Quintile Of Body Mass Index Research Articles

Inflammation Modifies the Paradoxical Association between Body Mass Index and Mortality in Hemodialysis Patients

High body mass index (BMI) is paradoxically associated with better outcome in hemodialysis (HD) patients. Persistent inflammation commonly features in clinical conditions where the obesity paradox is described. We examined the relationship between BMI and mortality in HD patients, accounting for inflammation, in a historic cohort study of 5904 incident HD patients enrolled in 2007-2009 (312 facilities; 15 European countries) with ≥3 months of follow-up. Patients were classified by presence (n=3231) or absence (n=2673) of inflammation (C-reactive protein ≥10 mg/l and/or albumin ≤35 g/l). Patients were divided into quintiles by BMI (Q1-Q5: <21.5, 21.5-24.0, >24.0-26.4, >26.4-29.8, and >29.8 kg/m(2), respectively). Noninflamed patients in BMI Q5 formed the reference group. During a median follow-up period of 36.7 months, 1929 deaths occurred (822 cardiovascular), with 655 patients censored for renal transplantation and 1183 for loss to follow-up. Greater mortality was observed in inflamed patients (P<0.001). In fully adjusted time-dependent analyses, the all-cause mortality risk in noninflamed patients was higher only in the lowest BMI quintile (hazard ratio [HR, 1.80; 95% confidence interval [95% CI], 1.26 to 2.56). No protective effect was associated with higher BMI quintiles in noninflamed patients. Conversely, higher BMI associated with lower all-cause mortality risk in inflamed patients (HR [95% CI] for Q1: 5.63 [4.25 to 7.46]; Q2: 3.88 [2.91 to 5.17]; Q3: 2.89 [2.16 to 3.89]; Q4: 2.14 [1.59 to 2.90]; and Q5: 1.77 [1.30 to 2.40]). Thus, whereas a protective effect of high BMI was observed in inflamed patients, this effect was mitigated in noninflamed patients.

P04 - Body Mass Index (BMI) e quality of life (QoL) in cancer patients – the ‘Tor Vergata’ Observational study in oNCOlogy– TV-ONCO study

