4.7 Review

The obesity paradox: Understanding the effect of obesity on mortality among individuals with cardiovascular disease

期刊

PREVENTIVE MEDICINE
卷 62, 期 -, 页码 96-102

出版社

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ypmed.2014.02.003

关键词

Obesity paradox; Cardiovascular disease; Selection bias; Epidemiology

资金

  1. Fonds de la Recherche en Sante du Quebec
  2. Society for Epidemiologic Research Travel Award
  3. CIHR Institute of Circulatory and Respiratory Health Skills Development Award
  4. Canada Research Chair program

向作者/读者索取更多资源

Objective. To discuss possible explanations for the obesity paradox and explore whether the paradox can be attributed to a form of selection bias known as collider stratification bias. Method. The paper is divided into three parts. First, possible explanations for the obesity paradox are reviewed. Second, a simulated example is provided to describe collider stratification bias and how it could generate the obesity paradox. Finally, an example is provided using data from 17,636 participants in the US National and Nutrition Examination Survey (NHANES III). Generalized linear models were fit to assess the effect of obesity on mortality both in the general population and among individuals with diagnosed cardiovascular disease (CVD). Additionally, results from a bias analysis are presented. Results. In the general population, the adjusted risk ratio relating obesity and all-cause mortality was 1.24 (95% CI 1.11, 1.39). Adjusted risk ratios comparing obese and non-obese among individuals with and without CVD were 0.79 (95% CI 0.68, 0.91) and 130 (95% CI = 1.12, 1.50), indicating that obesity has a protective association among individuals with CVD. Conclusion. Results demonstrate that collider stratification bias is one plausible explanation for the obesity paradox. After conditioning on CVD-status in the design or analysis, obesity can appear protective among individuals with CVD. (C) 2014 Elsevier Inc. All rights reserved.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.7
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

Article Rheumatology

Global, regional, and national burden of other musculoskeletal disorders 1990-2017: results from the Global Burden of Disease Study 2017

Saeid Safiri, Ali Asghar Kolahi, Marita Cross, Kristin Carson-Chahhoud, Amir Almasi-Hashiani, Jay Kaufman, Mohammad Ali Mansournia, Mahdi Sepidarkish, Ahad Ashrafi-Asgarabad, Damian Hoy, Gary Collins, Anthony D. Woolf, Lyn March, Emma Smith

Summary: Globally, the point prevalence and death rates of other musculoskeletal disorders increased in 2017, with higher estimates among females and increasing prevalence with age. The data suggests a need for specific disease information within this category for future global burden of disease estimates to inform resource allocation and interventions.

RHEUMATOLOGY (2021)

Letter Endocrinology & Metabolism

Selection bias can creep into unselected cohorts and produce counterintuitive findings

Steven D. Stovitz, Hailey R. Banack, Jay S. Kaufman

INTERNATIONAL JOURNAL OF OBESITY (2021)

Article Medical Laboratory Technology

Use of Racial and Ethnic Categories in Medical Testing and Diagnosis: Primum Non Nocere

Jay S. Kaufman, Joanna Merckx, Richard S. Cooper

Summary: Medicine has evolved from a mystical healing art to a mature science of human health through a rigorous process of quantification, experimentation, and evaluation. Folkloric traditions, such as race- and ethnic-specific medicine will fade from use as we become increasingly critical of outdated and irrational clinical practices and replace these with personalized, evidenced-based tests, algorithms, and procedures that privilege patients' individual humanity over obsolete and misleading labels.

