Department of Epidemiology, School of Public Health, Southern Medical University, No. 1023-1063, Satai South Road, Baiyun District, Guangzhou, Guangdong, 510515, China.
Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China.
BMC Med. 2024 Oct 8;22(1):438. doi: 10.1186/s12916-024-03665-9.
The associations of weight change with all-cause and cause-specific mortality stratified by age remains unclear. We evaluated the age-stratified (< 65 vs ≥ 65 years) associations of weight change with all-cause and cause-specific mortality in a large sample of Chinese adults.
Our cohort study included 746,991 adults aged at least 45 years from the Shenzhen Healthcare Big Data Cohort in China. BMI change were categorized as change within 5% (stable), decrease by 5% to 10%, decrease by > 10%, increase by 5% to 10%, and increase by > 10%. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, non-communicable disease, cardiovascular disease (CVD), and cancer mortality according to BMI change, with adjustment for potential confounders.
During a median follow-up of 2.2 years (2,330,180 person-years), there were 10,197 deaths. A notable interaction emerged between weight change and age. For participants ≥ 65 years, compared with stable BMI, more than a 10% decrease in BMI was associated with higher risk of all-cause mortality (HR: 1.69, 95% CI: 1.54-1.86), non-communicable disease mortality (HR: 1.67, 95% CI: 1.52-1.84), CVD mortality (HR: 1.55, 95% CI: 1.34-1.80), and cancer mortality (HR: 1.59, 95% CI: 1.33-1.92). Similar patterns of results for 5% to 10% decrease in BMI were observed. More than a 10% increase in BMI was associated with increased risk of all-cause mortality (HR: 1.13, 95% CI: 1.04-1.24), non-communicable disease mortality (HR: 1.14, 95% CI: 1.04-1.25), and CVD mortality (HR: 1.27, 95% CI: 1.12-1.44). For participants < 65 years, only more than a 10% decrease in BMI was associated with higher risk of all-cause mortality (HR: 1.41, 95% CI: 1.12-1.77), non-communicable disease mortality (HR: 1.43, 95% CI: 1.13-1.81), and cancer mortality (HR: 1.79, 95% CI: 1.29-2.47).
Weight loss and excessive weight gain were associated with increased risks of mortality among older adults, while only excessive weight loss was associated with increased risks of mortality among middle-aged adults.
体重变化与全因和特定原因死亡率的关联按年龄分层仍不清楚。我们评估了体重变化与中国成年人大量样本中的全因和特定原因死亡率的年龄分层（<65 岁与≥65 岁）关联。
我们的队列研究包括中国深圳医疗大数据队列中至少 45 岁的 746991 名成年人。BMI 变化分为 5%以内（稳定）、减少 5%至 10%、减少>10%、增加 5%至 10%和增加>10%。使用 Cox 比例风险模型，根据 BMI 变化，调整潜在混杂因素后，估算全因、非传染性疾病、心血管疾病（CVD）和癌症死亡率的风险比（HR）和 95%置信区间（CI）。
在中位数为 2.2 年（2330180 人年）的随访期间，有 10197 人死亡。体重变化与年龄之间存在显著的交互作用。对于≥65 岁的参与者，与 BMI 稳定相比，BMI 下降超过 10%与全因死亡率（HR：1.69，95%CI：1.54-1.86）、非传染性疾病死亡率（HR：1.67，95%CI：1.52-1.84）、CVD 死亡率（HR：1.55，95%CI：1.34-1.80）和癌症死亡率（HR：1.59，95%CI：1.33-1.92）的风险增加有关。观察到 BMI 减少 5%至 10%的类似结果模式。BMI 增加超过 10%与全因死亡率（HR：1.13，95%CI：1.04-1.24）、非传染性疾病死亡率（HR：1.14，95%CI：1.04-1.25）和 CVD 死亡率（HR：1.27，95%CI：1.12-1.44）的风险增加有关。对于<65 岁的参与者，只有 BMI 减少超过 10%与全因死亡率（HR：1.41，95%CI：1.12-1.77）、非传染性疾病死亡率（HR：1.43，95%CI：1.13-1.81）和癌症死亡率（HR：1.79，95%CI：1.29-2.47）的风险增加有关。
体重减轻和过度体重增加与老年人的死亡率增加有关，而只有过度体重减轻与中年人的死亡率增加有关。