Background: Obesity has been consistently linked to an increased risk of developing cancer. A recent retrospective study on > 8000 pts has found longer survival in pts with metastatic cancer and high BMI (Martin.J Clin Oncol. 2015). Data on the effect of BMI on the Health-related quality of life (HRQoL), are scarce. The purpose of this study was to evaluate the effect of BMI on QoL in pts with metastatic or inoperable cancer.Methods: We prospectively evaluated the association between baseline BMI and the HRQoL among 136 pts with metastatic or inoperable cancer. Quality of life was measured through the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-C30, version3.0). Associations between BMI and QoL were determined by means of univariate and multivariate analysis. We classified our patients on the basis of their BMI status (underweight <18.5 kg/m2, normal weight 18.5-24.9 kg/m2, overweight 25–29.9 kg/m2, obese > 30 kg/m2), sex, number of sites of metastases (inoperable or one site, two sites, more than two sites), cancer primary site (breast, lung, upper GI, colorectum, GU, other).Results: Among recruited pts 5 were underweight (3.7%), 59 normal weight (43.4%), 46 overweight (33.8%) and 26 obese (19.1%). Male 56 (41.1%) and female 80 (58.9%). Pts inoperable or one site of metastases 26 (19.1%); pts with two and more than two sites of metastases were 63 (46.3%) and 47 (34.6%), respectively. Primary sites were GU (n 20, 14.7%), upper GI (n 18, 13.2%), colorectum (n 46, 33.8%), breast (n 25, 18.4%), lung (n 17, 12.5%), or other (n 10, 7.4%). Median Global Health Status (GHS) score was 50 for underweight pts, 50 for normal weight pts, 58 for overweight pts and 67 for obese pts. By dividing pts in BMI quintiles, we found that pts group with lowest BMI category (BMI<18) had a significantly lower median GHS score as compared with the pts group with highest BMI category (BMI>31), 50 vs 75, p 0.02. Other significant differences between these two extreme BMI categories were in Physical Functioning (median score 67v90, p 0.01), Role Functioning (67v100, p 0.02), Emotional Functioning (67v91, p 0.02) and Social Functioning (67v100, p 0.02).Conclusion: Our results show that better HRQoL is associated with higher BMI possibly owing to additional energetic reserve counteracting cachexia. Further studies will need to address whether intensified nutritional support to achieve weight gain is warranted to improve HRQoL. Background: Obesity has been consistently linked to an increased risk of developing cancer. A recent retrospective study on > 8000 pts has found longer survival in pts with metastatic cancer and high BMI (Martin.J Clin Oncol. 2015). Data on the effect of BMI on the Health-related quality of life (HRQoL), are scarce. The purpose of this study was to evaluate the effect of BMI on QoL in pts with metastatic or inoperable cancer. Methods: We prospectively evaluated the association between baseline BMI and the HRQoL among 136 pts with metastatic or inoperable cancer. Quality of life was measured through the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-C30, version3.0). Associations between BMI and QoL were determined by means of univariate and multivariate analysis. We classified our patients on the basis of their BMI status (underweight <18.5 kg/m2, normal weight 18.5-24.9 kg/m2, overweight 25–29.9 kg/m2, obese > 30 kg/m2), sex, number of sites of metastases (inoperable or one site, two sites, more than two sites), cancer primary site (breast, lung, upper GI, colorectum, GU, other). Results: Among recruited pts 5 were underweight (3.7%), 59 normal weight (43.4%), 46 overweight (33.8%) and 26 obese (19.1%). Male 56 (41.1%) and female 80 (58.9%). Pts inoperable or one site of metastases 26 (19.1%); pts with two and more than two sites of metastases were 63 (46.3%) and 47 (34.6%), respectively. Primary sites were GU (n 20, 14.7%), upper GI (n 18, 13.2%), colorectum (n 46, 33.8%), breast (n 25, 18.4%), lung (n 17, 12.5%), or other (n 10, 7.4%). Median Global Health Status (GHS) score was 50 for underweight pts, 50 for normal weight pts, 58 for overweight pts and 67 for obese pts. By dividing pts in BMI quintiles, we found that pts group with lowest BMI category (BMI<18) had a significantly lower median GHS score as compared with the pts group with highest BMI category (BMI>31), 50 vs 75, p 0.02. Other significant differences between these two extreme BMI categories were in Physical Functioning (median score 67v90, p 0.01), Role Functioning (67v100, p 0.02), Emotional Functioning (67v91, p 0.02) and Social Functioning (67v100, p 0.02). Conclusion: Our results show that better HRQoL is associated with higher BMI possibly owing to additional energetic reserve counteracting cachexia. Further studies will need to address whether intensified nutritional support to achieve weight gain is warranted to improve HRQoL.

Catch-up growth in infants with laryngomalacia after supraglottoplasty

ImportanceLaryngomalacia, the most common congenital anomaly of the infant airway, can lead to poor feeding and failure to thrive. The decision to perform the standard surgical treatment, supraglottoplasty, is often based upon a sustained period of poor weight gain or weight loss. ObjectiveTo characterize patterns of growth in infants with laryngomalacia, preceding and following supraglottoplasty. DesignRetrospective chart review. Bioinformatics techniques were used to procure data from a clinical data warehouse based on the HL7 Reference Information Model consisting of all infants who underwent supraglottoplasty from June 1, 2005 to October 31, 2013. Height and weight measurements were obtained from 76 operated patients allowing for characterization of growth changes from the time of surgery to an average of 9 months following surgery. Logistic regression analysis was performed to examine the following variables for correlations with changes in weight, height and body mass index percentiles: patient age at surgery, preoperative weight, gender, and ethnic background. SettingAcademic pediatric tertiary medical center. ParticipantsPatients under 2 years of age at the time of surgery, who underwent supraglottoplasty for laryngomalacia, with height and weight measurements recorded within 3 months preceding surgery and greater than 3 months following surgery. InterventionSupraglottoplasty. Main outcomes and measuresChange in weight, height and body mass index (BMI) percentile from pre-op to post-op. ResultsBMI increased from a mean of 15.4 to 18.0 and BMI percentile from a mean of 34 to 51 from pre-op to post-op. The largest BMI percentile increases were observed in infants that were 3 months or younger at the time of surgery, as well as in those under 12 months of age, who were in the lowest BMI quintile. Conclusions and relevanceInfants who underwent supraglottoplasty tended to be small in weight and stature, and gained weight after surgery. Most of the weight gain occurred within 6 months of surgery. The largest increases in BMI percentile were observed in infants who were younger and smaller at the time of surgery while the infants older than 18 months had no significant gain.

Sex and ethnic-origin specific BMI cut points improve prediction of 40-year mortality: the Israel GOH study.