CLINICAL CHEMISTRY (2021)

Letter Endocrinology & Metabolism

Selection bias: The unseen enemy is always the most fearsome

Steven D. Stovitz, Hailey R. Banack, Jay S. Kaufman

INTERNATIONAL JOURNAL OF OBESITY (2022)

Article Endocrinology & Metabolism

Global, regional, and national burden of cancers attributable to excess body weight in 204 countries and territories, 1990 to 2019

Saeid Safiri, Nahid Karamzad, Jay S. Kaufman, Seyed Aria Nejadghaderi, Nicola Luigi Bragazzi, Mark J. M. Sullman, Amir Almasi-Hashiani, Mohammad Ali Mansournia, Gary S. Collins, Ali-Asghar Kolahi, Ahmedin Jemal

Summary: This study provides a comprehensive report on the levels and trends of 13 cancers attributable to excess body weight (EBW) from 1990 to 2019 in 204 countries and territories. The findings suggest that the burden of EBW-attributable cancers has been increasing globally over the past three decades. There are significant variations between countries and regions, highlighting the need for tailored preventive interventions.

OBESITY (2022)

Article Medicine, General & Internal

Changes in exposure to ambient fine particulate matter after relocating and long term survival in Canada: quasi-experimental study

Hong Chen, Jay S. Kaufman, Toyib Olaniyan, Lauren Pinault, Michael Tjepkema, Li Chen, Aaron van Donkelaar, Randall Martin, Perry Hystad, Chen Chen, Megan Kirby-McGregor, Li Bai, Richard Burnett, Tarik Benmarhnia

Summary: The study investigated the association between changes in long-term residential exposure to ambient fine particulate matter (PM2.5) and premature mortality in Canada. The results showed that decreases in PM2.5 were associated with lower mortality, while increases in PM2.5 were associated with higher mortality, particularly in relation to deaths from cardiometabolic causes. Overall, the findings support the continuous improvement of air quality.

BMJ-BRITISH MEDICAL JOURNAL (2021)

Article Oncology

Global, regional, and national cancer deaths and disability-adjusted life-years (DALYs) attributable to alcohol consumption in 204 countries and territories, 1990-2019

Saeid Safiri, Seyed Aria Nejadghaderi, Nahid Karamzad, Kristin Carson-Chahhoud, Nicola Luigi Bragazzi, Mark J. M. Sullman, Amir Almasi-Hashiani, Mohammad Ali Mansournia, Gary S. Collins, Jay S. Kaufman, Ali-Asghar Kolahi

Summary: Alcohol consumption is associated with various cancers, and it places a higher burden on males, the elderly, and developed regions. Despite recent decreases, significant numbers of cancer deaths and DALYs are still attributable to alcohol consumption.

CANCER (2022)

Article Oncology

Global, regional, and national burden of cancers attributable to tobacco smoking in 204 countries and territories, 1990-2019

Saeid Safiri, Seyed Aria Nejadghaderi, Morteza Abdollahi, Kristin Carson-Chahhoud, Jay S. Kaufman, Nicola Luigi Bragazzi, Maziar Moradi-Lakeh, Mohammad Ali Mansournia, Mark J. M. Sullman, Amir Almasi-Hashiani, Ali Taghizadieh, Gary S. Collins, Ali-Asghar Kolahi

Summary: This study reveals that the burden of cancer caused by smoking is still significant, with variations across countries and regions. There is a need for increased utilization of evidence-based smoking cessation support to reduce the burden of smoking-related diseases.

CANCER MEDICINE (2022)

Article Environmental Sciences

Inequities in ambient fine particulate matter: A spatiotemporal analysis in Canadian communities

Megan Kirby-McGregor, Chen Chen, Hong Chen, Tarik Benmarhnia, Jay S. Kaufman

Summary: This study found that ambient PM2.5 concentrations in Canada decreased from 2001 to 2016, but disadvantaged communities with lower income, education, and higher proportions of aboriginal population did not benefit equally. This highlights the need to address environmental injustice in air pollution policies.

