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Epidemiology and population health

Impact of body mass index and body weight variabilities on mortality: a nationwide cohort study

International Journal of Obesity volume 43, pages 412–423 (2019)Cite this article

Subjects

Abstract

Background/objectives

There is limited information regarding the impact of body mass index (BMI) and body weight (BWt) variabilities on mortality. This study aimed to investigate the association between BMI, BWt variabilities and subsequent mortality in the Korean population.

Subjects/methods

This study used a representative sample cohort enrolled in the national health examination program conducted by the Korean National Health Insurance Service, and 125,391 individuals were included and followed up until 2013 (mean follow-up period = 84 months). BMI and BWt variabilities were estimated as the standard deviation (SD) and coefficient of variation (CV) of serial measurements of BMI and BWt (BMI_SD, BWt_SD, BMI_CV, and BWt_CV). Cox proportional hazard regression models were used to evaluate the all-cause and cause-specific mortality according to variability indices.

Results

Baseline BMI showed a non-linear association with all-cause mortality. The highest quartile (Q4) groups of variability indices were associated with increased all-cause mortality risk compared to the lowest quartile (Q1) groups after adjusting for confounding factors (hazard ratio [95% confidence interval] = 1.23 [1.11–1.37] for BMI_SD; 1.25 [1.06–1.47] for BMI_CV; 1.33 [1.20–1.48] for BWt_SD; 1.42 [1.28–1.58] for BWt_CV). The hazard ratios of all-cause mortality increased from the Q2 to the Q4 groups of variability indices, in each sex group and among individuals aged ≥40 years. Furthermore, Q4 groups of variability indices were positively associated with cause-specific mortality compared to groups with Q1–Q3 of the indices (1.28 [1.05–1.56] for BWt_SD, 1.21 [1.001–1.47] for BMI_CV, 1.29 [1.06–1.56] for BWt_CV regarding cardiovascular diseases mortality; 1.18 [1.03–1.36] for BWt_SD, 1.21 [1.06–1.39] for BMI_CV, 1.26 [1.10–1.44] for BWt_CV regarding cancer mortality).

Conclusions

Our results suggest that BMI and BWt variabilities are independent risk factors for all-cause and cause-specific mortality.

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Acknowledgement

The authors appreciate to Korea National Health Insurance Corporation for providing the data.

Author information

Author notes

  1. These authors contributed equally: Kyung Hwan Cho, Yong Gyu Park.

Authors and Affiliations

  1. Department of Family Medicine, Sahmyook Medical Center, Seoul, Republic of Korea

    Ga Eun Nam, Byoungduck Han & Sung Jung Cho

  2. Department of Family Medicine, Korea University Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea

    Kyung Hwan Cho & Yang Hyun Kim

  3. Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of Korea

    Kyungdo Han & Yong Gyu Park

  4. Department of Family Medicine, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea

    Yong Kyun Roh

  5. Department of Family Medicine, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Republic of Korea

    Seon Mee Kim & Youn Seon Choi

  6. Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, Seoul, Republic of Korea

    Do Hoon Kim

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Correspondence to Kyung Hwan Cho or Yong Gyu Park.

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Nam, G.E., Cho, K.H., Han, K. et al. Impact of body mass index and body weight variabilities on mortality: a nationwide cohort study. Int J Obes 43, 412–423 (2019). https://doi.org/10.1038/s41366-018-0079-0

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