Although obesity has been associated with a higher risk for premature death, the sex and ethnic-origin specific body mass index (BMI) levels that are associated with increased mortality are controversial. We investigated the 40-year cumulative all-cause mortality, in relation to the BMI in adult life, among men and women originating from Yemen, Europe/America, Middle East and North Africa, using sex and ethnic-origin specific BMI cut points. A random stratified cohort (n = 5710) was sampled from the central population registry and followed since 1969 for vital status. Weight, height and blood pressure were measured, and smoking status was recorded at baseline. BMI was analysed according to conventional categories and according to sex and ethnic-origin specific quintiles. Elevated and significant mortality hazard ratios (HRs) of 1.21 [95% confidence interval (CI) 1.00-1.45] for women and 1.22 (95%CI 1.03-1.44) for men were found for the highest origin-specific BMI quintile. In men, the lowest ethnic-origin specific quintile was also significantly associated with increased mortality (HR of 1.22 95% CI 1.03-1.45), adjusting for age, smoking and blood pressure. Obesity was associated with mortality in non-smokers (HR = 1.29, 95% CI 1.04-1.61 in men and HR = 1.46, 95% CI 1.19-1.79 in women), whereas leanness was associated with mortality only among smoking men (HR = 1.39, 95% CI 1.09-1.77). Refinement of BMI categories using country of origin specific quintiles demonstrated significantly increased mortality in the upper quintile in both sexes, while according to the conventional values this association did not prevail in men. We propose the establishment of sex and origin-specific BMI categories when setting goals for disease prevention.

Anthropometric measurements in childhood and prediction of cardiovascular risk factors in adulthood: Kaunas cardiovascular risk cohort study.

BackgroundThis study aimed to examine the associations between anthropometric measurements in childhood and adulthood as well as the effect of childhood body mass index (BMI) and skinfold thickness in the prediction of adult cardiovascular risk factors.MethodsThe Study subjects were participants of the Kaunas Cardiovascular Risk Cohort study. They were 12–13 years old at the time of the baseline survey (1977) and 48–49 years old in the 35-year follow-up survey (2012, n = 506). In childhood, height, weight, subscapular and triceps skinfold thickness measurements were taken. In 2012, health examination involved measurements of blood pressure (BP), BMI, waist circumference, glucose, lipids, and high-sensitivity C-reactive protein (CRP) levels. Logistic regression models were fitted to assess the associations of childhood BMI and skinfold thicknesses as well as BMI gain with cardiovascular risk factors in middle age. All logistic regression models were adjusted for sex, physical activity level, alcohol consumption, smoking and family history of obesity.ResultsOver 35 years of follow-up, BMI gain was greater in men than in women. Anthropometric measurements in childhood significantly correlated with values measured in adulthood. The highest correlation coefficients were defined for weight and BMI measurements (in girls r = 0.56 and r = 0.51 respectively; in boys r = 0.45 and r = 0.41 respectively, P < 0.001). Mean values of change in BMI were similar in all quintiles of childhood BMI; however, prevalence of adult obesity increased considerably with increasing quintiles. The risk of adult obesity, metabolic syndrome, hyperglycaemia or type 2 diabetes, and elevated level of high-sensitivity CRP increased with a rise in childhood BMI and skinfold thicknesses, irrespectively of BMI gain from childhood to adulthood. No relationship was found between childhood anthropometric measurements and arterial hypertension, raised level of triglycerides or reduced level of HDL cholesterol. Gain in BMI from childhood to adulthood was associated with increased odds of all above-mentioned risk factors independently of childhood BMI.ConclusionsRisk of metabolic syndrome, hyperglycaemia and diabetes, and elevated high-sensitivity CRP may be affected by childhood BMI and skinfold thickness, while risk of hypertension, raised triglycerides and reduced HDL cholesterol is associated more strongly with BMI gain from childhood to adulthood.

