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Int J Obes (Lond). 2013 Jun;37(6):790-9. doi: 10.1038/ijo.2012.155.

Prospective cohort study of body mass index and the risk of hospitalisation: findings from 246361 participants in the 45 and Up Study.

Author information

1
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia; Australian Centre for Economic Research on Health, The Australian National University, Canberra, Australian Capital Territory, Australia.

Abstract

OBJECTIVE:

To quantify the risk of hospital admission in relation to fine increments in body mass index (BMI).

DESIGN, SETTING, AND PARTICIPANTS:

Population-based prospective cohort study of 246,361 individuals aged greater than or equal to 45 years, from New South Wales, Australia, recruited from 2006-2009. Self-reported data on BMI and potential confounding/mediating factors were linked to hospital admission and death data.

MAIN OUTCOMES:

Cox-models were used to estimate the relative risk (RR) of incident all-cause and diagnosis-specific hospital admission (excluding same day) in relation to BMI.

RESULTS:

There were 61,583 incident hospitalisations over 479,769 person-years (py) of observation. In men, hospitalisation rates were lowest for BMI 20-<25 kg m(-2) (age-standardised rate: 120/1000 py) and in women for BMI 18.5-<25 kg m(-2) (102/1000 py); above these levels, rates increased steadily with increasing BMI; rates were 203 and 183/1000 py, for men and women with BMI 35-50 kg m(-2), respectively. This pattern was observed regardless of baseline health status, smoking status and physical activity levels. After adjustment, the RRs (95% confidence interval) per 1 kg m(-2) increase in BMI from ≥ 20 kg m(-2) were 1.04(1.03-1.04) for men and 1.04(1.04-1.05) for women aged 45-64; corresponding RRs for ages 65-79 were 1.03(1.02-1.03) and 1.03(1.03-1.04); and for ages ≥ 80 years, 1.01(1.00-1.01) and 1.01(1.01-1.02). Hospitalisation risks were elevated for a large range of diagnoses, including a number of circulatory, digestive, musculoskeletal and respiratory diseases, while being protective for just two-fracture and hernia.

CONCLUSIONS:

Above normal BMI, the RR of hospitalisation increases with even small increases in BMI, less so in the elderly. Even a small downward shift in BMI, among those who are overweight not just those who are obese, could result in a substantial reduction in the risk of hospitalisation.

PMID:
22986682
DOI:
10.1038/ijo.2012.155
[Indexed for MEDLINE]

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