Impact of body mass index and metabolically unhealthy status on mortality in the Japanese general population: The JMS cohort study

Autoři: Toshihide Izumida aff001;  Yosikazu Nakamura aff002;  Shizukiyo Ishikawa aff002
Působiště autorů: Kamitaira Clinic, Nanto, Toyama, Japan aff001;  Division of Public Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan aff002
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224802


This study aimed to investigate the associations of body mass index (BMI) and metabolically unhealthy weight with all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality as well as the effect of age on the associations. This prospective study enrolled Japanese individuals in the general population. Participants were divided into eight phenotypes according to the BMI classification and metabolic status. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a Cox regression hazard model. In total, 10,824 individuals with a mean age of 55.3 years were evaluated. During a mean follow-up of 18.4 years (198,776 person-years), 2,274 participants died. Among the metabolically unhealthy, the association between BMI and mortality was J-shaped after adjustment for various confounders (multivariable HR [95% CI] for all-cause mortality: underweight, 2.0 [1.5–2.7]; obesity 2.8 [2.1–3.6]). The association remained the same in metabolically unhealthy participants aged <65 years and ≥65 years. The results were compatible in the analyses restricted to subjects who never smoked. Regardless of age, metabolically unhealthy underweight (MUHU) have approximately a 3-fold higher risk of CVD mortality, compared with metabolically healthy normal weight. Not only metabolically unhealthy obesity, but also MUHU was strongly associated with an increased risk of mortality. More attention should be given to the health issues of metabolically unhealthy participants without obesity, particularly those with MUHU.

Klíčová slova:

Body Mass Index – Cardiovascular diseases – Glucose metabolism – Glucose tolerance tests – Cholesterol – Obesity – Physical activity


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Článek vyšel v časopise


2019 Číslo 11