Body mass index and infectious disease mortality in midlife in a cohort of 2.3 million adolescents.

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  • Additional Information
    • Source:
      Publisher: Nature Pub. Group Country of Publication: England NLM ID: 101256108 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5497 (Electronic) Linking ISSN: 03070565 NLM ISO Abbreviation: Int J Obes (Lond) Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : Nature Pub. Group, c2005-
    • Subject Terms:
      Body Mass Index* ; Communicable Diseases*/complications ; Communicable Diseases*/epidemiology ; Communicable Diseases*/mortality ; Obesity*/complications ; Obesity*/epidemiology ; Overweight*/complications ; Overweight*/epidemiology; Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged
    • Abstract:
      Background: Obesity was linked to altered immunity, but also to favorable outcomes among patients with infectious disease (ID) in some settings. We assessed the association between adolescent body mass index (BMI) and ID mortality.
      Methods: BMI of 2 294 139 Israeli adolescents (60% men; age 17.4±0.3 years) was measured between 1967 and 2010. The outcome, obtained by linkage with official national records, was death due to ID as the underlying cause. Multivariable Cox proportional hazards models were applied.
      Results: During 42 297 007 person-years of follow-up (median 18.4 years), there were 689 deaths from ID (mean age 44.1±10.5 years). Adjusted hazard ratios (HR) were 1.039 (1.011-1.068) and 1.146 (1.099-1.194) among men and women, respectively, per unit increment in BMI (P for sex interaction=4.4 × 10 -5 ). Adjusted hazard ratios among men were 1.2 (1.0-1.5), 1.9 (1.4-2.5) and 2.5 (1.5-4.2) for those with high-normal BMI (22.0-24.9 kg m -2 ), overweight and obese, respectively, compared with the 18.5⩽BMI<22 kg m -2 reference group, and 1.7 (1.1-2.6), 2.6 (1.6-4.3) and 6.6 (3.3-13.1) among women, respectively. The increased risk among underweight (<18.5 kg m -2 ) boys was attenuated when the study sample was restricted to those with unimpaired health at baseline. A multivariable spline model indicated a minimum risk for total ID mortality at 20.7 and 18.0 kg m -2 for men and women, respectively, with significantly increased risk seen above adolescent BMI values of 23.6 and 24.0 kg m -2 , respectively. The association with BMI was particularly evident for bacterial infections (predominantly sepsis), airways and central nervous system infections (63% of the ID deaths).
      Conclusions: Adolescent overweight and obesity were strongly associated with ID mortality, especially of bacterial origin and among women.
    • References:
      Vaccine. 2015 Aug 26;33(36):4422-9. (PMID: 26163925)
      BMC Infect Dis. 2007 Mar 09;7:13. (PMID: 17349033)
      Lancet Infect Dis. 2006 Jul;6(7):438-46. (PMID: 16790384)
      N Engl J Med. 2010 Feb 11;362(6):485-93. (PMID: 20147714)
      Lancet. 2014 Aug 2;384(9941):427-37. (PMID: 24797573)
      J Pediatr. 2013 Sep;163(3):835-40.e1. (PMID: 23706357)
      Int J Obes (Lond). 2011 Mar;35(3):401-8. (PMID: 20680015)
      Expert Opin Ther Targets. 2015;19(11):1531-43. (PMID: 26083575)
      N Engl J Med. 2009 Nov 12;361(20):1935-44. (PMID: 19815859)
      Burns. 2012 Mar;38(2):252-60. (PMID: 22030440)
      Cancer. 2012 Dec 1;118(23):5989-96. (PMID: 22648558)
      PLoS One. 2013 Dec 11;8(12):e82779. (PMID: 24349359)
      Clin Infect Dis. 2011 Feb 1;52(3):301-12. (PMID: 21208911)
      PLoS One. 2014 Jul 30;9(7):e103172. (PMID: 25076128)
      Isr J Med Sci. 1992 Jan;28(1):33-7. (PMID: 1733896)
      J Alzheimers Dis. 2016 Dec 6;55(3):1207-1221. (PMID: 27814299)
      Interact Cardiovasc Thorac Surg. 2010 Jul;11(1):20-3. (PMID: 20388700)
      Surg Endosc. 2011 Nov;25(11):3531-4. (PMID: 21638185)
      Am J Public Health. 2005 Sep;95(9):1623-30. (PMID: 16051935)
      Vital Health Stat 11. 2002 May;(246):1-190. (PMID: 12043359)
      N Engl J Med. 2016 Jun 23;374(25):2430-40. (PMID: 27074389)
      Lancet. 2012 Dec 15;380(9859):2095-128. (PMID: 23245604)
      Int J Infect Dis. 2011 Jan;15(1):e54-7. (PMID: 21095152)
      J Clin Endocrinol Metab. 2014 Jun;99(6):2095-103. (PMID: 24601695)
      Clin Infect Dis. 2011 Sep;53(5):413-21. (PMID: 21844024)
      Int J Obes Relat Metab Disord. 2003 Nov;27(11):1391-7. (PMID: 14574351)
      Endocr Metab Immune Disord Drug Targets. 2006 Jun;6(2):127-35. (PMID: 16787286)
      N Engl J Med. 2011 Nov 17;365(20):1876-85. (PMID: 22087679)
      Ann Surg. 2009 Jul;250(1):166-72. (PMID: 19561456)
      Clin Infect Dis. 2016 Apr 1;62(7):845-52. (PMID: 26703865)
      Breast Cancer Res Treat. 2016 Jul;158(1):157-67. (PMID: 27306419)
      Diabetes Care. 2016 Nov;39(11):1996-2003. (PMID: 27733421)
      Int J Obes (Lond). 2012 Aug;36(8):1072-7. (PMID: 22024641)
      JAMA. 2014 Feb 26;311(8):806-14. (PMID: 24570244)
      Autoimmunity. 2006 Mar;39(2):137-41. (PMID: 16698670)
      Vaccine. 2014 Feb 7;32(7):881-7. (PMID: 24360890)
      Obesity (Silver Spring). 2013 Dec;21(12):E762-9. (PMID: 23526732)
      N Engl J Med. 2011 Apr 7;364(14):1315-25. (PMID: 21470009)
      Arch Intern Med. 2011 Oct 24;171(19):1768-70; discussion 1770. (PMID: 22025437)
      Am J Surg. 2012 Nov;204(5):574-9. (PMID: 22892201)
      J Vasc Surg. 2012 May;55(5):1306-12. (PMID: 22542344)
      Surg Obes Relat Dis. 2014 Mar-Apr;10 (2):291-7. (PMID: 24439117)
      Cancer. 2016 Apr 1;122(7):1068-77. (PMID: 26900677)
      Int J Epidemiol. 2016 Aug;45(4):1159-1168. (PMID: 26686843)
      Int J Obes (Lond). 2014 Jan;38(1):113-9. (PMID: 23670219)
      Women Health. 2008;47(4):1-17. (PMID: 18843937)
      Pediatrics. 2001 Dec;108(6):E108. (PMID: 11731635)
    • Publication Date:
      Date Created: 20171031 Date Completed: 20190325 Latest Revision: 20190325
    • Publication Date:
      20221213
    • Accession Number:
      10.1038/ijo.2017.263
    • Accession Number:
      29081504