Age and gender aspects of the association of generalized obesity with development of fatal and nonfatal cardiovascular events (results of the prospective cohort study “Interepepid”)
https://doi.org/10.29413/ABS.2021-6.5.24
Abstract
Background. Currently, obesity has become one of the most important medical and social problems in the world due to its high prevalence. Numerous literature data indicate that high BMI is associated with increased mortality from cardiovascular diseases.
The aim: to study the relationship between overweight and generalized obesity with the development of fatal and non-fatal cardiovascular events among residents of the Chui region of the Kyrgyz Republic, taking into account gender and age.
Material and methods. This study was carried out as part of the international crosssectional epidemiological study “Interepid”. The total follow-up period was 7 years. Life status at the end of the follow-up period was monitored in 1096 respondents out of 1341 initial cohorts (response – 82.1 %). The endpoints were cases of fatal and non-fatal cardiovascular events. The frequency of events was assessed using methods of analysis of survival (Cox proportional hazard regression model, parametric survival models, survival by the Kaplan – Meier method).
Results. A total of 181 cases of fatal and non-fatal cardiovascular events (16.44 %) were recorded during the follow-up. In persons with normal body weight, the incidence of cardiovascular complications was 10 %. In overweight individuals, the value of this indicator increased and reached 17.99 % (p˂ 0.001), and in individuals with obesity – 24.5 % (p˂ 0.0001). The increase in the frequency of events with the increase in body mass index did not depend on the gender of the respondents but was typical only for people under 60 years of age. For elderly patients, there was no relationship between BMI and the development of cardiovascular complications. In contrast, the relative risk had an insignificant tendency to decrease by 2.6 % for every 1 kg/m2 increase in body mass index (RR – 0.974; 95% CI: 0.924–1.025).
Conclusion. The increase of body mass index above 25 kg/m2 is an independent risk factor for the development of fatal and non-fatal cardiovascular events in the analyzed cohort of the Chui region residents, regardless of gender, but only in persons under 60 years of age.
About the Authors
A. G. PolupanovKyrgyzstan
Dr. Sc. (Med.), Professor, Chief Research Officer at the Department of Arterial Hypertension,
Togolok Moldo str. 3, Bishkek 720040
A. U. Mamatov
Kyrgyzstan
Postgraduate at the Department of Therapy No. 2 of the Faculty of Medicine,
Kievskaya str. 44, Bishkek 720065
M. T. Duishenalieva
Kyrgyzstan
Research Officer at the Department of Arterial Hypertension,
Togolok Moldo str. 3, Bishkek 720040
A. T. Аrykova
Kyrgyzstan
Lecturer at the Department of Therapy No. 2 of the Faculty of Medicine,
Kievskaya str. 44, Bishkek 720065
F. T. Rysmatova
Kyrgyzstan
Cand. Sc. (Med.), Head of the Department of Internal Medicine No. 3,
Lenina str. 331, Osh 723500
I. Kh. Bebezov
Kyrgyzstan
Dr. Sc. (Med.), Professor. Head of the Department of Cardiac Surgery and Invasive Research and Treatment Methods,
L’va Tolstogo str. 114/1, Bishkek 720007
S. M. Akhunbaev
Kyrgyzstan
Cand. Sc. (Med.), Rector,
L’va Tolstogo str. 114/1, Bishkek 720007
I. S. Sabirov
Kyrgyzstan
Dr. Sc. (Med.), Professor, Head of the Department of Internal Diseases No. 2 of the Faculty of Medicine,
Kievskaya str. 44, Bishkek 720065
A. S. Dzhumagulova
Kyrgyzstan
Dr. Sc. (Med.), Professor at the Cardiac Surgery and X-ray Endovascular Surgery Department,
I. Akhunbaeva str. 92, Bishkek 720020
References
1. World Health Organization. 10 facts about obesity. 2017; 1-10.
2. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al. National, regional, and global trends in body mass index since 1980: Systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011; 377(9765): 557-567. doi: 10.1016/S0140-6736(10)62037-5
3. Souza SA, Silva AB, Cavalcante UMB, Lima CMBL, de Souza TC. Adult obesity in different countries: an analysis via beta regression models. Cad Saude Publica. 2018; 34(8): e00161417. doi: 10.1590/0102-311X00161417
4. Katz D, Friedman R. Diet, weight regulation, and obesity. In: Nutrition in clinical practice. 2nd ed. Philadelphia: Lippincott Williams&Wilkins. 2008.
5. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond). 2008; 32(9): 1431-1437. doi: 10.1038/ijo.2008.102
6. Romanova TA, Nyshanova ST, Polupanov AG, Khalmatov AN. The spread of arterial hypertension and other risk factors for cardiovascular diseases in the rural population of Kyrghyzstan. Profilaktika zabolevanij i ukreplenie zdorovya. 2007; 3: 14-17. (In Russ.).
