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Body composition and mortality risk in later life
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
2012 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 41, no 5, 677-681 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: body mass index is used widely to define overweight and obesity. Both high and low body mass indices are associated with increased mortality risk during middle age, but the relationship is less clear in later life. Thus, studies on the relationships between other aspects of body composition and mortality among older subjects are needed.

OBJECTIVE: to investigate associations between different aspects of body composition and mortality in older people.

METHODS: the study population comprised 921 participants aged ≥65 years who underwent dual-energy X-ray (DXA) absorptiometric examination at the Sports Medicine Unit, Umeå University. The main reason for admission was clinical suspicion of osteoporosis. Total, abdominal and gynoid fat masses and lean body mass were measured by DXA absorptiometry at baseline, and the cohort was followed (mean duration, 9.2 years) for mortality events.

RESULTS: during follow-up, 397 participants died. Lean mass was associated negatively with mortality in men and women (P < 0.001). Total fat mass showed a U-shaped association with mortality in men (P < 0.01) and a negative association in women (P < 0.01). A higher ratio of abdominal to gynoid fat mass increased mortality risk in women (P = 0.04), but not in men (P = 0.91).

CONCLUSIONS: lean mass is associated strongly with survival in older subjects. Greater fat mass is protective in older women, whereas very low or very high fat mass increases the risk of death in men. Further research is needed to better understand the mechanisms underlying these associations.

Place, publisher, year, edition, pages
Oxford University Press, 2012. Vol. 41, no 5, 677-681 p.
Keyword [en]
Fat mass, fat distribution, lean mass, mortality, dual energy x-ray absorptiometry, dual energy x-ray absorptiometry (DXA), older people
National Category
Geriatrics
Research subject
Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-49831DOI: 10.1093/ageing/afs087PubMedID: 22820447OAI: oai:DiVA.org:umu-49831DiVA: diva2:457953
Available from: 2011-11-21 Created: 2011-11-21 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Body fat distribution, inflammation and cardiovascular disease
Open this publication in new window or tab >>Body fat distribution, inflammation and cardiovascular disease
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Cardiovascular disease (CVD) is one of the major health issues of our time. The prevalence of CVD is increasing, both in industrialized and in developing countries, and causes suffering and a decreased quality of life for millions of people worldwide. CVD can have multiple etiologies, but the main underlying cause is atherosclerosis, which causes blood clot formation and obstructs vital arteries.

Multiple risk factors of atherosclerosis have been identified, and body fatness is one of the most important ones. 

The main aims of this thesis were to investigate the relation between body fatness and: CVD risk factors (paper I), incident stroke (paper II), and overall mortality (paper III). The results showed that abdominal obesity is strongly associated with both CVD risk factors and stroke incidence (papers I-II). The results also suggested that a substantial part of the association between increased body fat and stroke can be explained by an increase in traditional stroke risk factors associated with increased body fat (paper II). A gynoid fat distribution, with a high share of fat located around the hip, is, on the other hand, associated with lower risk factor levels in both men and women, and with a decreased risk of stroke in women (papers I-II). This illustrates the importance of assessing the overall distribution of body fat rather, than solely focusing on total body fatness.

In elderly women, total body fat was found to be associated with increased survival, while abdominal fat moderately increased mortality risk (paper III). Lean mass (fat-free mass) was strongly associated with increased survival among elderly men and women (paper III).

Erythrocyte sedimentation rate (ESR) is an indicator of inflammation and, possibly, an indicator of atherosclerotic disease. In paper IV, the relationship between ESR in young adulthood and the later risk of myocardial infarction (MI) was studied. Results showed that higher levels of ESR were associated with a higher MI risk, in a dose-responsive manner, and was independent of other well-established risk factors.

In summary, both total and regional fat distribution are associated with CVD risk factors and stroke, but do not seem to correspond to an increase in mortality risk among the elderly. Also, inflammation, detected as an increase in ESR, is associated with long term MI risk in young men. 

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. 95 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1451
Keyword
fat mass, lean mass, fat distribution, stroke, myocardial infarction, cardiovascular disease, cardiovascular risk factors, inflammation, dual energy x-ray absorptiometry, mortality, erythrocyte sedimentation rate
National Category
Family Medicine Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-49833 (URN)978-91-7459-305-1 (ISBN)
Public defence
2011-12-16, Bergasalen, by 27, 90185 Norrlands Universitetssjukhus, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2011-11-25 Created: 2011-11-21 Last updated: 2011-11-25Bibliographically approved

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