title: Obesity and risk of sepsis: a population-based cohort study.
abstract: OBJECTIVE
  Sepsis, the syndrome of microbial infection complicated by systemic inflammation, is associated with significant morbidity and mortality. To determine if obesity increases risk of sepsis events.
  
  
  METHODS
  Data from the 30,239 subject population-based longitudinal cohort study REasons for Geographic and Racial Differences in Stroke (REGARDS) were used. Using measurements at the start of the study, we defined obesity using body mass index (BMI; <18.5 kg/m(2) = underweight, 18.5-24.9 = normal, 25.0-29.9 = overweight, 30.0-39.9 = obese, ≥40 = morbidly obese) and waist circumference (WC; [male ≤102 cm or female ≤88 cm] = normal, [male >102 cm or female >88 cm] = obese). Over an 8-year observation period, we evaluated the association between obesity and subsequent sepsis events, adjusting for sociodemographic factors, health behaviors, chronic medical conditions, statin use, and high-sensitivity C-reactive protein.
  
  
  RESULTS
  There were 975 incident sepsis events. Compared to those with a BMI of 18.5-24.9, sepsis risk was higher only for BMI ≥ 40 (hazard ratio [HR] 1.57, [1.16-2.14]). Risk of sepsis was associated with increased WC (HR 1.34 [1.14-1.56]). In a model with both BMI and WC, sepsis risk was associated with increased WC (HR 1.47 [1.20-1.79]) but not BMI.
  
  
  CONCLUSIONS
  Obesity is independently associated with future sepsis events. WC is a better predictor of future sepsis risk than BMI.
authors.affiliation: Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, Alabama, USA.
authors.forename: Henry E
authors.initials: HE
authors.lastname: Wang
authors.forename: Russell
authors.initials: R
authors.lastname: Griffin
authors.forename: Suzanne
authors.initials: S
authors.lastname: Judd
authors.forename: Nathan I
authors.initials: NI
authors.lastname: Shapiro
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
mesh_terms: D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000473:pathology*; D012307:Risk Factors; D018805:Sepsis / Q000150:complications / Q000453:epidemiology*; D012959:Socioeconomic Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D002097:C-Reactive Protein