Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults

Background<br> Sepsis represents a major worldwide healthcare burden. However, how body-mass index (BMI) is related to the long-term risk of sepsis-related mortality in low- and middle-income countries remains uncertain. <br><br> Methods<br> We examined the associations of se...

Full description

Bibliographic Details
Main Authors: Weng, L, Fan, J, Yu, C, Guo, Y, Bian, Z, Wei, Y, Yang, L, Chen, Y, Du, H, Chang, L, Gong, W, Chen, J, Chen, Z, Du, B, Lv, J, Li, L
Format: Journal article
Language:English
Published: BioMed Central 2020
_version_ 1797050889394978816
author Weng, L
Fan, J
Yu, C
Guo, Y
Bian, Z
Wei, Y
Yang, L
Chen, Y
Du, H
Chang, L
Gong, W
Chen, J
Chen, Z
Du, B
Lv, J
Li, L
author_facet Weng, L
Fan, J
Yu, C
Guo, Y
Bian, Z
Wei, Y
Yang, L
Chen, Y
Du, H
Chang, L
Gong, W
Chen, J
Chen, Z
Du, B
Lv, J
Li, L
author_sort Weng, L
collection OXFORD
description Background<br> Sepsis represents a major worldwide healthcare burden. However, how body-mass index (BMI) is related to the long-term risk of sepsis-related mortality in low- and middle-income countries remains uncertain. <br><br> Methods<br> We examined the associations of sepsis-related mortality with both baseline BMI and waist circumference (WC) using data from China Kadoorie Biobank, a prospective cohort recruited during 2004–2008 and followed up to December 2016. After excluding participants with chronic obstructive pulmonary disease, tuberculosis, cancer, heart disease, and stroke, and omitting the first 3 years of follow-up, 440,763 participants remained for analysis. <br><br> Results<br> During a median follow-up of 10.0 years, 1957 sepsis-related deaths (3,134,870 person-years) were included for analysis. Compared with reference BMI of 22.5 to < 25.0 kg/m2, the multivariable-adjusted hazard ratios (HRs) for sepsis-related mortality were 2.42 (95% CIs 2.07–2.84) for BMI of < 18.5, 1.59 (1.36–1.85) for 18.5 to < 20.0, 1.21 (1.06–1.38) for 20.0 to < 22.5, 0.97 (0.83–1.13) for 25.0 to < 27.5, 0.98 (0.80–1.21) for 27.5 to < 30.0, and 1.22 (0.93–1.60) for ≥ 30.0 kg/m2. Further adjustment for WC led to slightly augmentation of the effect size for the lower BMI groups and null association in the obese group. In the association analysis between WC and sepsis-related mortality, compared with the middle quintile group, only the highest quintile group showed an increased risk of sepsis-related mortality after adjusted for BMI (HR = 1.54; 95% CI 1.28–1.84). <br><br> Conclusions<br> Underweight, lower normal weight, and abdominal obesity are associated with increased future risk of sepsis-related mortality over 10 years in the Chinese population. The double burden of underweight and obesity indicates a heavy sepsis burden faced by low- and middle-income countries.
first_indexed 2024-03-06T18:11:54Z
format Journal article
id oxford-uuid:0350ff16-e02b-4e6a-ada2-3847dd2ecf75
institution University of Oxford
language English
last_indexed 2024-03-06T18:11:54Z
publishDate 2020
publisher BioMed Central
record_format dspace
spelling oxford-uuid:0350ff16-e02b-4e6a-ada2-3847dd2ecf752022-03-26T08:45:22ZBody-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adultsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0350ff16-e02b-4e6a-ada2-3847dd2ecf75EnglishSymplectic ElementsBioMed Central2020Weng, LFan, JYu, CGuo, YBian, ZWei, YYang, LChen, YDu, HChang, LGong, WChen, JChen, ZDu, BLv, JLi, LBackground<br> Sepsis represents a major worldwide healthcare burden. However, how body-mass index (BMI) is related to the long-term risk of sepsis-related mortality in low- and middle-income countries remains uncertain. <br><br> Methods<br> We examined the associations of sepsis-related mortality with both baseline BMI and waist circumference (WC) using data from China Kadoorie Biobank, a prospective cohort recruited during 2004–2008 and followed up to December 2016. After excluding participants with chronic obstructive pulmonary disease, tuberculosis, cancer, heart disease, and stroke, and omitting the first 3 years of follow-up, 440,763 participants remained for analysis. <br><br> Results<br> During a median follow-up of 10.0 years, 1957 sepsis-related deaths (3,134,870 person-years) were included for analysis. Compared with reference BMI of 22.5 to < 25.0 kg/m2, the multivariable-adjusted hazard ratios (HRs) for sepsis-related mortality were 2.42 (95% CIs 2.07–2.84) for BMI of < 18.5, 1.59 (1.36–1.85) for 18.5 to < 20.0, 1.21 (1.06–1.38) for 20.0 to < 22.5, 0.97 (0.83–1.13) for 25.0 to < 27.5, 0.98 (0.80–1.21) for 27.5 to < 30.0, and 1.22 (0.93–1.60) for ≥ 30.0 kg/m2. Further adjustment for WC led to slightly augmentation of the effect size for the lower BMI groups and null association in the obese group. In the association analysis between WC and sepsis-related mortality, compared with the middle quintile group, only the highest quintile group showed an increased risk of sepsis-related mortality after adjusted for BMI (HR = 1.54; 95% CI 1.28–1.84). <br><br> Conclusions<br> Underweight, lower normal weight, and abdominal obesity are associated with increased future risk of sepsis-related mortality over 10 years in the Chinese population. The double burden of underweight and obesity indicates a heavy sepsis burden faced by low- and middle-income countries.
spellingShingle Weng, L
Fan, J
Yu, C
Guo, Y
Bian, Z
Wei, Y
Yang, L
Chen, Y
Du, H
Chang, L
Gong, W
Chen, J
Chen, Z
Du, B
Lv, J
Li, L
Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults
title Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults
title_full Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults
title_fullStr Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults
title_full_unstemmed Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults
title_short Body-mass index and long-term risk of sepsis-related mortality: a population-based cohort study of 0.5 million Chinese adults
title_sort body mass index and long term risk of sepsis related mortality a population based cohort study of 0 5 million chinese adults
work_keys_str_mv AT wengl bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT fanj bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT yuc bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT guoy bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT bianz bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT weiy bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT yangl bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT cheny bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT duh bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT changl bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT gongw bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT chenj bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT chenz bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT dub bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT lvj bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults
AT lil bodymassindexandlongtermriskofsepsisrelatedmortalityapopulationbasedcohortstudyof05millionchineseadults