title: Effects of body mass index and weight change on mortality in older men with impaired glucose regulation.
abstract: To assess the effect of baseline body mass index (BMI) status and weight change on mortality in older men with impaired glucose regulation (IGR).
  
  
  
  Eight hundred eighty-five men with IGR aged 60 to 90 were included. Baseline and endpoint weight were measured. All-cause and cardiovascular mortality were observed during a median follow-up period of 10years. Multivariate Cox regressions were used to estimate associations between BMI, weight change and mortality.
  
  
  
  Relative to normal weight, overweight was associated with lower all-cause mortality (hazard ratios, HRs [95% confidence interval, 95% CI]: 0.57 [0.41, 0.78]) and cardiovascular mortality (0.52 [0.29, 0.93]), whereas obesity did not significantly decrease or increase the mortality risk. Furthermore, compared to weight stability, all types of weight change led to increased mortality risk, except small weight gain. Specifically, after adjustment for covariates and the initial weight, the HRs (95% CI) of large weight loss were 1.64 (1.15, 2.34) for all-cause mortality and 1.85 (1.10, 3.14) for cardiovascular mortality, and the HRs (95% CI) of large weight gain were 1.55 (1.01, 2.40) for all-cause mortality and 2.11 (1.04, 4.30) for cardiovascular mortality. Similar associations were observed when weight change was redefined in sensitivity analyses.
  
  
  
  Both BMI at baseline and weight change have independent U-shaped associations with all-cause and cardiovascular mortality among older men with IGR. The present study suggests that older men with IGR may ensure their best survival by being overweight at baseline or by maintaining their weight regardless of their baseline weight status.
authors.affiliation: Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Zhi-Bing
authors.initials: ZB
authors.lastname: Li
authors.affiliation: Center of Biomedical Analysis, Tsinghua University, Beijing, China.
authors.forename: Man-Liu
authors.initials: ML
authors.lastname: Wang
authors.affiliation: Healthcare Department, Agency for Offices Administration of PLA, Beijing, China.
authors.forename: Sheng-Yong
authors.initials: SY
authors.lastname: Dong
authors.affiliation: Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Ban-Ruo
authors.initials: BR
authors.lastname: Sun
authors.affiliation: Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Xin-Yu
authors.initials: XY
authors.lastname: Miao
authors.affiliation: Department of Health Care, Chinese PLA General Hospital, Beijing, China.
authors.forename: Fu-Sheng
authors.initials: FS
authors.lastname: Fang
authors.affiliation: Healthcare Department, Agency for Offices Administration of PLA, Beijing, China.
authors.forename: Zheng-Xue
authors.initials: ZX
authors.lastname: Dai
authors.affiliation: Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Chun-Lin
authors.initials: CL
authors.lastname: Li
authors.affiliation: Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China. Electronic address: tianhui@medmail.com.cn.
authors.forename: Hui
authors.initials: H
authors.lastname: Tian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D001835:Body Weight; D000068959:Body Weight Maintenance; D002318:Cardiovascular Diseases / Q000401:mortality*; D002681:China; D018149:Glucose Intolerance / Q000503:physiopathology*; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D009765:Obesity; D050177:Overweight; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Body mass index; Impaired glucose regulation; Mortality; Older men; Weight change