive impairment diagnosis. Higher BMI in this context seems to be protective of cognitive function for people at risk for dementia. Our findings also support domain-specific effects of obesity on various cognitive functions rather than a final common pathway.

Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV.

Observations of overweight and obesity in association with neuropsychological performance (NP) vary over the adult life course depending on baseline levels, biological sex, age, race, temporality of measurements, and other factors. Therefore, similar published analyses across cohorts are inconsistent. In our sample of women living with HIV (WLWH) and women without HIV (WWOH), we conducted comparable analyses as those published in men with and without HIV. We examined cross-sectional and longitudinal associations between body mass index (BMI) and waist circumference (WC) and NP. Four hundred thirty two 432 virologically-suppressed WLWH and 367 WWOH, ≥40 years in the Women's Interagency HIV Study (WIHS) with anthropometry and NP assessments every two years from 2009-2019 were included in the study. Demographically-adjusted T-scores were calculated for six NP domains: learning, memory, executive function, processing speed, attention and working memory, and motor function. Multivariable linear regression models stratified by HIV status were used to examine cross-sectional associations of BMI and WC by NP domain; repeated measures analyses assessed baseline BMI and WC in association with longitudinal change in NP. Covariates included sociodemographic, behavioral, and HIV-related characteristics. At baseline among all women, the median age was 45 years, 65% were Non-Latinx Black women, and 45% were obese women. Obese WLWH (BMI≥30.0 kg/m2) had poorer executive function (β=-2.27, 95%CI [-4.46, -0.07]) versus WLWH with healthy BMI (18.5-24.9 kg/m2). Longitudinally over ~8 years, obese versus overweight WWOH improved on memory (β=2.19, 95%CI [0.13, 4.26]), however overweight versus healthy WWOH experienced declining memory (β= -2.67, 95%CI [-5.40, -0.07]). Increasing WC was associated with declining executive, processing speed, and motor function (p's<0.05); an at-risk WC was associated with improved memory (β=1.81, 95%CI [0.19, 3.44]) among WWOH. Among WLWH, increasing BMI was associated with improved learning (β=0.07, 95%CI [0.00, 0.15]. Our cross-sectional and longitudinal analyses evaluating the associations of BMI and WC and NP were mixed compared to previous reports. This illustrates the importance of sociodemographic characteristics, baseline levels of exposures and outcomes, HIV status, temporality of measurements, and other factors when evaluating aging HIV epidemiology study results.

Longitudinal relationship between body mass index and depressive symptoms among Chinese adults: The moderating roles of lifestyle factors and age

ObjectiveThis study aims to verify the moderating roles of lifestyle factors and age between body mass index (BMI), BMI trajectory and depressive symptoms of Chinese adults through a prospective design. MethodsThe participants who are 18 years old and above from the China Family Panel Studies (CFPS) were included in the 2016 baseline and 2018 follow-up research. BMI was calculated according to self-report weight (kilogram) and height (centimeter). Depressive symptoms were evaluated via the Center for Epidemiologic Studies Depression (CESD-20) scale. Inverse probability-of-censoring weighted estimation (IPCW) was used to check whether selection bias existed. Modified Poisson regression was performed to calculate prevalence and risk ratios as well as 95% confidence intervals. ResultsAfter adjustment, it was found that the positive associations of persistent underweight (RR = 1.154, P < 0.001) and normal weight → underweight (RR = 1.143, P < 0.001) with 2018 depressive symptoms were significant among middle-aged people, while the negative association of persistent overweight/obesity (RR = 0.972, P < 0.001) was significant in young adults. Notably, smoking moderated the relationship between baseline BMI and subsequent depressive symptoms (interaction P = 0.028). Also, exercise regularly and exercise duration weekly moderated the relationships of baseline BMI (interaction P = 0.004 and 0.015) and trajectories of BMI (interaction P = 0.008 and 0.011) with depressive symptoms among Chinese adults, respectively. ConclusionWeight management strategies for underweight and normal weight → underweight adults should pay attention to the role of exercise in maintaining normal weight and improving depressive symptoms.

