Endocrinol Metab.  2020 Dec;35(4):933-942. 10.3803/EnM.2020.871.

Variabilities in Weight and Waist Circumference and Risk of Myocardial Infarction, Stroke, and Mortality: A Nationwide Cohort Study

Affiliations
  • 1Department of Biomedicine & Health Science, Graduate School, The Catholic University of Korea, Seoul, Korea
  • 2Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
  • 3Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
  • 4Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
  • 5Department of Family Medicine, Sahmyook Medical Center, Seoul, Korea
  • 6Department of Family Medicine, Gimpo Woori Hospital, Seoul, Korea
  • 7Department of Family Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
  • 8Department of Medical Lifescience, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Background
Evidence regarding the association between variabilities in obesity measures and health outcomes is limited. We aimed to examine the association between variabilities in obesity measures and cardiovascular outcomes and all-cause mortality.
Methods
We identified 4,244,460 individuals who underwent health examination conducted by the Korean National Health Insurance Service during 2012, with ≥3 anthropometric measurements between 2009 and 2012. Variabilities in body weight (BW) and waist circumference (WC) were assessed using four indices including variability independent of the mean (VIM). We performed multivariable Cox proportional hazards regression analyses.
Results
During follow-up of 4.4 years, 16,095, 18,957, and 30,200 cases of myocardial infarction (MI), stroke, and all-cause mortality were recorded. Compared to individuals with the lowest quartiles, incrementally higher risks of study outcomes and those of stroke and all-cause mortality were observed among individuals in higher quartiles of VIM for BW and VIM for WC, respectively. The multivariable adjusted hazard ratios and 95% confidence intervals comparing the highest versus lowest quartile groups of VIM for BW were 1.17 (1.12 to 1.22) for MI, 1.20 (1.16 to 1.25) for stroke, and 1.66 (1.60 to 1.71) for all-cause mortality; 1.07 (1.03 to 1.12) for stroke and 1.29 (1.25 to 1.33) for all-cause mortality regarding VIM for WC. These associations were similar with respect to the other indices for variability.
Conclusion
This study revealed positive associations between variabilities in BW and WC and cardiovascular outcomes and allcause mortality. Our findings suggest that variabilities in obesity measures are associated with adverse health outcomes in the general population.

Keyword

Body weight; Waist circumference; Stroke; Myocardial infarction; Mortality; Variability

Figure

  • Fig. 1 Flow diagram of study population.


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