Usefulness of Measuring Both Body Mass Index and Waist Circumference for the Estimation of Visceral Adiposity and Related Cardiometabolic Risk Profile (from the INSPIRE ME IAA Study)

Despite its well-documented relation with visceral adiposity (VAT) and cardiometabolic risk (CMR), whether waist circumference (WC) should be measured in addition to body mass index (BMI) remains debated. This study tested the relevance of adding WC to BMI for the estimation of VAT and CMR. In the International Study of Prediction of Intra-abdominal Adiposity and Its Relationship with Cardiometabolic Risk/Intra-abdominal Adiposity, 297 physicians recruited 4,504 patients (29 countries). Both BMI and WC were measured, whereas VAT and liver fat were assessed by computed tomography. A composite CMR score was calculated. From the 4,109 patients included in the present analyses (20 ≤ BMI < 40 kg/m(2), 47% women), about 30% displayed discordant values for WC and BMI quintiles, despite a strong correlation between the 2 anthropometric variables (r = 0.87 and r = 0.84 for men and women, respectively, p <0.001). Within each single BMI unit, VAT and WC showed substantial variability between subjects (mean difference between 90th and 10th percentiles: 175 cm(2)/16 cm and 137 cm(2)/18 cm for VAT/WC in men and women, respectively). Within each BMI category, increasing gender-specific WC tertiles were associated with significantly higher VAT, liver fat, and with a more adverse CMR profile. In conclusion, this large international cardiometabolic study highlights the frequent discordance between BMI and WC, driven by the substantial variability in VAT for a given BMI. Within each BMI category, WC was cross-sectionally associated with VAT, liver fat, and CMR factors. Thus, WC allows a further refinement of the CMR related to any given BMI.

Entering a new era of body indices: the feasibility of a body shape index and body roundness index to identify cardiovascular health status.

BackgroundThe Body Mass Index (BMI) and Waist Circumference (WC) are well-used anthropometric predictors for cardiovascular diseases (CVD), but their validity is regularly questioned. Recently, A Body Shape Index (ABSI) and Body Roundness Index (BRI) were introduced as alternative anthropometric indices that may better reflect health status.ObjectiveThis study assessed the capacity of ABSI and BRI in identifying cardiovascular diseases and cardiovascular disease risk factors and determined whether they are superior to BMI and WC.Design and Methods4627 Participants (54±12 years) of the Nijmegen Exercise Study completed an online questionnaire concerning CVD health status (defined as history of CVD or CVD risk factors) and anthropometric characteristics. Quintiles of ABSI, BRI, BMI, and WC were used regarding CVD prevalence. Odds ratios (OR), adjusted for age, sex, and smoking, were calculated per anthropometric index.Results1332 participants (27.7%) reported presence of CVD or CVD risk factors. The prevalence of CVD increased across quintiles for BMI, ABSI, BRI, and WC. Comparing the lowest with the highest quintile, adjusted OR (95% CI) for CVD were significantly different for BRI 3.2 (1.4–7.2), BMI 2.4 (1.9–3.1), and WC 3.0 (1.6–5.6). The adjusted OR (95% CI) for CVD risk factors was for BRI 2.5 (2.0–3.3), BMI 3.3 (1.6–6.8), and WC 2.0 (1.6–2.5). No association was observed for ABSI in both groups.ConclusionsBRI, BMI, and WC are able to determine CVD presence, while ABSI is not capable. Nevertheless, the capacity of BRI as a novel body index to identify CVD was not superior compared to established anthropometric indices like BMI and WC.

The association between physical fitness and academic achievement in Texas state house legislative districts: an ecologic study.

The association of physical fitness with cognitive function in children and adolescents is unclear. The purpose of this ecological study was to describe the association between academic achievement, body mass index (BMI), and cardiovascular fitness (CVF) in a large sample of elementary, middle, and high school students in Texas. FITNESSGRAM(®) results for 2,550,144 students were matched with standardized composite academic test (TAKS) results from 2008 to 2009. Analyses were conducted on the percent of students meeting TAKS standards by BMI and CVF quintiles. Analyses of variance with Tukey adjustment examined differences between the most favorable 5th quintile (referent) and all other quintiles. The prevalence of students meeting the TAKS standard was significantly higher in the highest fitness category for BMI and CVF compared to all other categories, regardless of sex or grade category (p < .05). Linear modeling suggested a 5% increase in the prevalence of students meeting healthy BMI and CVF standards would result in a 2.25% and 0.65% increase in the prevalence of students meeting the TAKS standard (both p < .05). Findings suggest a healthy BMI and CVF are associated with higher academic achievement, and the need for additional research examining the role of potential confounders and/or effect modifiers longitudinally.

