BMI of 27-28 kg/m2 and little abdominal obesity best for patients with cerebrovascular disease
Relation between adiposity and vascular events, malignancy, and mortality in patients with stable cerebrovascular diseaseLiterature - Jaspers NEM, Dorresteijn JAN, van der Graaf Y, et al, on behalf of the SMART Study Group - International Journal of Obesity 2017; published online ahead of print
- Overweight individuals (BMI 25.0–29.9) had a lower risk of both incident malignancy (HR: 0.69; 95% CI: 0.49-0.98) and all-cause mortality (HR: 0.75; 95% CI: 0.57-0.98) compared with normal weight individuals (BM: 18.5-24.9). Obese and normal weight individuals did not differ for risk of any outcome.
- No evidence of non-linearity or a relation between BMI and outcomes were found in the unadjusted models. In the fully adjusted model, however, the relations between BMI and vascular events, vascular mortality, incident malignancy and all-cause mortality were non-linear.
- The nadir for vascular events was 27.5 kg/m2 (95% CI: 14.3-36.7), for vascular mortality 27.1 kg/m2 (95% CI: 21.9-29.3), for incident malignancy 28.1 kg/m2 (95% CI: 19.0-38.2) and for all-cause mortality 28.0 kg/m2 (95% CI: 26.3-29.2).
- No evidence of non-linearity in the relation between waist circumference and outcomes were found in the unadjusted models. In the fully adjusted models, no relations were found between waist-circumference and vascular events, vascular mortality or incident malignancy, in either males or females.
- The relation between waist circumference and all-cause mortality was non-linear (males: P = 0.001; females: P=0.02). The nadir for males was 94.8 cm (95% CI: 80.3–100.1) and for females 84.0 cm (95% CI: 18.7–134.8).
- No evidence of non-linearity was found in any relation between VAT% and risk of vascular events, malignancy or vascular- and all-cause mortality. In the fully adjusted models, VAT% had a positive relation with vascular mortality (HR: 1.23; 95% CI: 1.00-1.51) and all-cause mortality (HR: 1.22; 95% CI: 1.05-1.42).
In clinically stable patients with cerebrovascular disease, the lowest risk of incident malignancy, vascular events and mortality was associated with a BMI of 27-28 kg/m2. Moreover, the lowest risk of all-cause mortality was observed for a waist-circumference of 84.0 cm for women and 94.8 cm for men. These data reinforce the importance of little abdominal obesity.