4.7 Article

Association of Body Mass Index and Waist Circumference with All-Cause Mortality in Hemodialysis Patients

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 9, Issue 5, Pages -

Publisher

MDPI
DOI: 10.3390/jcm9051289

Keywords

obesity; body mass index; waist circumference; mortality; hemodialysis

Funding

  1. Bio & Medical Development Program through the NRF of Korea - Ministry of Science and ICT (MSIT) [NRF-2017M3A9E8023001, NRF-2017M3A9E8023018]
  2. Basic Science Research Program through the National Research Foundation (NRF) of Korea - Ministry of Education [NRF-2018R1D1A1B07042999]
  3. Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) - Ministry of Health & Welfare, Republic of Korea [HI18C0331, BCRI19030]
  4. Chonnam National University Hospital Institute for Biomedical Science [BCRI19030]

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In this study based on a large nationally representative sample of Korean adults, we investigated the potential associations of the body mass index (BMI) and waist circumference (WC) with mortality in patients undergoing hemodialysis. We obtained the data of 18,699 participants >20 years of age who were followed up with for 4 years and for whom BMI and WC information were available, using a nationally representative dataset from the Korean National Health Insurance System. Patients were stratified into five levels by their baseline BMI and into six levels by their WC (5-cm increments). A total of 4975 deaths occurred during a median follow-up period of 48.2 months. Participants with a higher BMI had a lower mortality rate than those with a lower BMI. In a fully adjusted Cox regression analysis, being overweight and obese was associated with a significantly lower relative risk of all-cause mortality relative to the reference group. Conversely, the mortality rate was higher among participants with a high WC than among those with a low WC. Participants with the highest WC had a higher risk of mortality, while those with the lowest WC level had a significantly lower risk of mortality. In conclusion, all-cause mortality was positively associated with WC, a measure of abdominal obesity, and inversely associated with BMI, a measure of body volume, in patients undergoing hemodialysis.

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