The impact of general and central obesity for all-cause hospitalization among Iranian adults: a 20 year follow-up-results from the TLGS cohort

BackgroundFew studies have examined the effect of obesity indices on total number of hospitalizations. We examined the associations between body mass index (BMI) and waist circumference (WC) and rate of all-cause hospitalizations among Iranian adult participated in the Tehran Lipid and Glucose Study cohort.MethodsThis study included 8202 individuals (3727 men) aged ≥ 30 years, who were followed for a median of 18 years. Participants were categorized into three groups according to their baseline BMI: normal weight, overweight and obese. In addition, they were classified according to WC in two categories: normal WC and high WC. Negative Binomial regression model was used to estimate the incidence rate ratios (IRRs) and 95% confidence interval (95% CI) of all-cause hospitalizations in relation to obesity indices.ResultsThe overall crude rate of all-cause hospitalizations were 77.6 (95% CI, 73.9–81.2) and 76.9 (73.4–80.3) per 1000 person-year in men and women, respectively. The covariate adjusted rate of all-cause hospitalizations was 27% higher in obese men than normal weight men (IRR (95% CI): 1.27 (1.11–1.42)). Among women, overweight and obese individuals had 17% (1.17 (1.03–1.31)) and 40% (1.40 (1.23–1.56)) higher rate of hospitalization compared to normal weight women. Having high WC was associated with 18% (1.18 (1.08–1.29)) and 30% (1.30 (1.18–1.41)) higher rate of all-cause hospitalization in men and women, respectively.ConclusionsObesity and high WC were associated with increased hospitalization rates during long-term follow-up. Our findings suggests that successful obesity prevention programs may decrease the number of hospitalizations, particularly, in women.

Association between body mass index and reversion to normoglycemia from impaired fasting glucose among Chinese adults: a 5-year cohort study.

Evidence regarding the relationship between body mass index (BMI) and reversion to normoglycemia from prediabetes is still limited. The purpose of our study is to survey the link of BMI on reversion to normoglycemia among patients with impaired fasting glucose (IFG). This study, a retrospective cohort, covered 32 regions and 11 cities in China and collected 258,74 IFG patients who underwent a health check from 2010 to 2016. We investigated the association between baseline BMI and reversion to normoglycemia in patients with IFG using the Cox proportional-hazards regression model. The nonlinear relationship between BMI and reversion to normoglycemia was determined using a Cox proportional hazards regression with cubic spline functions and smooth curve fitting. In addition, we also performed a series of sensitivity analyses and subgroup analyses. A competing risk multivariate Cox regression was performed using progression to diabetes as a competing risk for reversal of normoglycemic events. After adjusting covariates, the results showed that BMI was negatively related to the probability of reversion to normoglycemia (HR=0.977, 95%CI:0.971-0.984). Compared with participants with normal BMI(<24kg/m2), overweight (BMI:24-28kg/m2) participants with IFG had a 9.9% lower probability of returning to normoglycemia (HR=0.901,95%CI:0.863-0.939), while obese patients (BMI ≥ 28kg/m2) had a 16.9% decreased probability of reverting from IFG to normoglycemia (HR=0.831,95%CI:0.780-0.886). There was also a nonlinear relationship between them, and the inflection point of BMI was 21.7kg/m2. The effect sizes (HR) on the left sides of the inflection point were 0.972(95%CI:0.964-0.980). The competing risks multivariate Cox's regression and sensitivity analysis demonstrated the robustness of our results. This study demonstrates a negative and nonlinear relationship between BMI and reversion to normoglycemia in Chinese patients with IFG. Minimizing BMI to 21.7 kg/m2 in patients with IFG through aggressive intervention may significantly increase the probability of returning to normoglycemia.

The Impact of BMI Changes on the Incidence of Glomerular Hematuria in Korean Adults: A Retrospective Study Based on the NHIS-HEALS Cohort

Obesity and recurrent hematuria are known risk factors for chronic kidney disease. However, there has been controversy on the association between obesity and glomerular hematuria. This study aimed to investigate the association between body mass index (BMI) and weight change and recurrent and persistent hematuria in glomerular disease using a large-scale, population-based Korean cohort. Data were collected from the National Health Insurance Service-National Health Screening Cohort. Cox proportional hazards regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for recurrent and persistent hematuria in glomerular disease according to the BMI group. Compared with the BMI 23-25 kg/m2 group, the HR (95% CI) for incident recurrent and persistent hematuria in glomerular disease was 0.921 (0.831-1.021) in the BMI <23 kg/m2 group, 0.915 (0.823-1.018) in the BMI 25-30 kg/m2 group, and 1.151 (0.907-1.462) in the BMI ≥30 kg/m2 group. Compared with the stable weight group, the HRs (95% CIs) for incident recurrent and persistent hematuria in glomerular disease were 1.364 (1.029-1.808) and 0.985 (0.733-1.325) in the significant weight loss and gain groups, respectively. Despite adjusting for confounders, this result remained significant. Baseline BMI was not associated with the risk of incident recurrent and persistent hematuria in glomerular disease. Weight loss greater than 10% was associated with the incidence of recurrent and persistent hematuria in glomerular disease. Therefore, maintaining an individual's weight could help prevent recurrent and persistent hematuria in glomerular disease in middle-aged and older Korean adults.

