Association between body mass index and mortality in the Korean elderly: A nationwide cohort study
The objective of this study was to investigate the relationship between body mass index (BMI) and mortality in the elderly. This study was a nation-wide population-based retrospective cohort study of the National Health Insurance System-Senior Database (NHIS-SD). In this study, a total of 75,856 sub...
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creator | Lee, Seung-Hyun Kim, Do-Hoon Park, Joo-Hyun Kim, Shinhye Choi, Moonyoung Kim, Hyonchong Seul, Da Eun Park, Soo Gyeong Jung, Jin-Hyung Han, Kyungdo Park, Young-Gyu |
description | The objective of this study was to investigate the relationship between body mass index (BMI) and mortality in the elderly. This study was a nation-wide population-based retrospective cohort study of the National Health Insurance System-Senior Database (NHIS-SD). In this study, a total of 75,856 subjects were identified and selected from among 251,593 individuals aged ≥ 65 years who underwent health screening at least once between 2009 and 2012 and who had no history of diabetes, cardiovascular disease, stroke, cancer, or chronic obstructive pulmonary disease (COPD). The subjects of this study were followed-up until 2013 to identify the total mortality and the cause-specific mortality of 6 groups divided according to BMI. The hazard ratio (HR) by reference group (23 ≤ BMI < 25 kg/m2) of each group was calculated. A significant increase in the HR with a decreased BMI was observed in the group with a BMI < 23 kg/m2, whereas the HR in the group with a BMI ≥ 25 kg/m2 was not significantly different than that of the reference group (23 ≤ BMI < 25 kg/m2). This pattern was also seen in the subgroup analyses in relation to age, smoking history, alcohol use, exercise level, and socioeconomic status. In this study, we found that a low BMI was a risk factor for death in the elderly and that no significant difference in mortality was seen in the elderly with a BMI of 25 or over. In terms of an optimal BMI in the elderly, it is important to maintain an appropriately healthy range of BMI with the aim of preventing weight loss. |
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This study was a nation-wide population-based retrospective cohort study of the National Health Insurance System-Senior Database (NHIS-SD). In this study, a total of 75,856 subjects were identified and selected from among 251,593 individuals aged ≥ 65 years who underwent health screening at least once between 2009 and 2012 and who had no history of diabetes, cardiovascular disease, stroke, cancer, or chronic obstructive pulmonary disease (COPD). The subjects of this study were followed-up until 2013 to identify the total mortality and the cause-specific mortality of 6 groups divided according to BMI. The hazard ratio (HR) by reference group (23 ≤ BMI < 25 kg/m2) of each group was calculated. A significant increase in the HR with a decreased BMI was observed in the group with a BMI < 23 kg/m2, whereas the HR in the group with a BMI ≥ 25 kg/m2 was not significantly different than that of the reference group (23 ≤ BMI < 25 kg/m2). This pattern was also seen in the subgroup analyses in relation to age, smoking history, alcohol use, exercise level, and socioeconomic status. In this study, we found that a low BMI was a risk factor for death in the elderly and that no significant difference in mortality was seen in the elderly with a BMI of 25 or over. In terms of an optimal BMI in the elderly, it is important to maintain an appropriately healthy range of BMI with the aim of preventing weight loss.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0207508</identifier><identifier>PMID: 30444893</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Aged, 80 and over ; Alcoholic beverages ; Biology and Life Sciences ; Body mass ; Body Mass Index ; Body size ; Body weight loss ; Cancer ; Cardiovascular diseases ; Chronic obstructive pulmonary disease ; Cohort analysis ; Databases, Factual ; Diabetes mellitus ; Female ; Follow-Up Studies ; Geriatrics ; Health risk assessment ; Humans ; Lung cancer ; Lung diseases ; Male ; Medicine and Health Sciences ; Mortality ; Obesity ; Obstructive lung disease ; Older people ; People and Places ; Population studies ; Republic of Korea - epidemiology ; Retrospective Studies ; Risk analysis ; Risk Factors ; Smoking ; Social Sciences ; Socio-economic aspects ; Socioeconomic factors ; Socioeconomics ; Stroke ; Subgroups ; Weight loss</subject><ispartof>PloS one, 2018-11, Vol.13 (11), p.e0207508-e0207508</ispartof><rights>2018 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Lee et al 2018 Lee