The Association Between Body Mass Index and Increased Utilization of Healthcare Services: A Retrospective Cohort Study of 51, 521 Young Adult Males

To examine the association between the entire body mass index (BMI) range and healthcare utilization. Weight and height were measured during medical examinations of recruits prior to their entry into the military in Israel. All recruits were followed-up during service and all of their medical information was recorded in a central electronic medical record. We extracted medical and sociodemographic data for all Jewish male combat recruits during their first year of service. The study included 51,521 subjects who were divided into quintiles according to BMI. Using logistic regression models, we determined the association between BMI and high numbers of physician encounters, emergency room visits, referrals to specialists, imaging, laboratory tests, and medication prescriptions. In comparison with the lowest BMI quintile, there was a significant increase in the highest quintile with regard to an increased number of physician encounters (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19-1.36), emergency room visits (OR, 1.2; 95% CI, 1.12-1.29), referrals to specialists (OR, 1.22; 95% CI, 1.14-1.31), and medication prescriptions (OR, 1.23; 95% CI, 1.15-1.32). An increase in the number of laboratory tests was not statistically significant and there was no difference in imaging referrals. Adjustment for various sociodemographic variables and medical conditions did not significantly change the results. Higher BMI is related to increased utilization of healthcare services, even for BMI values in the normal range.

Body‐mass index and mortality risk in US Blacks compared to Whites

ObjectiveTo compare body-mass index (BMI)-related mortality risk in US Blacks vs. Whites as the relationship appears to differ across race/ethnicity groups.Design and MethodsWe pooled cross-sectional surveys of nationally representative samples of 11,934 Blacks and 59,741 Whites aged 35–75 in the National Health Interview Survey from 1997–2002 with no history of cardiovascular disease or cancer. Mortality follow-up was available through 2006. BMI was calculated from self-reported height and weight. We used adjusted Cox regression analysis to adjust for potential confounders.ResultsOver 9 years of follow-up, there were 4,303 deaths (1,205 among never smokers). Age-adjusted mortality rates were higher in Blacks compared to Whites at BMI < 25 kg/m2 and showed no increase at higher levels of BMI. In men, adjusted hazard ratios for all-cause death rose in a similar fashion across upper BMI quintiles in Blacks and Whites; in women, however, BMI was positively associated with mortality risk in Whites, but inversely associated in Blacks (p interaction = 0.01). Racial disparities were amplified in subsidiary analyses that introduced a 12-month lag for mortality or focused on CVD mortality.ConclusionsThe relationship of elevated BMI to mortality appears weaker in US Blacks than in Whites, especially among women.

Body-Mass Index and All-Cause Mortality in US Adults With and Without Diabetes

Previous studies found normal weight compared to overweight/obese adults with type 2 diabetes had a higher mortality risk, and body-mass index (BMI)-mortality studies do not typically account for baseline diabetes status. To determine if diabetes influences the BMI-mortality relationship. Using a prospective study design, we analyzed data from a nationally representative sample of US adults participating in the National Health Interview Survey from 1997 to 2002, and followed for mortality through 2006. Excluding those with heart disease or cancer, our final analytic sample included 74,710 (34,805 never smoker) adults. BMI was calculated from self-reported height and weight. Diabetes status was based on self-reported diagnosis from a health professional. We used direct age standardization to calculate all-cause mortality rates and adjusted Cox models for all-cause mortality hazard ratios by BMI quintile; this was done separately for adults with diabetes and without diabetes. Among never smokers, mean age was 50.1years and 43% were men. Mean BMI was 27.4kg/m(2), 26% were obese, and 2,035 (5%) reported diagnosed diabetes. After 9years, there were 4,355 deaths (754 of 4,740 with diabetes; 3,601 of 69,970 without) among 74,710 participants, and 1,238 (247 of 2,035 with diabetes; 991 of 32,770 without) among 34,805 never smokers. We observed a qualitative interaction with diabetes on the BMI-mortality relationship (p = 0.002). Death rates were substantially higher among participants with diabetes compared to those without diabetes across all BMI quintiles. However, death rates in participants with diabetes fell with increasing BMI quintile, while rates followed a J-shaped curve among those without diabetes. In adjusted Cox models, BMI was positively associated with mortality in adults without diabetes, but inversely associated with mortality among participants with diabetes. Mortality increased with increasing BMI in adults without diabetes, but decreased with increasing BMI among their counterparts with diabetes. Future studies need to be better designed to answer the question of whether normal weight adults with diabetes have a higher risk of mortality, by minimizing the possibility of reverse causation. Future studies should also account for prevalent diabetes in all investigations of the BMI-mortality relationship.

