학술논문
Change in Body Mass Index and Cardiovascular Outcomes in Patients With Cancer.
Document Type
Academic Journal
Author
Ueno K; Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan; Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.; Kaneko H; Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan; Department of Advanced Cardiology, University of Tokyo, Tokyo, Japan. Electronic address: hidehikaneko-circ@umin.ac.jp.; Suzuki Y; Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan.; Okada A; Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.; Fujiu K; Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan; Department of Advanced Cardiology, University of Tokyo, Tokyo, Japan.; Jo T; Department of Health Services Research, University of Tokyo, Tokyo, Japan.; Takeda N; Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan.; Kamiya K; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.; Ako J; Department of Cardiovascular Medicine, School of Medicine, Kitasato University, Kanagawa, Japan.; Morita H; Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan.; Node K; Department of Cardiovascular Medicine, Saga University, Saga, Japan.; Yasunaga H; Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan.; Komuro I; Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan.
Source
Publisher: [Oxford, England] Country of Publication: England NLM ID: 0405543 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1942-5546 (Electronic) Linking ISSN: 00256196 NLM ISO Abbreviation: Mayo Clin Proc Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: To investigate the association between body mass index (BMI) changes and the risk of cardiovascular disease (CVD) in patients with cancer.
Patients and Methods: This retrospective observational study used data from the JMDC Claims Database obtained between January 2005, and April 2021. We included 52,344 individuals (median [IQR] age, 53 years [46 to 60 years]; 23,584 [45.1%] men) with cancer and no prior CVD. Patients were classified into 3 groups based on the percentage change in BMI from the initial health checkup to the checkup 1 year later: -5.0% or less (BMI loss), -5.0% to 5.0% (stable BMI), and 5.0% or more (BMI gain). The primary end point was composite CVD events including heart failure, atrial fibrillation, ischemic heart disease, and stroke.
Results: During a median follow-up period of 763 days (IQR, 369 to 1274 days), 3124 composite CVD events were observed. Compared with stable BMI, the hazard ratios (HRs) of BMI loss and gain for CVD events were 1.16 (95% CI, 1.00 to 1.34) and 1.10 (95% CI, 0.96 to 1.25), respectively. A U-shaped association was observed between the BMI changes and CVD events, particularly for nonatherosclerotic CVD outcomes including heart failure and atrial fibrillation. Compared with stable BMI, both BMI loss and gain increased the risk of heart failure (HR, 1.30; 95% CI, 1.08 to 1.57 and HR, 1.22; 95% CI, 1.02 to 1.47, respectively) and atrial fibrillation (HR, 1.70; 95% CI, 1.18 to 2.45 and HR, 1.55; 95% CI, 1.07 to 2.24, respectively).
Conclusion: Cancer survivors with BMI loss and gain were at greater risk of CVD. Body mass index loss is associated with a higher risk of CVD.
(Copyright © 2024 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)
Patients and Methods: This retrospective observational study used data from the JMDC Claims Database obtained between January 2005, and April 2021. We included 52,344 individuals (median [IQR] age, 53 years [46 to 60 years]; 23,584 [45.1%] men) with cancer and no prior CVD. Patients were classified into 3 groups based on the percentage change in BMI from the initial health checkup to the checkup 1 year later: -5.0% or less (BMI loss), -5.0% to 5.0% (stable BMI), and 5.0% or more (BMI gain). The primary end point was composite CVD events including heart failure, atrial fibrillation, ischemic heart disease, and stroke.
Results: During a median follow-up period of 763 days (IQR, 369 to 1274 days), 3124 composite CVD events were observed. Compared with stable BMI, the hazard ratios (HRs) of BMI loss and gain for CVD events were 1.16 (95% CI, 1.00 to 1.34) and 1.10 (95% CI, 0.96 to 1.25), respectively. A U-shaped association was observed between the BMI changes and CVD events, particularly for nonatherosclerotic CVD outcomes including heart failure and atrial fibrillation. Compared with stable BMI, both BMI loss and gain increased the risk of heart failure (HR, 1.30; 95% CI, 1.08 to 1.57 and HR, 1.22; 95% CI, 1.02 to 1.47, respectively) and atrial fibrillation (HR, 1.70; 95% CI, 1.18 to 2.45 and HR, 1.55; 95% CI, 1.07 to 2.24, respectively).
Conclusion: Cancer survivors with BMI loss and gain were at greater risk of CVD. Body mass index loss is associated with a higher risk of CVD.
(Copyright © 2024 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)