et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-1e1ea2c3ef715fa38952d0758cf85705dcc06f4786b1de910b6c56e11bf525963</citedby><cites>FETCH-LOGICAL-c526t-1e1ea2c3ef715fa38952d0758cf85705dcc06f4786b1de910b6c56e11bf525963</cites><orcidid>0000-0001-7421-4501</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6239300/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6239300/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2104,2930,23873,27931,27932,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30444893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Li, Shengxu</contributor><creatorcontrib>Lee, Seung-Hyun</creatorcontrib><creatorcontrib>Kim, Do-Hoon</creatorcontrib><creatorcontrib>Park, Joo-Hyun</creatorcontrib><creatorcontrib>Kim, Shinhye</creatorcontrib><creatorcontrib>Choi, Moonyoung</creatorcontrib><creatorcontrib>Kim, Hyonchong</creatorcontrib><creatorcontrib>Seul, Da Eun</creatorcontrib><creatorcontrib>Park, Soo Gyeong</creatorcontrib><creatorcontrib>Jung, Jin-Hyung</creatorcontrib><creatorcontrib>Han, Kyungdo</creatorcontrib><creatorcontrib>Park, Young-Gyu</creatorcontrib><title>Association between body mass index and mortality in the Korean elderly: A nationwide cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The objective of this study was to investigate the relationship between body mass index (BMI) and mortality in the elderly. This study was a nation-wide population-based retrospective cohort study of the National Health Insurance System-Senior Database (NHIS-SD). In this study, a total of 75,856 subjects were identified and selected from among 251,593 individuals aged ≥ 65 years who underwent health screening at least once between 2009 and 2012 and who had no history of diabetes, cardiovascular disease, stroke, cancer, or chronic obstructive pulmonary disease (COPD). The subjects of this study were followed-up until 2013 to identify the total mortality and the cause-specific mortality of 6 groups divided according to BMI. The hazard ratio (HR) by reference group (23 ≤ BMI < 25 kg/m2) of each group was calculated. A significant increase in the HR with a decreased BMI was observed in the group with a BMI < 23 kg/m2, whereas the HR in the group with a BMI ≥ 25 kg/m2 was not significantly different than that of the reference group (23 ≤ BMI < 25 kg/m2). This pattern was also seen in the subgroup analyses in relation to age, smoking history, alcohol use, exercise level, and socioeconomic status. In this study, we found that a low BMI was a risk factor for death in the elderly and that no significant difference in mortality was seen in the elderly with a BMI of 25 or over. In terms of an optimal BMI in the elderly, it is important to maintain an appropriately healthy range of BMI with the aim of preventing weight loss.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alcoholic beverages</subject><subject>Biology and Life Sciences</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Body size</subject><subject>Body weight loss</subject><subject>Cancer</subject><subject>Cardiovascular diseases</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Cohort analysis</subject><subject>Databases, Factual</subject><subject>Diabetes mellitus</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Geriatrics</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Lung cancer</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Obesity</subject><subject>Obstructive lung disease</subject><subject>Older people</subject><subject>People and Places</subject><subject>Population studies</subject><subject>Republic of Korea - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Smoking</subject><subject>Social Sciences</subject><subject>Socio-economic aspects</subject><subject>Socioeconomic factors</subject><subject>Socioeconomics</subject><subject>Stroke</subject><subject>Subgroups</subject><subject>Weight loss</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNptkk1v1DAQhiMEoqXwDxBY4tLLLv6IHYdDpVVVoKISFzhbjj3peuXYi-2l5N-T3U2rFnHxWON3npmx3qp6S_CSsIZ83MRdCtovtzHAElPccCyfVaekZXQhKGbPH91Pqlc5bzDmTArxsjphuK5r2bLTqlvlHI3TxcWAOih3AFOMdkSDzhm5YOEP0sGiIaaivSvjlENlDehbTKADAm8h-fETWqFwoNw5C8jE9aRHuezs-Lp60Wuf4c0cz6qfn69-XH5d3Hz_cn25ulkYTkVZECCgqWHQN4T3msmWUzttJU0veYO5NQaLvm6k6IiFluBOGC6AkK7nlLeCnVXvj9ytj1nN35MVJaymEtOD4vqosFFv1Da5QadRRe3UIRHTrdKpOONBUdzLphZ1Q2Vbt02v28ZI6DhuGZZYk4l1MXfbdQNYA6Ek7Z9An74Et1a38bcSlE0MPAHOZ0CKv3aQixpcNuC9DhB3h7k5odO5n_vDP9L_b1cfVSbFnBP0D8MQrPaWua9Se8uo2TJT2bvHizwU3XuE_QWUVb7y</recordid><startdate>20181116</startdate><enddate>20181116</enddate><creator>Lee, Seung-Hyun</creator><creator>Kim, Do-Hoon</creator><creator>Park, Joo-Hyun</creator><creator>Kim, Shinhye</creator><creator>Choi, Moonyoung</creator><creator>Kim, Hyonchong</creator><creator>Seul, Da Eun</creator><creator>Park, Soo Gyeong</creator><creator>Jung, Jin-Hyung</creator><creator>Han, Kyungdo</creator><creator>Park, Young-Gyu</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-7421-4501</orcidid></search><sort><creationdate>20181116</creationdate><title>Association between body mass index and mortality in the Korean elderly: A nationwide cohort study</title><author>Lee, Seung-Hyun ; Kim, Do-Hoon ; Park, Joo-Hyun ; Kim, Shinhye ; Choi, Moonyoung ; Kim, Hyonchong ; Seul, Da Eun ; Park, Soo Gyeong ; Jung, Jin-Hyung ; Han, Kyungdo ; Park, Young-Gyu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-1e1ea2c3ef715fa38952d0758cf85705dcc06f4786b1de910b6c56e11bf525963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alcoholic beverages</topic><topic>Biology and Life Sciences</topic><topic>Body mass</topic><topic>Body Mass Index</topic><topic>Body size</topic><topic>Body weight loss</topic><topic>Cancer</topic><topic>Cardiovascular diseases</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Cohort analysis</topic><topic>Databases, Factual</topic><topic>Diabetes mellitus</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Geriatrics</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Lung cancer</topic><topic>Lung diseases</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Mortality</topic><topic>Obesity</topic><topic>Obstructive lung disease</topic><topic>Older people</topic><topic>People and Places</topic><topic>Population studies</topic><topic>Republic of Korea - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Smoking</topic><topic>Social Sciences</topic><topic>Socio-economic aspects</topic><topic>Socioeconomic factors</topic><topic>Socioeconomics</topic><topic>Stroke</topic><topic>Subgroups</topic><topic>Weight loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Seung-Hyun</creatorcontrib><creatorcontrib>Kim, Do-Hoon</creatorcontrib><creatorcontrib>Park, Joo-Hyun</creatorcontrib><creatorcontrib>Kim, Shinhye</creatorcontrib><creatorcontrib>Choi, Moonyoung</creatorcontrib><creatorcontrib>Kim, Hyonchong</creatorcontrib><creatorcontrib>Seul, Da Eun</creatorcontrib><creatorcontrib>Park, Soo Gyeong</creatorcontrib><creatorcontrib>Jung, Jin-Hyung</creatorcontrib><creatorcontrib>Han, Kyungdo</creatorcontrib><creatorcontrib>Park, Young-Gyu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Seung-Hyun</au><au>Kim, Do-Hoon</au><au>Park, Joo-Hyun</au><au>Kim, Shinhye</au><au>Choi, Moonyoung</au><au>Kim, Hyonchong</au><au>Seul, Da Eun</au><au>Park, Soo Gyeong</au><au>Jung, Jin-Hyung</au><au>Han, Kyungdo</au><au>Park, Young-Gyu</au><au>Li, Shengxu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between body mass index and mortality in the Korean elderly: A nationwide cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-11-16</date><risdate>2018</risdate><volume>13</volume><issue>11</issue><spage>e0207508</spage><epage>e0207508</epage><pages>e0207508-e0207508</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The objective of this study was to investigate the relationship between body mass index (BMI) and mortality in the elderly. This study was a nation-wide population-based retrospective cohort study of the National Health Insurance System-Senior Database (NHIS-SD). In this study, a total of 75,856 subjects were identified and selected from among 251,593 individuals aged ≥ 65 years who underwent health screening at least once between 2009 and 2012 and who had no history of diabetes, cardiovascular disease, stroke, cancer, or chronic obstructive pulmonary disease (COPD). The subjects of this study were followed-up until 2013 to identify the total mortality and the cause-specific mortality of 6 groups divided according to BMI. The hazard ratio (HR) by reference group (23 ≤ BMI < 25 kg/m2) of each group was calculated. A significant increase in the HR with a decreased BMI was observed in the group with a BMI < 23 kg/m2, whereas the HR in the group with a BMI ≥ 25 kg/m2 was not significantly different than that of the reference group (23 ≤ BMI < 25 kg/m2). This pattern was also seen in the subgroup analyses in relation to age, smoking history, alcohol use, exercise level, and socioeconomic status. In this study, we found that a low BMI was a risk factor for death in the elderly and that no significant difference in mortality was seen in the elderly with a BMI of 25 or over. In terms of an optimal BMI in the elderly, it is important to maintain an appropriately healthy range of BMI with the aim of preventing weight loss.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30444893</pmid><doi>10.1371/journal.pone.0207508</doi><orcidid>https://orcid.org/0000-0001-7421-4501</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Aged Aged, 80 and over Alcoholic beverages Biology and Life Sciences Body mass Body Mass Index Body size Body weight loss Cancer Cardiovascular diseases Chronic obstructive pulmonary disease Cohort analysis Databases, Factual Diabetes mellitus Female Follow-Up Studies Geriatrics Health risk assessment Humans Lung cancer Lung diseases Male Medicine and Health Sciences Mortality Obesity Obstructive lung disease Older people People and Places Population studies Republic of Korea - epidemiology Retrospective Studies Risk analysis Risk Factors Smoking Social Sciences Socio-economic aspects Socioeconomic factors Socioeconomics Stroke Subgroups Weight loss |
title | Association between body mass index and mortality in the Korean elderly: A nationwide cohort study |
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