| Title | Analysis of Changes in Weight, Waist Circumference, or Both, and All-Cause Mortality in Chinese Adults |
| Authors | Yuan, Yu Liu, Kang Zheng, Mengyi Chen, Shuohua Wang, Hao Jiang, Qin Xiao, Yang Zhou, Lue Liu, Xuezhen Yu, Yanqiu Wu, Jiachen Ding, Xiong Yang, Handong Li, Xiulou Min, Xinwen Zhang, Ce Zhang, Xiaomin He, Meian Zheng, Yan Sun, Dianjianyi Qi, Lu Hemler, Elena C. Wu, Shouling Wu, Tangchun Pan, An |
| Affiliation | Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth,Minist Educ, Dept Occupat & Environm Hlth,Key Lab Environm & H, Wuhan, Peoples R China Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, State Key Lab Environm Hlth Incubating, Wuhan, Peoples R China Guangzhou Med Univ, Sch Publ Hlth, Guangzhou, Peoples R China North China Univ Sci & Technol, Grad Sch, Tangshan, Peoples R China Kailuan Grp, Hlth Dept, Tangshan, Peoples R China Hubei Univ Med, Sinopharm Dongfeng Gen Hosp, Dept Cardiovasc Dis, Shiyan, Peoples R China Fudan Univ, Human Phenome Inst, State Key Lab Genet Engn, Shanghai, Peoples R China Fudan Univ, Sch Life Sci, Shanghai, Peoples R China Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Hlth Sci Ctr, Beijing, Peoples R China Tulane Univ, Sch Publ Hlth & Trop Med, Dept Epidemiol, New Orleans, LA USA Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA North China Univ Sci & Technol, Kailuan Gen Hosp, Dept Cardiol, Tangshan, Peoples R China Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth,Minist Educ, Dept Epidemiol & Biostat,Key Lab Environm & Hlth, Wuhan, Peoples R China |
| Keywords | BODY-MASS INDEX ANTHROPOMETRIC MEASURES CARDIOVASCULAR-DISEASE OLD-AGE RISK OBESITY HEALTH ASSOCIATIONS ADIPOSITY COHORT |
| Issue Date | 8-Aug-2022 |
| Publisher | JAMA NETWORK OPEN |
| Abstract | IMPORTANCE Although numerous studies have separately investigated the associations of changes in weight or waist circumference with mortality risk, few studies have examined the associations of concurrent changes in these 2 anthropometric parameters with all-cause mortality. OBJECTIVE To assess the associations of changes in body weight, waist circumference, or both, combined with all-cause mortality. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from 2 longitudinal cohort studies in Dongfeng-Tongji and Kailuan, China. Participants included 58 132 adults (aged 40 years and older) with measures of weight and waist circumference at baseline and follow-up visit. Statistical analysis was performed from June 2020 to September 2021. EXPOSURES Changes in weight and waist circumference between 2 visits (2008-2010 to 2013 in the Dongfeng-Tongji cohort, and 2006-2007 to 2010-2011 in the Kailuan study). Stable weight was defined as change in weight within 2.5 kg between the 2 visits and stable waist circumference was defined as changes within 3.0 cm. Changes were categorized as loss, stable, or gain for weight and waist circumference separately, and created a 9-category variable to represent the joint changes. MAIN OUTCOMES AND MEASURES All-cause mortality from follow-up visit (2013 in Dongfeng-Tongji cohort and 2010-2011 in Kailuan study) until December 31, 2018. Cox proportional hazard regression models were used to estimate the associations with adjustment for potential confounders. Results were obtained in the 2 cohorts separately and pooled via fixed-effect meta-analysis. RESULTS A total of 10 951 participants in the Dongfeng-Tongji cohort (median [IQR] age, 62 [56-66] years; 4203 [38.4%] men) and 47 181 participants in the Kailuan study (median [IQR] age, 51 [46-58] years; 36 663 [77.7%] men) were included in the analysis. During 426 072 person-years of follow-up, 4028 deaths (523 in the Dongfeng-Tongji cohort and 3505 in the Kailuan study) were documented. When changes in weight and waist circumference were examined separately, U-shape associations were found: both gain and loss in weight (weight loss: pooled hazard ratio [HR], 1.33; 95% CI, 1.23-1.43; weight gain: HR, 1.10; 95% CI, 1.02-1.19) or waist circumference (waist circumference loss: HR, 1.14; 95% CI, 1.05-1.24; waist circumference gain: HR, 1.11; 95% CI, 1.03-1.21) were associated with higher mortality risk compared with stable weight or waist group. When changes in weight and waist circumference were jointly assessed, compared with participants with stable weight and waist circumference (16.9% of the total population [9828 of 58 132] with 508 deaths), participants with different combinations of weight and waist circumference change all had higher mortality risks except for those with stable weight but significant loss in waist. Notably, those who lost weight but gained waist circumference (6.4% of the total population [3698 of 58 132] with 308 deaths) had the highest risk of all-cause mortality (HR, 1.69; 95% CI, 1.46-1.96; absolute rate difference per 100 000 person-years in the Dongfeng-Tongji cohort: 414; 95% CI, 116-819; and in the Kailuan study: 333; 95% CI, 195-492) among the joint subgroups. CONCLUSIONS AND RELEVANCE In this cohort study, weight loss with concurrent waist circumference gain was associated with a higher mortality risk in middle-aged and older Chinese adults. This study's findings suggest the importance of evaluating the changes in both body weight and waist circumference when assessing their associations with mortality. |
| URI | http://hdl.handle.net/20.500.11897/650443 |
| ISSN | 2574-3805 |
| DOI | 10.1001/jamanetworkopen.2022.25876 |
| Indexed | SCI(E) |
| Appears in Collections: | 公共卫生学院 |
