Associations of body fat and inflammation with non-communicable chronic diseases and mortality: A prospective cohort study
Notice bibliographique
Résumé
Abstract Introduction Certain leading medical organizations are considering alternatives to the body mass index (BMI) as a predictor of the risk for non-communicable chronic disease (NCD) or death. Our objective was to evaluate the associations between various measures of body fat and the risk of incident NCDs or mortality, independent of inflammation. Methods This was a population-based prospective cohort study (the UK Biobank cohort) set in the United Kingdom. The participants (between 40 and 69 years) accrued between March 2006 and October 2010, and followed until December 2022. The exposures were BMI, waist:hip ratio (WHR), bioimpedance analysis-measured body fat (fat BIA ), C-reactive protein (CRP) and various other measures of body fat obtained by dual-energy X-ray absorptiometry (including visceral adipose tissue) and magnetic resonance imaging. The outcomes were all-cause death, cardiovascular disease (heart failure, hypertension, myocardial infarction, pulmonary embolism, and stroke), cancers (breast, colorectal, endometrial, esophageal, kidney, ovarian, pancreatic, and prostate), diabetes, asthma, gallbladder disease, chronic back pain, and osteoarthritis. Results There were 500,107 participants: the median age was 58 years (interquartile range 50-63) at baseline and 45.6% were male. The 5 th and 95 th %iles for measures of body fat were: BMI 20.5 (considered “healthy”) and 37.0 kg/m 2 (considered “unhealthy”), WHR 0.71 and 0.94, BIA 24.8 and 47.6% in females, and in males BMI 22.0 (considered “healthy”) and 35.4 kg/m 2 (considered “unhealthy”), WHR 0.83 and 1.05, BIA 15.5 and 34.7%. BMI was strongly correlated to fat BIA (0.85 in females, 0.80 in males) but less so with WHR (0.46 in females, 0.59 in males). All measures of body fat were positively associated with the incidence of NCDs but only WHR remained positively associated with death after full adjustment (HR 95 th %ile vs 5 th %ile [95%CI]: BMI 0.80 [0.76,0.84], WHR 1.21 [1.16,1.28], BIA 0.80 [0.76,0.84] in females; BMI 0.89 [0.85,0.93], WHR 1.19 [1.14,1.24], BIA 0.89 [0.85,0.92] in males). Simpler models that adjusted for age, sex, CRP, WHR and either BMI or fat BIA gave similar results. Associations between body fat and the incidence of NCDs after accounting for the competing risk of death were also similar. Conclusion BMI was strongly correlated with fat BIA , but WHR and VAT DXA were less so. All measures of body fat were associated with the incidence of NCDs but only WHR was independently associated with mortality. These findings support the hypothesis that body fat may be protective against death, and that the excess risk associated with higher WHR may be mediated by something other than body fat. Key Questions What is already known about this topic? Obesity as measured by body mass index is associated with chronic disease but less so with mortality. Less is known about alternative measures of body fat. What this study adds? Body mass index is strongly correlated with body fat as measured by bioimpedance analysis, but less so with the waist:hip ratio and visceral adipose tissue. All measures of body fat were associated with the incidence of chronic disease but only the waist:hip ratio was independently associated with mortality. How this study might affect research, practice or policy? These findings support the hypothesis that body fat may be protective against death, and that the excess risk associated with higher waist:hip ratio may be mediated by something other than body fat.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».