SCIENCE OF THE TOTAL ENVIRONMENT (2023)

Article Multidisciplinary Sciences

Impact of lowering fine particulate matter from major emission sources on mortality in Canada: A nationwide causal analysis

Hong Chen, Matthew Quick, Jay S. Kaufman, Chen Chen, Jeffrey C. Kwong, Aaron van Donkelaar, Jun Meng, Randall V. Martin, JinHee Kim, Eric Lavigne, Li Bai, Yi Li, Michael Tjepkema, Tarik Benmarhnia, Richard T. Burnett

Summary: Reducing anthropogenic contributions to PM2.5 could lead to significant health benefits, even in a country like Canada where PM2.5 levels are already low. A 10% annual reduction in PM2.5 contributions from transportation and power generation sources could prevent a substantial number of deaths per million by 2016.

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA (2022)

Letter Pediatrics

Investigating changes in incidence and severity of pediatric appendicitis during the COVID-19 pandemic in Canada: an interrupted time series analysis

Francesca del Giorgio, Merieme Habti, Joanna Merckx, Jay S. Kaufman, Jocelyn Gravel, Nelson Piche, Esli Osmanlliu, Olivier Drouin

WORLD JOURNAL OF PEDIATRICS (2023)

Article Cardiac & Cardiovascular Systems

Chronic Exposure to Fine Particulate Matter Increases Mortality Through Pathways of Metabolic and Cardiovascular Disease: Insights From a Large Mediation Analysis

Li Bai, Tarik Benmarhnia, Chen Chen, Jeffrey C. Kwong, Richard T. Burnett, Aaron van Donkelaar, Randall Martin, JinHee Kim, Jay S. Kaufman, Hong Chen

Summary: This study investigates the mediation effect of diabetes and cardiovascular diseases on the relationship between long-term exposure to PM2.5 and mortality. The results suggest that a significant portion of the effect of PM2.5 on deaths can be attributed to its impact on diabetes and cardiovascular diseases, emphasizing the importance of PM2.5 on cardiovascular health deterioration.

JOURNAL OF THE AMERICAN HEART ASSOCIATION (2022)

Article Psychology, Clinical

A Brief Primer on Conducting Regression-Based Causal Mediation Analysis

Yi Li, Kazuki Yoshida, Jay S. Kaufman, Maya B. Mathur

Summary: This article provides an overview of regression-based causal mediation analysis in the field of traumatic stress and offers guidance on conducting mediation analysis using the R package regmedint. The authors discuss the causal interpretations of the estimated quantities in causal mediation analysis, including total, direct, and indirect effects, especially when there is an interaction between exposure and mediator. They also discuss the necessary assumptions and suitable study designs for valid estimation of these causal quantities, as well as the differences between causal mediation analysis and traditional methods of mediation. By using data from a published longitudinal study, the authors illustrate how to conduct and interpret mediation analysis using regmedint and compare the results to those obtained using traditional methods, highlighting the importance of accounting for exposure-mediator interaction.

PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY (2023)

Article Public, Environmental & Occupational Health

Uncovering the impact of COVID-19 on the place of death of cancer patients in South America

Doris Duran, Renzo Calderon Anyosa, Belinda Nicolau, Jay S. Kaufman

Summary: The COVID-19 pandemic has had a significant impact on cancer mortality rates and place of death in Brazil, Chile, and Peru. The implementation of lockdown measures resulted in a decrease in overall cancer mortality rates and an increase in at-home deaths, with a corresponding decrease in hospital deaths observed only in Chile.

CADERNOS DE SAUDE PUBLICA (2023)

Article Public Administration

Balancing work and care: the effect of paid adult medical leave policies on employment in Europe

Deepa Jahagirdar, Michelle Dimitris, Erin Strumpf, Jay S. Kaufman, Sam Harper, Jody Heymann, Efe Atabay, Ilona Vincent, Arijit Nandi

Summary: The increasing caregiving needs for family members are creating pressure on prime-age workers. This, combined with the ageing population, means more of the workforce may need to consider caring needs. Informal caregivers provide care without payment and usually have a close relationship with the recipient, making them a preferred option in meeting support needs.

JOURNAL OF SOCIAL POLICY (2021)

暂无数据