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Effects of weight change on all causes, digestive system and other causes mortality in Southern Italy: a competing risk approach

Abstract

Weight change is associated with all causes of death, cardiovascular, and cancer mortality and a heterogeneous group of other causes of death. We aimed to estimate the effect of weight change on all causes and cause-specific mortality in a cohort with a high prevalence of deaths due to diseases of the digestive system.MethodsIn this prospective cohort study, 2230 subjects aged 30 to 50 years were examined. The study consisted of a 32-year longitudinal study period (January 1985 to December 2017) and mortality follow-up. Outcomes were mortality from all causes and deaths from gastrointestinal disease. Root Mean Squared Error (RMSE) was evaluated to capture individual residual variation in Body Mass Index (BMI) after adjustment for baseline BMI, and the relationship of residual variation with mortality was calculated as cumulative incidence function and cause-specific hazard (CSH) rate.ResultsIn total, 793 participants died during the follow-up, 96 of them due to Digestive system causes. Magnitude of residual variation weight in the last quintile was associated with all-cause mortality (relative risk, 2.00; 95% CI, 1.54–2.59) and Digestive system causes (relative risk, 3.82; 95% CI, 1.86–7.81).ConclusionThe findings suggest an association between weight change and gastrointestinal disease mortality. Epidemiological works studying the correlation between weight change and mortality should consider this aspect.

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Fig. 1: Observed and fitted values of body mass index (BMI) and residuals in participants.
Fig. 2: Cumulative incidence function and cumulative hazard by digestive system and other causes deaths.

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Data availability

The data that support the findings of this study are available on request from the corresponding author ARO.

Code availability

The Stata code supporting the findings of this study are available upon request from the corresponding author.

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Funding

MICOL II: This research was supported by a grant from the Ministry of Health, Italy (Progetto Finalizzato Ministero della Sanita Numero 11 Gazzetta Ufficiale Nr. 263 (Serie Generale), de1 7-X1–92). MICOL III: This research was supported by a public grant from the Ministry of Health, Italy (Progetto Finalizzato del Ministero della Salute, ICS 160.2/RF 2003), 2004/2006). MICOL IV: This research was supported by a public grant from the Ministry of Health, Italy (Ricerca Corrente DDG 045 del 24.01.2017).

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Conceptualization: ARO and AC contributed equally to the conception and design of the research; Data curation: PS, CB, AM, IF, AB, GM, MGC, AMC, MN, VT, BDA, and ARO. Formal analysis: PS, CB. Methodology: AC, PS, and CB. Project administration: ARO. Supervision: ARO. Writing—original draft: AC. Writing—review and editing: ARO, GM. All authors have read and agreed to the published version of the paper.

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Correspondence to Alberto Ruben Osella.

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Ethical Committee approval for the MICOL Study: DDG-CE-347/1984; DDG-CE-453/1991; DDG-CE-589/2004; DDG-CE 782/2013. All subjects gave informed written consent to participate. All procedures were performed in accordance with the ethical standards of the institutional research committee (IRCCS Saverio de Bellis Research and with the 1964 Helsinki declaration.

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Campanella, A., Sorino, P., Bonfiglio, C. et al. Effects of weight change on all causes, digestive system and other causes mortality in Southern Italy: a competing risk approach. Int J Obes 46, 113–120 (2022). https://doi.org/10.1038/s41366-021-00954-8

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