Serum interleukin‐6 associated with hepatocellular carcinoma risk: A nested case–control study

Inflammatory markers have been associated with increased risk of several cancers, including colon, lung, breast and liver, but the evidence is inconsistent. We conducted a nested case-control study in the longitudinal cohort of atomic-bomb survivors. The study included 224 hepatocellular carcinoma (HCC) cases and 644 controls individually matched to cases on gender, age, city and time and method of serum storage, and countermatched on radiation dose. We measured C-reactive protein (CRP) and interleukin (IL)-6 using stored sera obtained within 6 years before HCC diagnosis from 188 HCC cases and 605 controls with adequate volumes of donated blood. Analyses with adjustment for hepatitis virus infection, alcohol consumption, smoking habit, body mass index (BMI) and radiation dose showed that relative risk (RR) of HCC [95% confidence interval (CI)] in the highest tertile of CRP levels was 1.94 (0.72-5.51) compared to the lowest tertile (p = 0.20). RR of HCC (95% CI) in the highest tertile of IL-6 levels was 5.12 (1.54-20.1) compared to the lowest tertile (p = 0.007). Among subjects with BMI > 25.0 kg/m(2) , a stronger association was found between a 1-standard deviation (SD) increase in log IL-6 and HCC risk compared to subjects in the middle quintile of BMI (21.3-22.9 kg/m(2) ), resulting in adjusted RR (95% CI) of 3.09 (1.78-5.81; p = 0.015). The results indicate that higher serum levels of IL-6 are associated with increased HCC risk, independently of hepatitis virus infection, lifestyle-related factors and radiation exposure. The association is especially pronounced among subjects with obesity.

Parent-Child Resemblance in Weight Status and Its Correlates in the United States

BackgroundFew studies have examined parent-child resemblance in body weight status using nationally representative data for the US.DesignWe analyzed Body Mass Index (BMI), weight status, and related correlates for 4,846 boys, 4,725 girls, and their parents based on US nationally representative data from the 2006 and 2007 Medical Expenditure Panel Survey (MEPS). Pearson partial correlation coefficients, percent agreement, weighted kappa coefficients, and binary and multinomial logistic regression were used to examine parent-child resemblance, adjusted for complex sampling design.ResultsPearson partial correlation coefficients between parent and child’s BMI measures were 0.15 for father-son pairs, 0.17 for father-daughter pairs, 0.20 for mother-son pairs, and 0.23 for mother-daughter pairs. The weighted kappa coefficients between BMI quintiles of parent and child ranged from −0.02 to 0.25. Odds ratio analyses found children were 2.1 (95% confidence interval (CI): 1.6, 2.8) times more likely to be obese if only their father was obese, 1.9 (95% CI: 1.5, 2.4) times more likely if only their mother was obese, and 3.2 (95% CI: 2.5, 4.2) times more likely if both parents were obese.ConclusionsParent-child resemblance in BMI appears weak and may vary across parent-child dyad types in the US population. However, parental obesity status is associated with children’s obesity status. Use of different measures of parent-child resemblance in body weight status can lead to different conclusions.

Cardiovascular death risk and body mass index in male and female Tumen City residents

Aim. To study the association between body mass index (BMI) and cardiovascular (CV) death risk in an open population ofTumenCity, using prospective data of the 12-year follow-up. Material and methods. In 1996, a cardiologic screening of a representative Tumen City sample (25–64 years) was performed, using standard methods and achieving a response rate of 80,4% (n=1608). Over 12 years of the prospective follow-up, 85 CV deaths in men (10,69%) and 33 CV deaths in women (4,06%) were registered. Using Cox regression models, the parameters of absolute and relative risk (AR, RR) were assessed. Survival assessment was performed using the Kaplan-Meier method. Results. In men, RR of CV death was significantly higher for the top quintile of body mass index, BMI (

