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Incidence of cardiovascular disease and mortality in underweight individuals

BACKGROUND: Few studies have evaluated the association between being underweight and having cardiovascular disease in the general population. We investigated the incidence of stroke, myocardial infarction (MI), and all‐cause mortality according to detailed underweight categories in a large populatio...

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Autores principales: Kwon, Hyuktae, Yun, Jae Moon, Park, Jin Ho, Cho, Be Long, Han, Kyungdo, Joh, Hee‐Kyung, Son, Ki Young, Cho, Su Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061358/
https://www.ncbi.nlm.nih.gov/pubmed/33619889
http://dx.doi.org/10.1002/jcsm.12682
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author Kwon, Hyuktae
Yun, Jae Moon
Park, Jin Ho
Cho, Be Long
Han, Kyungdo
Joh, Hee‐Kyung
Son, Ki Young
Cho, Su Hwan
author_facet Kwon, Hyuktae
Yun, Jae Moon
Park, Jin Ho
Cho, Be Long
Han, Kyungdo
Joh, Hee‐Kyung
Son, Ki Young
Cho, Su Hwan
author_sort Kwon, Hyuktae
collection PubMed
description BACKGROUND: Few studies have evaluated the association between being underweight and having cardiovascular disease in the general population. We investigated the incidence of stroke, myocardial infarction (MI), and all‐cause mortality according to detailed underweight categories in a large population cohort. METHODS: We included 4 164 364 individuals who underwent a health examination that was conducted as part of the Korean National Health Insurance Service between January 2009 and December 2012 and followed them up to determine the incidence of stroke, MI, and all‐cause mortality until 31 December 2016. Based on the body mass index, the study population was categorized into normal (18.50–22.99), mild (17.00–18.49), moderate (16.00–16.99), and severe underweight (<16.00) groups. Cox proportional hazards analyses were performed to calculate the hazard ratio for stroke, MI, and mortality according to the severity of underweight in reference to the normal weight. We adjusted for age, sex, lifestyle, economic status, co‐morbidity, blood pressure, glucose, lipid level, and waist circumference. RESULTS: The mean age of the 4 164 364 eligible subjects in this study cohort was 44.4 ± 14.3 years, and 46.1% of the participants were male; 46 728 strokes, 30 074 MIs, and 121 080 deaths occurred during 27 449 902 person‐years. The incidence of stroke, MI, and all‐cause mortality increased proportionally with the severity of underweight in the multivariate model. This proportional association became more evident when the waist circumference was additionally adjusted. The respective hazard ratios (95% confidence intervals) for mild, moderate, and severe underweight were 1.10 (1.06–1.15), 1.11 (1.02–1.20), and 1.38 (1.24–1.53) for stroke; 1.19 (1.14–1.25), 1.40 (1.27–1.53), and 1.86 (1.64–2.11) for MI; and 1.63 (1.60–1.67), 2.10 (2.02–2.17), and 2.98 (2.85–3.11) for all‐cause mortality. In stratified analyses based on waist circumference, the severity of underweight was consistently associated with a higher risk of stroke, MI, and death. CONCLUSIONS: The severity of underweight was associated with a higher risk of stroke, MI, and all‐cause mortality.
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spelling pubmed-80613582021-04-23 Incidence of cardiovascular disease and mortality in underweight individuals Kwon, Hyuktae Yun, Jae Moon Park, Jin Ho Cho, Be Long Han, Kyungdo Joh, Hee‐Kyung Son, Ki Young Cho, Su Hwan J Cachexia Sarcopenia Muscle Original Articles BACKGROUND: Few studies have evaluated the association between being underweight and having cardiovascular disease in the general population. We investigated the incidence of stroke, myocardial infarction (MI), and all‐cause mortality according to detailed underweight categories in a large population cohort. METHODS: We included 4 164 364 individuals who underwent a health examination that was conducted as part of the Korean National Health Insurance Service between January 2009 and December 2012 and followed them up to determine the incidence of stroke, MI, and all‐cause mortality until 31 December 2016. Based on the body mass index, the study population was categorized into normal (18.50–22.99), mild (17.00–18.49), moderate (16.00–16.99), and severe underweight (<16.00) groups. Cox proportional hazards analyses were performed to calculate the hazard ratio for stroke, MI, and mortality according to the severity of underweight in reference to the normal weight. We adjusted for age, sex, lifestyle, economic status, co‐morbidity, blood pressure, glucose, lipid level, and waist circumference. RESULTS: The mean age of the 4 164 364 eligible subjects in this study cohort was 44.4 ± 14.3 years, and 46.1% of the participants were male; 46 728 strokes, 30 074 MIs, and 121 080 deaths occurred during 27 449 902 person‐years. The incidence of stroke, MI, and all‐cause mortality increased proportionally with the severity of underweight in the multivariate model. This proportional association became more evident when the waist circumference was additionally adjusted. The respective hazard ratios (95% confidence intervals) for mild, moderate, and severe underweight were 1.10 (1.06–1.15), 1.11 (1.02–1.20), and 1.38 (1.24–1.53) for stroke; 1.19 (1.14–1.25), 1.40 (1.27–1.53), and 1.86 (1.64–2.11) for MI; and 1.63 (1.60–1.67), 2.10 (2.02–2.17), and 2.98 (2.85–3.11) for all‐cause mortality. In stratified analyses based on waist circumference, the severity of underweight was consistently associated with a higher risk of stroke, MI, and death. CONCLUSIONS: The severity of underweight was associated with a higher risk of stroke, MI, and all‐cause mortality. John Wiley and Sons Inc. 2021-02-22 2021-04 /pmc/articles/PMC8061358/ /pubmed/33619889 http://dx.doi.org/10.1002/jcsm.12682 Text en © 2021 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Kwon, Hyuktae
Yun, Jae Moon
Park, Jin Ho
Cho, Be Long
Han, Kyungdo
Joh, Hee‐Kyung
Son, Ki Young
Cho, Su Hwan
Incidence of cardiovascular disease and mortality in underweight individuals
title Incidence of cardiovascular disease and mortality in underweight individuals
title_full Incidence of cardiovascular disease and mortality in underweight individuals
title_fullStr Incidence of cardiovascular disease and mortality in underweight individuals
title_full_unstemmed Incidence of cardiovascular disease and mortality in underweight individuals
title_short Incidence of cardiovascular disease and mortality in underweight individuals
title_sort incidence of cardiovascular disease and mortality in underweight individuals
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061358/
https://www.ncbi.nlm.nih.gov/pubmed/33619889
http://dx.doi.org/10.1002/jcsm.12682
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