Jang Hyemin, Kim Jong Hun, Choi Seong Hye, Lee Yunhwan, Hong Chang Hyung, Jeong Jee Hyang, Han Hyun Jeong, Moon So Young, Park Kyung Won, Han Seol-Hee, Park Kee Hyung, Kim Hee Jin, Na Duk L, Seo Sang Won
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Neurology, Dementia Center, Stroke Center, Ilsan hospital, National Health Insurance Corporation, Goyang-shi, South Korea.
J Alzheimers Dis. 2015;46(2):399-406. doi: 10.3233/JAD-142790.
A relationship between body weight, cognitive impairment, and the onset of Alzheimer's disease (AD) was recently reported. However, to our knowledge, no studies have investigated the relationship between body weight and mortality in Asian AD patients.
We evaluated the relationship between body mass index (BMI) and mortality rate in Korean AD cohorts.
Participants were consecutively included from two Korean representative registries: 579 AD patients from Samsung Medical Center and 1911 AD patients from the Clinical Research Center for Dementia of South Korea study. We combined these two AD cohorts to evaluate the association between BMI and mortality. BMI was used to categorize the participants into underweight, normal-weight, overweight, and obesity subgroups. All deaths were confirmed through the nationwide mortality database of Statistics Korea.
53 of 181 (29.3%), 208 of 1,127 (18.5%), 88 of 626 (14.1%), and 115 of 556 (20.7%) patients died in the underweight, normal-weight, overweight, and obese subgroups during 43.7 months of follow-up. The time-dependent cox proportional hazards model showed that, relative to the normal-weight subgroup, the underweight group had higher mortality (HR 1.82 (95% CI, 1.07-3.09)) while overweight group had lower mortality rate (HR 0.60 (95% CI, 0.38-0.95)) The effects of underweight and overweight were prominent in younger and older elderly group, respectively. However, there were no interactive effects of dementia severity or gender and BMI on survival rate.
Relative to AD patients of normal weight, those who were underweight had an increased mortality rate, and overweight predicted decreased mortality in AD patients. Furthermore, our findings may help facilitate mortality stratification in AD patients by using baseline BMI.
最近有报道称体重、认知障碍与阿尔茨海默病（AD）的发病之间存在关联。然而，据我们所知，尚无研究调查亚洲AD患者体重与死亡率之间的关系。
我们评估了韩国AD队列中体重指数（BMI）与死亡率之间的关系。
参与者连续纳入两个韩国代表性登记处：三星医疗中心的579例AD患者和韩国痴呆症临床研究中心研究的1911例AD患者。我们将这两个AD队列合并，以评估BMI与死亡率之间的关联。BMI用于将参与者分为体重过轻、正常体重、超重和肥胖亚组。所有死亡均通过韩国统计局的全国死亡率数据库得到确认。
在43.7个月的随访期间，体重过轻、正常体重、超重和肥胖亚组中分别有181例中的53例（29.3%）、1127例中的208例（18.5%）、626例中的88例（14.1%）和556例中的115例（20.7%）患者死亡。时间依赖性Cox比例风险模型显示，相对于正常体重亚组，体重过轻组死亡率更高（风险比1.82（95%置信区间，1.07 - 3.09）），而超重组死亡率更低（风险比0.60（95%置信区间，0.38 - 0.95））。体重过轻和超重的影响分别在年轻和老年组中较为突出。然而，痴呆严重程度或性别与BMI对生存率没有交互作用。
相对于正常体重的AD患者，体重过轻者死亡率增加，超重则预示AD患者死亡率降低。此外，我们的研究结果可能有助于通过使用基线BMI促进AD患者的死亡分层。