Prospective study on metabolic factors and risk of prostate cancer

There are inconsistent data regarding the association between metabolic factors, separately and combined, and the risk of prostate cancer and death from prostate cancer. In the Metabolic Syndrome and Cancer Project (Me-Can), data on body mass index (BMI); blood pressure; and blood levels of glucose, cholesterol, and triglycerides were collected for 289,866 men. Cox proportional hazard models were used to calculate relative risks (RRs) by exposures in quintiles as well as for z scores (with a mean of 0 and a standard deviation of 1) together with a composite sum of scores to assess the combined effect of metabolic factors. RRs were corrected for random errors in measurement. During a mean follow-up of 12 years, 6673 men were diagnosed with prostate cancer and 961 died of the disease. Men with high levels of glucose and triglycerides were found to have a decreased risk of prostate cancer: top versus bottom quintile of glucose: RR, 0.82 (95% confidence interval [95% CI], 0.62-1.08; P value for trend = .03) and top versus bottom quintile of triglycerides: RR, 0.88 (95% CI, 0.74-1.04; P value for trend = .001). High BMI, elevated blood pressure, and a high composite z score were found to be associated with an increased risk of death from prostate cancer: top versus bottom quintile of BMI: RR, 1.36 (95% CI, 1.08-1.71); systolic blood pressure: RR, 1.62 (95% CI, 1.07-2.45); and per 1-unit increase of the composite z score: RR, 1.13 (95% CI, 1.03-1.25). The authors found no evidence of an association between high levels of metabolic factors and the risk of prostate cancer, but high BMI, elevated blood pressure, and a composite score of all metabolic factors were associated with an increased risk of death from prostate cancer.

Prehypertension in a Mexican Population: Influence of Age, Gender, and Body Fat

We studied the association of age, gender, and distribution of body fat with prehypertension in a sample of Mexican adults. This study was performed in a sample of 900 adults (275 men and 625 women), with the median age of 42 years. Resting blood pressure was measured in duplicate, and prehypertension and hypertension were defined according to JNC 7 criteria. The prevalence of hypertension and prehypertension in our population was 11.56% and 26.5%, respectively. The prevalence of prehypertension was significantly higher in men than in women. Prehypertension was associated with middle and old age (odds ratio [OR] = 2.6 and 2.4, respectively, P < .001), abdominal obesity (OR = 1.3, P = .008), upper quintiles of body mass index (OR = 2.05, P = .005), waist (OR = 1.97, P = .01) and hip (OR = 2.04, P = .005) circumferences, and body fat (OR = 2.37, P = .001). The main factors associated with the development of prehypertension are age, central obesity, and body fat.

Impact of body mass index and waist circumference on the cardiovascular risk and all-cause death in a general population: Data from the PAMELA study

Background and aimsElevated values of body mass index (BMI) and waist circumference (WC) are associated with an augmented cardiovascular (CV) risk. It is debated, however, whether and to what extent this depends on the body fat increase ‘per se’ or on the related cardiometabolic alterations. Methods and resultsIn 2005 subjects randomly selected from the general population of Monza (Italy), we assessed BMI, WC, office, home and 24 h blood pressure (BP), heart rate and metabolic variables. The impact of BMI and WC on the incidence of CV events, CV and all-cause mortality was estimated during a 148-month follow-up. Progressively higher values of BMI and WC were associated with a progressive increase in office, home and 24 h BP and in erratic BP variability (P < 0.0001 for trend). Metabolic variables were directly and significantly (P < 0.0001) related to BMI and WC, while an inverse significant relationship was detected with high-density lipoprotein (HDL)-cholesterol. The incidence of CV events, CV and all-cause deaths increased progressively from the lowest to the highest quintile of BMI and WC (P for trend always <0.005). Baseline BMI and WC higher by respectively 1 kg m−2 and 1 cm were associated with an increased risk of CV events, CV and all-cause death by 8%, 12% and 7% (for baseline BMI) and 4%, 5% and 4% (for baseline WC), respectively. After adjustment for confounders, only the increased risk of CV death related to higher baseline BMI remained significant (hazard ratio (HR) 1.062, confidence interval (CI) 95% 1.003–1.126, P < 0.05). ConclusionThe adverse prognostic impact of the accumulation of body fat is mediated by the associated haemodynamic and metabolic alterations. Baseline values of BMI, however, are an independent predictor of CV mortality.

Abstract P308: γ-Glutamyltransferase and Mortality from Cardiovascular Disease: EPOCH-JAPAN

