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Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study

BACKGROUNDS: Abdominal obesity has been linked to risk of mortality, but whether and how trajectory of waist circumstance (WC) underpins this association remains unclear. The study aimed to identify long-term WC change trajectories and examine their association and joint effect with body mass index...

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Autores principales: Liu, Ruru, Dang, Shaonong, Zhao, Yaling, Yan, Hong, Han, Yuewen, Mi, Baibing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463814/
https://www.ncbi.nlm.nih.gov/pubmed/36088350
http://dx.doi.org/10.1186/s13690-022-00861-y
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author Liu, Ruru
Dang, Shaonong
Zhao, Yaling
Yan, Hong
Han, Yuewen
Mi, Baibing
author_facet Liu, Ruru
Dang, Shaonong
Zhao, Yaling
Yan, Hong
Han, Yuewen
Mi, Baibing
author_sort Liu, Ruru
collection PubMed
description BACKGROUNDS: Abdominal obesity has been linked to risk of mortality, but whether and how trajectory of waist circumstance (WC) underpins this association remains unclear. The study aimed to identify long-term WC change trajectories and examine their association and joint effect with body mass index (BMI) on mortality among Chinese older adults. METHODS: This present study included participants 60 years of age or older from China Health and Nutrition Survey (CHNS) from 1991 to 2015. The duration of follow-up was defined as period from the first to latest visit date attended with information on mortality, end of follow-up, or loss to follow-up (censoring). Latent class trajectory analysis (LCTA) was used to assess the changes of WC trajectories overtime. Cox proportional hazard models were used to assess hazard ratios (HRs) and corresponding 95% confidence internal (CIs) for mortality. RESULTS: A total of 2601 participants with 8700 visits were included, and 562 mortality (21.6%) occurred during a median follow-up of 8.7 years. Using a group-based modeling approach, four distinct trajectories of WC change among Chinese older adults were identified as loss (13.5%), stable (46.8%), moderate gain (31.2%) and substantial gain (8.5%). With WC stable group as reference, the multivariable adjusted HRs for mortality were 1.34(95%CI:1.01-1.78) in loss group, 1.13(0.91-1.41) in moderate gain and 1.54(1.12-2.12) in substantial gain group. Compared with participants with normal BMI at baseline and maintained WC stable, the risk of mortality generally increased for all WC change group in initial overweight/obesity individuals, and the highest risk were observed for WC loss and stable pattern (HR:2.43, 95%CI: 1.41–4.19; HR:1.67 (1.07–2.60)). CONCLUSIONS: In older Chinese, both long-term WC loss and substantial gain conferred excess risk for mortality. The baseline BMI might modify the effect as overweight individuals had a greater risk imposed by WC loss than those in normal weight. Maintaining stable WC and normal weight might be necessary to reduce the risk of mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-022-00861-y.
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spelling pubmed-94638142022-09-11 Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study Liu, Ruru Dang, Shaonong Zhao, Yaling Yan, Hong Han, Yuewen Mi, Baibing Arch Public Health Research BACKGROUNDS: Abdominal obesity has been linked to risk of mortality, but whether and how trajectory of waist circumstance (WC) underpins this association remains unclear. The study aimed to identify long-term WC change trajectories and examine their association and joint effect with body mass index (BMI) on mortality among Chinese older adults. METHODS: This present study included participants 60 years of age or older from China Health and Nutrition Survey (CHNS) from 1991 to 2015. The duration of follow-up was defined as period from the first to latest visit date attended with information on mortality, end of follow-up, or loss to follow-up (censoring). Latent class trajectory analysis (LCTA) was used to assess the changes of WC trajectories overtime. Cox proportional hazard models were used to assess hazard ratios (HRs) and corresponding 95% confidence internal (CIs) for mortality. RESULTS: A total of 2601 participants with 8700 visits were included, and 562 mortality (21.6%) occurred during a median follow-up of 8.7 years. Using a group-based modeling approach, four distinct trajectories of WC change among Chinese older adults were identified as loss (13.5%), stable (46.8%), moderate gain (31.2%) and substantial gain (8.5%). With WC stable group as reference, the multivariable adjusted HRs for mortality were 1.34(95%CI:1.01-1.78) in loss group, 1.13(0.91-1.41) in moderate gain and 1.54(1.12-2.12) in substantial gain group. Compared with participants with normal BMI at baseline and maintained WC stable, the risk of mortality generally increased for all WC change group in initial overweight/obesity individuals, and the highest risk were observed for WC loss and stable pattern (HR:2.43, 95%CI: 1.41–4.19; HR:1.67 (1.07–2.60)). CONCLUSIONS: In older Chinese, both long-term WC loss and substantial gain conferred excess risk for mortality. The baseline BMI might modify the effect as overweight individuals had a greater risk imposed by WC loss than those in normal weight. Maintaining stable WC and normal weight might be necessary to reduce the risk of mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-022-00861-y. BioMed Central 2022-09-10 /pmc/articles/PMC9463814/ /pubmed/36088350 http://dx.doi.org/10.1186/s13690-022-00861-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Liu, Ruru
Dang, Shaonong
Zhao, Yaling
Yan, Hong
Han, Yuewen
Mi, Baibing
Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study
title Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study
title_full Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study
title_fullStr Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study
title_full_unstemmed Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study
title_short Long-term waist circumference trajectories and body mass index with all-cause mortality in older Chinese adults: a prospective nationwide cohort study
title_sort long-term waist circumference trajectories and body mass index with all-cause mortality in older chinese adults: a prospective nationwide cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463814/
https://www.ncbi.nlm.nih.gov/pubmed/36088350
http://dx.doi.org/10.1186/s13690-022-00861-y
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