Department of Information & Statistics, Chungbuk National University, Cheongju, Republic of Korea.
Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.
BMC Endocr Disord. 2022 May 11;22(1):123. doi: 10.1186/s12902-022-01041-3.
The prevalence of diabetes mellitus (DM), cardio-cerebrovascular diseases (CCVDs) has increased during recent decades. We aimed to investigate the relationship between body mass index (BMI) and each of several outcomes (DM, CCVDs, or mortality) based on the Korean National Health Insurance Service-Health Screening cohort.
BMI was categorized as appropriate for Asian populations, into underweight (< 18.5 kg/m), normal (18.5-< 23 kg/m), overweight (23-< 25 kg/m), grade 1 obesity (25-< 30 kg/m), grade 2 obesity (30-< 35 kg/m), and grade 3 obesity (≥35 kg/m). In addition, BMI was further stratified into one unit. Multivariate Cox proportional hazards regression analyses were conducted to examine the association between BMI category and the primary outcomes (DM, CCVDs, or mortality).
A total of 311,416 individuals were included. The median follow-up was 12.5 years. Compared to normal BMI, underweight, overweight, and grade 1-3 obese individuals had a higher risk of the primary outcomes (hazard ratio [95% confidence intervals] 1.293 [1.224-1.365], 1.101 [1.073-1.129], 1.320 [1.288-1.353], 1.789 [1.689-1.897], and 2.376 [2.019-2.857], respectively, in men and 1.084 [1.010-1.163], 1.150 [1.116-1.185], 1.385 [1.346-1.425], 1.865 [1.725-2.019], and 2.472 [2.025-3.028], respectively, in women). Setting the reference BMI to 20-< 21 kg/m and categorizing into one unit increment, BMI was associated with the primary outcomes in a J-shaped manner in both sexes. The risk of DM increased with higher BMI in both sexes, while all-cause mortality decreased in men with a BMI 21-< 31 kg/m and women with BMI 22-< 30 kg/m.
BMI was associated with all-cause mortality in a J-shaped manner in both sexes, while it was associated with risk of DM in a dose-response relationship. The relationship between BMI and the primary outcomes was J-shaped.
近年来，糖尿病（DM）和心脑血管疾病（CCVDs）的患病率有所上升。本研究旨在基于韩国国家健康保险服务-健康筛查队列，调查体重指数（BMI）与多种结局（DM、CCVDs 或死亡率）之间的关系。
BMI 按照亚洲人群的标准分为消瘦（<18.5kg/m）、正常（18.5-<23kg/m）、超重（23-<25kg/m）、1 级肥胖（25-<30kg/m）、2 级肥胖（30-<35kg/m）和 3 级肥胖（≥35kg/m）。此外，BMI 还进一步分为一个单位。采用多变量 Cox 比例风险回归分析，探讨 BMI 类别与主要结局（DM、CCVDs 或死亡率）之间的关系。
共纳入 311416 人。中位随访时间为 12.5 年。与正常 BMI 相比，消瘦、超重和 1-3 级肥胖者发生主要结局的风险更高（男性的危险比[95%置信区间]分别为 1.293[1.224-1.365]、1.101[1.073-1.129]、1.320[1.288-1.353]、1.789[1.689-1.897]和 2.376[2.019-2.857]，女性分别为 1.084[1.010-1.163]、1.150[1.116-1.185]、1.385[1.346-1.425]、1.865[1.725-2.019]和 2.472[2.025-3.028]）。以 20-<21kg/m 为参考 BMI，并将其分为一个单位的增量，在两性中，BMI 与主要结局呈 J 形相关。两性中 BMI 与 DM 风险呈剂量-反应关系，BMI 与全因死亡率呈 J 形相关。
在两性中，BMI 与全因死亡率呈 J 形相关，而与 DM 风险呈剂量-反应关系。BMI 与主要结局的关系呈 J 形。