7. Dzhumagulova AS, Polupanov AG, Khalmatov AN, Altymysheva AT, Mamatov AU, Romanova TA. Gender and ethnic characteristics of the prevalence of obesity among residence of small towns and rural areas of the Kyrgyz Republic (according to the Interepid Study). Kardiologicheskij Vestnik. 2019; 2: 61-66. (In Russ.).
8. Janssen I, Mark AE. Elevated body mass index and mortality risk in the elderly. Obes Rev. 2007; 8(1): 41-59. doi: 10.1111/j.1467-789X.2006.00248.x
9. Aune D, Sen A, Prasad M, Norat T, Janszky I, Tonstad S, et al. BMI and all-cause mortality: Systematic review and nonlinear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants. BMJ. 2016; 353: i2156.35. doi: 10.1136/bmj.i2156
10. Barry V, Baruth M, Beets M, Durstine JL, Liu J, Blair SN. Fitness vs. fatness on all-cause mortality: A meta- analysis. Prog Cardiovasc Dis. 2014; 56(4): 382-390. doi: 10.1016/j.pcad.2013.09.002
11. Hansel B, Roussel R, Elbez Y, Marre M, Krempf M, Ikeda Y, et al. Cardiovascular risk in relation to body mass index and use of evidence-based preventive medications in patients with or at risk of atherothrombosis. Eur Heart J. 2015; 36(40): 2716-2728. doi: 10.1093/eurheartj/ehv347
12. Polupanov AG, Kontsevaya AV, Khalmatov AN, Altymysheva AT, Suvorova E.T, Romanova TA, et al. Ethnic features of arterial hypertension prevalence in small town and countryside residents of the Kyrgyz Republic: results of the International Study Interepid. Cardiovascular Therapy and Prevention. 2013; 12(6): 4-8. (in Russ.). doi: 10.15829/1728-8800-2013-6-4-8
13. Global BMI Mortality Collaboration, Di Angelantonio E, Bhupathiraju S, Wormser D, Gao P, Kaptoge S, et al. Body-mass index and all-cause mortality: Individual participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016; 388(10046): 776-786. doi: 10.1016/S0140-6736(16)30175-1
14. Ni Mhurchu C, Rodgers A, Pan WH, Gu DF, Woodward M, Asia Pacific Cohort Studies Collaboration. Body mass index and cardiovascular disease in the Asia-Pacific Region: an overview of 33 cohorts involving 310 000 participants. Int J Epidemiol. 2004; 33(4): 751-758. doi: 10.1093/ije/dyh163
15. Liao W, Luo Z, Hou Y. Cui N, Liu X, Huo W, et al. Age and gender specific association between obesity and depressive symptoms: A large-scale cross-sectional study. BMC Public Health. 2020; 20(1): 1565. doi: 10.1186/s12889-020-09664-8
16. Hosseini Z, Veenstra G, Khan NA, Conklin AI Associations between social connections, their interactions, and obesity differ by gender: A population-based, cross-sectional analysis of the Canadian Longitudinal Study on Aging. PLoS ONE. 2020; 15(7): e0235977. doi: 10.1371/journal.pone.0235977
17. Tsao YC, Lee YY, Chen JY, Yeh WC, Chuang CH, Yu W, et al. Gender- and age-specific associations between body fat composition and C-reactive protein with lung function: A cross-sectional study. Sci Rep. 2019; 9(1): 384. doi: 10.1038/s41598-018-36860-9 1
18. Tsao YC, Chen JY, Yeh WC, Li WC. Gender- and age-specific associations between visceral obesity and renal function impairment. Obes Facts. 2019; 12(1): 67-77. doi: 10.1159/000496626
19. Wang Q, Xu L, Li J, Sun L, Qin W, Ding G, et al. Association of anthropometric indices of obesity with hypertension in Chinese elderly: An analysis of age and gender differences. Int J Environ Res Public Health. 2018; 15(4): 801. doi: 10.3390/ijerph15040801
Review
For citations:
Polupanov A.G., Mamatov A.U., Duishenalieva M.T., Аrykova A.T., Rysmatova F.T., Bebezov I.Kh., Akhunbaev S.M., Sabirov I.S., Dzhumagulova A.S. Age and gender aspects of the association of generalized obesity with development of fatal and nonfatal cardiovascular events (results of the prospective cohort study “Interepepid”). Acta Biomedica Scientifica. 2021;6(5):245-252. (In Russ.) https://doi.org/10.29413/ABS.2021-6.5.24