Background: Recently, γ-Glutamyltransferase (γ-GTP) has been positively associated with risk of cardiovascular disease (CVD), especially among non-drinkers. But the evidence is limited in Asian populations. The present study investigated the association between γ-GTP with mortality from ischemic stroke, hemorrhagic stroke and coronary heart disease in Japanese men and women, and further in non-drinkers. Methods: A total of 41,040 Japanese (men/women: 15,987/25,053) aged 40-79 years with no self-reported history of CVD at baseline from the Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) which is a pooled analysis comprising 13 well-qualified Japanese cohorts for examining the relationship between health examination measures and CVD mortality. Sex-specific hazard ratios(HRs) and their 95% confident intervals(CIs) of CVD mortality for one-standardized deviation increment of log-transformed γ-GTP were calculated by Cox hazard models, adjusting for age (continuous), smoking status (never, past, 1–20/day and ≥21/day), drinking status (never, past and current), and sex-specific quintiles of body mass index, triglycerides, total cholesterol, systolic blood pressure, aspartate transaminase and alanine transaminase in multivariable model. Results: During an average 8.7-year follow-up, there were 314 (146 men and 168 women) deaths from stroke, 154 (101men and 53 women) deaths from coronary heart disease, and 701 (361 men and 340 women) deaths from total CVD. A significant association was found in the multivariable model between γ-GTP and mortality form stroke and total CVD in men, and mortality from coronary heart disease and total CVD in women. The respective multivariable HRs (95% CI) were 1.36 (1.13–1.65) and 1.17 (1.03–1.33) in men, and 1.76 (1.36–2.28) and 1.33 (1.19–1.49) in women. Because the proportion of current drinkers was 73% in men and 29% in women, we further examined the associations in non-drinkers. The respective multivariable HRs (95% CI) were 1.58 (1.08–2.31) and 1.42 (1.13–1.80) in male non-drinkers and 1.72 (1.28–2.33) and 1.32 (1.16–1.51) in female non-drinkers. Conclusions: γ-GTP was positively associated with CVD mortality in both Japanese men and women, specifically in non-drinkers.

Prospective study of optimal obesity index cutoffs for predicting development of multiple metabolic risk factors: the Korean genome and epidemiology study.

BackgroundIn this prospective cohort study, we estimated the risk of developing more than 1 metabolic risk factor, using different obesity indices. In addition, we investigated the relative usefulness of the obesity indices for predicting development of such risk factors and calculated optimal cutoffs for the obesity indices.MethodsThe cohort comprised 10 038 representative residents of a small city and a rural county who were recruited in 2001–2002. Follow-up examinations were conducted every 2 years. Among the 3857 participants without metabolic syndrome at baseline, 1102 new cases occurred during the 6-year follow-up. Receiver operating characteristic (ROC) curves for the obesity indices were plotted to compare the usefulness of the obesity indices.ResultsThe numbers of new cases of multiple metabolic risk factors among people in the highest quintiles of body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and waist-height ratio at the baseline examination were 2 to 3 times those in the lowest quintiles. The area under the ROC curve for WHR was significantly higher than that for BMI. The optimal BMI cutoff was 24 kg/m2 in men and women, and the optimal WC cutoffs were 80 cm and 78 cm in men and women, respectively.ConclusionsBoth overall obesity and central obesity predicted risk of developing multiple metabolic risk factors, and WHR appeared to be a better discriminator than BMI. To prevent development of metabolic diseases among Koreans, it might be useful to lower the cutoff for abdominal obesity, as defined by WC.

Body mass index, long‐term weight change, and esophageal squamous cell carcinoma

Observational studies suggest that body mass index (BMI) is inversely associated with esophageal squamous cell carcinoma (ESCC). However, questions remain regarding reverse causation and confounding, especially by smoking, as alternative explanations. The authors examined the association between BMI and measures of weight history and risk of ESCC in a population-based Australian case-control study (from 2002 to 2005) comprising 287 patients with ESCC (cases) and a control group of 1544 individuals who were sampled from a population registry. Stratified analyses were performed specifically to explore whether this association was influenced by smoking. Multivariable logistic regression models were used to derive odds ratios (ORs). After adjusting for smoking, significant inverse associations with ESCC for BMI and weight 1 year before diagnosis, maximum adult BMI, and weight gain since age 20 years were observed (all P(trend) < .001). The risk of ESCC was reduced by 35% (range, 23%-44%) per 5-unit increase in recent BMI. Participants who gained weight after age 20 years had a lower risk than those who maintained their weight during adult life (OR for gain of >20 kg, 0.51; 95% confidence interval [CI], 0.33-0.77). In stratified analyses, higher BMI was associated with a decreasing risk of ESCC both in never-smokers (OR, 0.32; 95% CI 0.13-0.76) and smokers (OR 0.22, 95%CI 0.07-0.67) comparing the highest versus the lowest BMI quintile. In this study, the inverse associations between BMI, long-term weight gain, and other body measures and ESCC appeared to be robust and could not be explained by smoking status or potential confounding factors.