Change in weight and body mass index associated with all-cause mortality in Korea: A nationwide longitudinal study

Taskforce Team of the Obesity Fact Sheet of the Korean Society for the Study of Obesity

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)

Abstract

Context: Many studies have reported conflicting evidence on the association between weight change and mortality. Objective: We investigated the association between weight change and subsequent all-cause mortality, using a large-scale, population-based cohort from the National Health Insurance System health checkup data between 2005 and 2015. Methods: A total of 11,524,763 subjects older than age 20 years were included. Weight was measured every 2 years and weight change over 4 years was divided into eight categories, from weight loss $15% to weight gain $20%, for every 5% of weight change. The hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were analyzed using multivariable Cox proportional hazard models compared with the stable weight group (weight change,5%) after adjusting for age, sex, smoking, drinking, exercise, diabetes mellitus, hypertension, dyslipidemia, cancer, and income. Results: Weight loss was associated with increased mortality rates compared with weight gain; the group with weight loss $15% had the highest HR for all-cause mortality (HR, 2.598; 95% CI, 2.537 to 2.659). The HR for all-cause mortality in the $20% weight gain group was 1.784 (95% CI, 1.695 to 1.877). Across all body mass index (BMI) categories, weight loss $15% was associated with increased mortality rates and the highest mortality rates were found in the BMI $30 kg/m2 group (HR, 3.469; 95% CI, 2.236 to 5.381). Conclusions: Weight change over 4 years showed a reverse J-shaped all-cause mortality curve, independent of BMI status. Weight loss was associated with a greater risk of mortality than was weight gain.

Original languageEnglish
Pages (from-to)4041-4050
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume102
Issue number11
DOIs
Publication statusPublished - 2017

Bibliographical note

Funding Information:
We thank the Korean National Health Insurance Corporation and all the participants of the study and health checkup. This study was supported by Grant HC16C2285 from the Korean Health Technology and Research and Development project, Ministry of Health and Welfare, Republic of Korea.

Funding Information:
Financial Support: This study was supported by Grant HC16C2285 from the Korean Health Technology and Research and Development project, Ministry of Health and Welfare, Republic of Korea.

Publisher Copyright:
Copyright © 2017 Endocrine Society.

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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