Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model.

<h4>Objective</h4>The association of body mass index (BMI) and all-cause mortality is controversial, frequently referred to as a paradox. Whether the cause is metabolic factors or statistical biases is still controversial. We assessed the association of BMI and all-cause mortality consid...

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Autores principales:	Jia Li, Gyorgy Simon, M Regina Castro, Vipin Kumar, Michael S Steinbach, Pedro J Caraballo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bf0355c87f9e4d1c93bc4cd21c5b7157
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spelling	oai:doaj.org-article:bf0355c87f9e4d1c93bc4cd21c5b71572021-12-02T20:15:34ZAssociation of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model.1932-620310.1371/journal.pone.0253696https://doaj.org/article/bf0355c87f9e4d1c93bc4cd21c5b71572021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253696https://doaj.org/toc/1932-6203<h4>Objective</h4>The association of body mass index (BMI) and all-cause mortality is controversial, frequently referred to as a paradox. Whether the cause is metabolic factors or statistical biases is still controversial. We assessed the association of BMI and all-cause mortality considering a wide range of comorbidities and baseline mortality risk.<h4>Methods</h4>Retrospective cohort study of Olmsted County residents with at least one BMI measurement between 2000-2005, clinical data in the electronic health record and minimum 8 year follow-up or death within this time. The cohort was categorized based on baseline mortality risk: Low, Medium, Medium-high, High and Very-high. All-cause mortality was assessed for BMI intervals of 5 and 0.5 Kg/m2.<h4>Results</h4>Of 39,739 subjects (average age 52.6, range 18-89; 38.1% male) 11.86% died during 8-year follow-up. The 8-year all-cause mortality risk had a "U" shape with a flat nadir in all the risk groups. Extreme BMI showed higher risk (BMI <15 = 36.4%, 15 to <20 = 15.4% and ≥45 = 13.7%), while intermediate BMI categories showed a plateau between 10.6 and 12.5%. The increased risk attributed to baseline risk and comorbidities was more obvious than the risk based on BMI increase within the same risk groups.<h4>Conclusions</h4>There is a complex association between BMI and all-cause mortality when evaluated including comorbidities and baseline mortality risk. In general, comorbidities are better predictors of mortality risk except at extreme BMIs. In patients with no or few comorbidities, BMI seems to better define mortality risk. Aggressive management of comorbidities may provide better survival outcome for patients with body mass between normal and moderate obesity.Jia LiGyorgy SimonM Regina CastroVipin KumarMichael S SteinbachPedro J CaraballoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253696 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jia Li Gyorgy Simon M Regina Castro Vipin Kumar Michael S Steinbach Pedro J Caraballo Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model.
description	<h4>Objective</h4>The association of body mass index (BMI) and all-cause mortality is controversial, frequently referred to as a paradox. Whether the cause is metabolic factors or statistical biases is still controversial. We assessed the association of BMI and all-cause mortality considering a wide range of comorbidities and baseline mortality risk.<h4>Methods</h4>Retrospective cohort study of Olmsted County residents with at least one BMI measurement between 2000-2005, clinical data in the electronic health record and minimum 8 year follow-up or death within this time. The cohort was categorized based on baseline mortality risk: Low, Medium, Medium-high, High and Very-high. All-cause mortality was assessed for BMI intervals of 5 and 0.5 Kg/m2.<h4>Results</h4>Of 39,739 subjects (average age 52.6, range 18-89; 38.1% male) 11.86% died during 8-year follow-up. The 8-year all-cause mortality risk had a "U" shape with a flat nadir in all the risk groups. Extreme BMI showed higher risk (BMI <15 = 36.4%, 15 to <20 = 15.4% and ≥45 = 13.7%), while intermediate BMI categories showed a plateau between 10.6 and 12.5%. The increased risk attributed to baseline risk and comorbidities was more obvious than the risk based on BMI increase within the same risk groups.<h4>Conclusions</h4>There is a complex association between BMI and all-cause mortality when evaluated including comorbidities and baseline mortality risk. In general, comorbidities are better predictors of mortality risk except at extreme BMIs. In patients with no or few comorbidities, BMI seems to better define mortality risk. Aggressive management of comorbidities may provide better survival outcome for patients with body mass between normal and moderate obesity.
format	article
author	Jia Li Gyorgy Simon M Regina Castro Vipin Kumar Michael S Steinbach Pedro J Caraballo
author_facet	Jia Li Gyorgy Simon M Regina Castro Vipin Kumar Michael S Steinbach Pedro J Caraballo
author_sort	Jia Li
title	Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model.
title_short	Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model.
title_full	Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model.
title_fullStr	Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model.
title_full_unstemmed	Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model.
title_sort	association of bmi, comorbidities and all-cause mortality by using a baseline mortality risk model.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/bf0355c87f9e4d1c93bc4cd21c5b7157
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Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model.

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