The Mediterranean, DASH, and MIND diets and the incident of hypertension over a median follow-up of 7.4 years in the Tehran Lipid and Glucose Study

BackgroundDespite the favorable effects of well-known dietary patterns in the treatment of hypertension (HTN), such as the Mediterranean (MED) and Dietary Approach to Stop Hypertension (DASH) diets, it is uncertain if adherence to these diets can reduce the risk of HTN, especially in non-Mediterranean populations. Moreover, none of the previous studies evaluated the association between the MED-DASH Intervention for Neurodegenerative Delay (MIND) diet adherence and the incidence of HTN. Therefore, we aimed to assess the association of adherence to these diets with the development of HTN in adults.MethodsThis prospective study included 2706 adults free of HTN who were selected from the Tehran Lipid and Glucose Study. The MED, DASH, and MIND diet scores were computed at baseline using dietary information collected with the food frequency questionnaire. Associations between the dietary indices and risk of HTN over a median follow-up of 7.4 years were examined using Cox proportional hazards regression analysis.ResultsThe baseline mean age of participants was 37.9 ± 12.5 years (age range: 20–79 years), and 52.4% were women. During the 18262 person-years follow-up, 599 incidents of HTN were identified. There was no significant relationship between the dietary scores and the risk of HTN, either as continuous or categorical variables, even after excluding individuals with early/late HTN diagnosis, prehypertension, diabetes, or chronic kidney disease at baseline. A significant interaction was found between body mass index (BMI) and DASH (P-interaction < 0.001). Stratified analyses based on baseline BMI status revealed an inverse association between DASH and HTN risk in individuals with normal-weight (HR = 0.84, 95% CI = 0.71–0.98, P = 0.031), although this association did not reach statistical significance across the tertiles of DASH.ConclusionsIn this study, MED, DASH, and MIND showed no significant association with the occurrence of HTN in adults. Further prospective studies on diverse populations are required to assess whether adherence to the MED, DASH, and MIND diets is an effective strategy for reducing the occurrence HTN.

Body mass index and incidence of lung cancer in the HUNT study: using observational and Mendelian randomization approaches

BackgroundTraditional observational studies have shown an inverse association between body mass index (BMI) and lung cancer risk. Mendelian randomization (MR) analysis using genetic variants as instruments for BMI may clarify the nature of the association.AimsWe studied the causal association between BMI and lung cancer incidence using observational and MR approaches.MethodsWe followed up 62,453 cancer-free Norwegian adults from 1995–97 (HUNT2) until 2017. BMI at baseline in HUNT2 was classified as < 25.0, 25.0–29.9 and ≥ 30.0 kg/m2. BMI change over ten years between HUNT1 (1984–86) and HUNT2 was calculated and classified into quartiles. Seventy-five genetic variants were included as instruments for BMI (among which 14 also associated with smoking behavior). Incident lung cancer cases were ascertained from the Cancer Registry of Norway. Cox regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Multivariable MR was used to examine the effect of BMI after genetically controlling for smoking.ResultsDuring a median follow-up of 21.1 years, 1009 participants developed lung cancer including 327 with lung adenocarcinoma. The HRs and 95% CIs for incidence of adenocarcinoma were 0.73 (0.58–0.92) for BMI 25.0–29.9 kg/m2 and 0.53 (0.37–0.76) for BMI ≥ 30 kg/m2 compared with BMI < 25.0 kg/m2 in HUNT2 (P for trend < 0.001). However, there was little evidence of a dose–response relationship between the BMI change from HUNT1 to HUNT2 in quartiles and the incidence of adenocarcinoma (P for trend = 0.08). Furthermore, multivariable MR approach suggested a positive association between genetically determined 1 kg/m2 increase in BMI and the incidence of adenocarcinoma (HR 1.25, 95% CI 1.02–1.53). No associations were found with other lung cancer histologic types.ConclusionsOur study suggests that the inverse association between baseline BMI and lung adenocarcinoma in observational analysis may not be causal. More MR studies are needed to confirm our finding of a positive association between BMI and lung adenocarcinoma.

Association of anthropometric indices with the development of multimorbidity in middle-aged and older adults: A retrospective cohort study.

