Kong Jong Won, Park Taegyu, Lee Dong Ryul, Lee Jungun
Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.
Ann Geriatr Med Res. 2020 Sep;24(3):195-203. doi: 10.4235/agmr.20.0030. Epub 2020 Aug 24.
Weight change is a known risk factor for mortality. Previous Korean studies only considered mortality consequences of weight change between two time points over relatively short periods. This study investigated whether body mass index (BMI) trajectory patterns were associated with all cause-mortality based on continuous BMI observations during a 10-year follow-up period among Korean older adults.
This study analyzed data from the 2006-2016 Korean Longitudinal Study of Aging database. The participants included in this study were 3,478 people aged 65 years or older who had no previous cancer history. A trajectory model was developed to classify different homogeneous trajectory subgroups according to BMI, and Cox proportional hazards models were used to investigate the association of BMI trajectory with all-cause mortality.
We identified four trajectory groups: obese (OG); overweight (OWG); high normal weight (HNWG); and low normal weight (LNWG). The LNWG and HNWG experienced continuous weight loss during the study period. Trajectories with higher BMI were associated with lower mortality. The adjusted hazard ratios (95% confidence intervals) for all-cause mortality in the LNWG, HNWG, and OWG were 2.40 (1.69-3.40), 1.75 (1.26-2.45), and 1.38 (0.99-1.96), respectively, compared with those in the OG.
We found that the lower the BMI of the weight trajectory group, the higher the mortality over 10 years in Korean older adults. This result suggested that baseline obesity status and degree of weight loss during follow-up contributed to mortality in later life.
体重变化是已知的死亡风险因素。以往韩国的研究仅考虑了相对短时期内两个时间点之间体重变化的死亡后果。本研究基于韩国老年人10年随访期间连续的体重指数(BMI)观察结果,调查了BMI轨迹模式是否与全因死亡率相关。
本研究分析了2006 - 2016年韩国老年纵向研究数据库中的数据。本研究纳入的参与者为3478名年龄在65岁及以上且无既往癌症病史的人。开发了一种轨迹模型,根据BMI对不同的同质轨迹亚组进行分类,并使用Cox比例风险模型研究BMI轨迹与全因死亡率的关联。
我们确定了四个轨迹组:肥胖组(OG);超重组(OWG);高正常体重组(HNWG);以及低正常体重组(LNWG)。在研究期间,LNWG和HNWG经历了持续的体重减轻。较高BMI的轨迹与较低的死亡率相关。与OG组相比,LNWG、HNWG和OWG组全因死亡率的调整后风险比(95%置信区间)分别为2.40(1.69 - 3.40)、1.75(1.26 - 2.45)和1.38(0.99 - 1.96)。
我们发现,在韩国老年人中,体重轨迹组的BMI越低,10年期间的死亡率越高。这一结果表明,基线肥胖状态和随访期间的体重减轻程度对晚年死亡率有影响。