No Obesity Paradox—BMI Incapable of Adequately Capturing the Relation of Obesity with All-Cause Mortality: An Inception Diabetes Cohort Study
Joint Authors
Bozorgmanesh, Mohammadreza
Arshi, Banafsheh
Sheikholeslami, Farhad
Hadaegh, Farzad
Azizi, Fereidoun
Source
International Journal of Endocrinology
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-08-07
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Background.
To reconcile “the obesity paradox,” we tested if (1) the contribution of anthropometric measures to mortality was nonlinear and (2) the confounding of hip circumference contributed to the obesity paradox recently observed among diabetic patients.
Methods.
We analyzed data of diabetic patients attending a community-based prospective, “Tehran lipid and glucose study.” In the mortality analysis, anthropometric measures—body mass index (BMI), waist, and hip circumference—were assessed using Cox models incorporating cubic spline functions.
Results.
During 12 990 person-years follow-up, BMI levels below 27 and those above 40 kg·m−2 were associated with increased mortality.
When we added waist circumference to the BMI in the multivariate-adjusted model, the steepness of BMI-mortality association curve slope for values below 27 kg·m−2 increased, whereas the steepness of BMI-mortality association curve slope for values above this threshold decreased.
Further adjusting the model for hip circumference, the steepness of the slopes of the association curve moved towards null on both extremes and no associations between BMI and all-cause mortality remained.
Conclusion.
BMI harbors intermixed positive and negative confounding effects on mortality of waist and hip circumference.
Failing to control for the confounding effect of hip circumference may stymie unbiased hazard estimation and render conclusions paradoxical.
American Psychological Association (APA)
Bozorgmanesh, Mohammadreza& Arshi, Banafsheh& Sheikholeslami, Farhad& Azizi, Fereidoun& Hadaegh, Farzad. 2014. No Obesity Paradox—BMI Incapable of Adequately Capturing the Relation of Obesity with All-Cause Mortality: An Inception Diabetes Cohort Study. International Journal of Endocrinology،Vol. 2014, no. 2014, pp.1-9.
https://search.emarefa.net/detail/BIM-1036447
Modern Language Association (MLA)
Bozorgmanesh, Mohammadreza…[et al.]. No Obesity Paradox—BMI Incapable of Adequately Capturing the Relation of Obesity with All-Cause Mortality: An Inception Diabetes Cohort Study. International Journal of Endocrinology No. 2014 (2014), pp.1-9.
https://search.emarefa.net/detail/BIM-1036447
American Medical Association (AMA)
Bozorgmanesh, Mohammadreza& Arshi, Banafsheh& Sheikholeslami, Farhad& Azizi, Fereidoun& Hadaegh, Farzad. No Obesity Paradox—BMI Incapable of Adequately Capturing the Relation of Obesity with All-Cause Mortality: An Inception Diabetes Cohort Study. International Journal of Endocrinology. 2014. Vol. 2014, no. 2014, pp.1-9.
https://search.emarefa.net/detail/BIM-1036447
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1036447