BackgroundPrevious studies have explored the relationship between body mass index (BMI) and multimorbidity. However, the relationship between other obesity indicators and their dynamic changes and multimorbidity has not been systematically estimated. Therefore, we aimed to investigate the association of BMI and other obesity indicators, including waist circumference (WC), waist-to-height ratio (WHtR), waist divided by height0.5 (WHT.5R), and body roundness index (BRI) and their changes and the risk of multimorbidity in middle-aged and older adults through a retrospective cohort study.MethodsData collected from annual health examination dataset in the Jinshui during 2017 and 2021. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate the effect of baseline and dynamic changes in the anthropometric indices on the risk of multimorbidity.ResultsA total of 75,028 individuals were included in the study, and 5,886 participants developed multimorbidity during the follow-up. Multivariate Cox regression analysis revealed a progressive increase in the risk of multimorbidity with increasing anthropometric indicators (BMI, WC, WHtR, WHT.5R, and BRI) (all P<0.001). Regardless of general obesity status at baseline, increased WC was associated with a high risk of multimorbidity. Compared to the subjects with baseline BMI<24 kg/m2 and WC<90 (men)/80 (women), the HRs (95% CI) of the baseline BMI<24 kg/m2 and WC≥90 (men)/80 (women) group and BMI≥24 kg/m2 and WC≥90 (men)/80 (women) group were 1.31 (1.08, 1.61) and 1.82 (1.68, 1.97), respectively. In addition, the dynamics of WC could reflect the risk of multimorbidity. When subjects with baseline WC<90 (men)/80 (women) progressed to WC≥90 (men)/80 (women) during follow-up, the risk of multimorbidity significantly increased (HR = 1.78; 95% CI, 1.64, 1.95), while the risk of multimorbidity tended to decrease when people with abnormal WC at baseline reversed to normal at follow-up (HR = 1.40; 95% CI, 1.26, 1.54) compared to those who still exhibited abnormal WC at follow-up (HR = 2.00; 95% CI, 1.82, 2.18).ConclusionsCentral obesity is an independent and alterable risk factor for the occurrence of multimorbidity in middle-aged and elderly populations. In addition to the clinical measurement of BMI, the measurement of the central obesity index WC may provide additional benefits for the identification of multimorbidity in the Chinese middle-aged and elderly populations.

Initial BMI and Weight Loss over Time Predict Mortality in Parkinson Disease.

Although weight loss is a frequent symptom in Parkinson disease (PD), there have been few studies on the association between body mass index (BMI) and mortality. The objective of this study was to investigate the association between BMI and change in BMI at diagnosis in patients with PD and all-cause mortality. Cohort study using Korean National Health Insurance Service-Elderly Cohort data. Patients with new-onset PD were selected using the International Classification of Diseases 10th edition code (G20). Then, patients who were diagnosed more than 3 times with PD and had been prescribed anti-parkinsonian medication for ≥30days were included. Those with a combined diagnosis of atypical parkinsonism and secondary parkinsonism were excluded. The primary outcome was all-cause mortality. Anthropometric data, including height and weight, were obtained from the health screening data to calculate BMI. The Cox proportional hazards model was used to assess mortality risk by BMI. Among the 2703 patients with PD, 492 (18.20%) died during the 11-year follow-up period. There was a significant inverse dose-response relationship between baseline BMI and mortality [<18.5kg/m2: hazard ratio (HR), 1.872, 95% CI, 1.338-2.494; 23-25kg/m2: HR, 0.695, 95% CI, 0.546-0.886; 25-30kg/m2: HR, 0.644, 95% CI, 0.476-0.869; ≥30kg/m2: HR, 0.396, 95% CI, 0.165-0.950]. Change in BMI of 10% revealed a significant association with mortality. Subgroup analyses by sex showed a significant inverse dose-response relationship between BMI and all-cause mortality only in women. We demonstrated an inverse dose-response association between BMI at diagnosis and mortality in patients with PD, especially in women. Early detection of PD before weight loss progression and proper management might improve mortality. The small number of obese PD participants in our study should be considered when interpreting and generalizing results.

Association Between Body Mass Index and Incident Dementia Among Community-Dwelling Older Adults: The Shanghai Aging Study.

