Association of body mass index and long-term mortality in patients from nationwide LIPIDOGRAM 2004–2015 cohort studies: no obesity paradox?
Authors' conclusion
Being underweight, overweight or obese is associated with a higher mortality risk in a population of patients in primary care. Patients who lost weight were older and more burdened with cardiometabolic diseases, which may suggest unintentional weight loss, and were at higher risk of death in the long-term follow-up. In nonsmoking patients without comorbidities, the lowest mortality was observed in those with a BMI < 25 kg/m2, and no U-curve relationship was observed.
Study context
- Population
- Adults under the care of family physicians in primary care in Poland (LIPIDOGRAM 2004, 2006, 2015); 61.7% females44,620 with follow-up
- Participants
- 45,615 participants
- Exposure
- Body mass index (BMI) categories vs normal weight
- Normal weightn = 10,987reference
- Underweightn = 320
- Overweightn = 19,134
- Obesityn = 15,174
- Outcome
- Long-term all-cause mortality
- Follow-up
- Up to December 2021; median 15.3 years
Methodological detailsnationwide, primary care, Kaplan-Meier and Cox regression analyses
- Nationwide
- Primary care
- Kaplan-Meier and Cox regression analyses
Main finding
As reported in the abstract
Normal weight
14%
Observational data: associations, not effects.
Further findings
Weight decrease by 5% over 2 years (LIPIDOGRAM Plus, n=1627) and long-term mortality
- HR for death
- 1.45 (95% CI 1.05-2.02, p = 0.03)
Weight decrease by 10% over 2 years (LIPIDOGRAM Plus) and long-term mortality
- HR for death
- 1.67 (95% CI 1.02-2.74, p < 0.001)
- Patients with weight loss were older and more burdened with comorbidities
Original publication
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