The relationship between body mass index (BMI) and dementia is inconclusive. Undesirable loss of fat-free mass is a risk factor for cognitive decline while obesity is also a risk factor for cardio-metabolic disorders among the older adults. This study aimed to examine the association between BMI and incident all-cause dementia among Chinese older adults using a prospective study. Participants were 1,627 community residents aged 60 or older without dementia from the Shanghai Aging Study. Cox regression models, incorporated with restricted cubic splines, were used to explore a nonlinear association between baseline BMI and risk of all-cause dementia as measured by hazard ratio (HR) using both frequentist and Bayesian approach. We diagnosed 136 incident dementia cases during the mean follow-up of 5.3 years. Compared with moderate BMI (18.5-24.0 kg/m2), low BMI (< 18.5 kg/m2) were related to an increased risk of dementia with the HR as 3.38 (95% CI 1.50-7.63), while high BMI (≥24.0 kg/m2) showed a decreased risk of dementia without statistical significance (HR = 0.91, 95% CI 0.60 to 1.39). Sensitivity analysis in participants without central obesity indicated that the association was still significant with even higher HR. Bayesian approach presented the similar results. Our result indicates that low BMI may contribute to high risk of incident dementia, even in individuals without central obesity.

Impact of BMI on Long-Term Outcomes in Patients with ST-Segment Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention.

Aim Obesity paradox remains a point of debate in ST-segment elevation myocardial infarction (STEMI) patients. The aim of this study was to examine the relationship between body mass index (BMI) and clinical outcomes in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods Outcomes were assessed in 1429 STEMI patients undergoing PPCI between January 2009 and January 2010 in Beijing. Patients were classified into 6 groups according to age (the younger and elderly groups consisting of patients ≤65 and > 65 years old) and baseline BMI (normal weight, BMI < 24 kg/m2; overweight, 24 kg/m2 ≤BMI < 28 kg/m2; obese, BMI ≥ 28 kg/m2). The primary outcome was death, acute myocardial infarction (AMI), or revascularization. Results On long-term follow-up (mean follow-up of 59 months), 13.9% of patients experienced the adverse event. Multivariate logistic regression analyses showed that low BMI was a significant predictor of the primary outcome only in the younger group. The odds ratio for overweight in comparison with normal weight was 0.741 (95% CI: 0.413–0.979; p = 0.038), the odds radio for obesity in comparison with normal-weight patients was 0.508 (95% CI: 0.344–0.750; p = 0.016) in the younger group. In the elderly group, diabetes, hypertension, triple disease, regular exercise, angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blockers (ARBs) use after discharge, and bleeding complication were associated with primary outcome. Conclusion The obesity paradox was recognized only in the younger age group in STEMI patients undergoing PPCI.

Post hoc Analysis of Clinical Outcomes in Placebo- and Pirfenidone-Treated Patients with IPF Stratified by BMI and Weight Loss

Background: Weight loss is frequently reported in patients with idiopathic pulmonary fibrosis (IPF) and may be associated with worse outcomes in these patients. Objective: The aim of this study was to investigate the relationships between body mass index (BMI) and weight loss, and outcomes over 1 year in patients with IPF. Methods: Data were included from placebo patients enrolled in ASCEND (NCT01366209) and CAPACITY (NCT00287716 and NCT00287729), and all patients in INSPIRE (NCT00075998) and RIFF Cohort A (NCT01872689). An additional analysis included data from pirfenidone-treated patients. Outcomes (annualized change in percent predicted forced vital capacity [%FVC], percent predicted carbon monoxide diffusing capacity, 6-min walk distance, St. George’s Respiratory Questionnaire total score, hospitalization, mortality, and serious adverse events) were analyzed by baseline BMI (<25 kg/m², 25 kg/m²–<30 kg/m², or ≥30 kg/m²) and annualized percent change in body weight (no loss, >0–<5% loss, or ≥5% loss). Results: Placebo-treated patients with a baseline BMI <25 kg/m² or annualized weight loss may experience worse outcomes versus those with a baseline BMI ≥25 kg/m² or no weight loss. The proportion of placebo-treated patients who experienced a relative decline of ≥10% in %FVC or death up to 1 year post-randomization was highest in patients with a baseline BMI <25 kg/m². Pirfenidone-treated patients with an annualized weight loss ≥5% may also experience worse outcomes versus those with no weight loss. Conclusions: Patients with a baseline BMI <25 kg/m² or annualized weight loss of >0–<5% or ≥5% may experience worse outcomes over 1 year versus those with a baseline BMI ≥25 kg/m² or no weight loss.

595ICE FALCON: a causation assessment method analogous to, but more powerful than, Mendelian Randomisation

595ICE FALCON: a causation assessment method analogous to, but more powerful than, Mendelian Randomisation