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J Gerontol A Biol Sci Med Sci. 2014 Sep;69(9):1162-9. doi: 10.1093/gerona/glu035. Epub 2014 Apr 2.

Obesity and 10-year mortality in very old African Americans and Yoruba-Nigerians: exploring the obesity paradox.

Author information

1
daniclar@iupui.edu.
2
Department of Biostatistics, Indiana University School of Medicine, Indianapolis.
3
Department of Psychiatry and.
4
Department of Medicine, College of Medicine, University of Ibadan, Nigeria.
5
Department of Medicine, Indiana University Center for Aging Research, Indianapolis. Department of Medicine, Regenstrief Institute, Inc., Indianapolis, Indiana. Department of Psychiatry, Indiana University School of Medicine, Indianapolis.

Abstract

BACKGROUND:

To compare the effect of obesity and related risk factors on 10-year mortality in two cohorts of older adults of African descent; one from the United States and one from Nigeria.

METHODS:

Study participants were community residents aged 70 or older of African descent living in Indianapolis, Indiana (N = 1,269) or Ibadan, Nigeria (1,197). We compared survival curves between the two cohorts by obesity class and estimated the effect of obesity class on mortality in Cox proportional hazards models controlling for age, gender, alcohol use, and smoking history, and the cardiometabolic biomarkers blood pressure, triglycerides, high-density lipoprotein, low-density lipoprotein, and C-reactive protein.

RESULTS:

We found that underweight was associated with an increased risk of death in both the Yoruba (hazards ratio = 1.35, 95% confidence interval: 1.12-1.63) and African American samples (hazards ratio = 2.49, 95% confidence interval: 1.40-4.43) compared with those with normal weight. The overweight and obese participants in both cohorts experienced survival similar to the normal weight participants. Controlling for cardiometabolic biomarkers had little effect on the obesity-specific hazard ratios in either cohort.

CONCLUSIONS:

Despite significant differences across these two cohorts in terms of obesity and biomarker levels, overall 10-year survival and obesity class-specific survival were remarkably similar.

KEYWORDS:

African; Biomarkers.; Mortality; Obesity; Older adults

PMID:
24694355
PMCID:
PMC4202260
DOI:
10.1093/gerona/glu035
[Indexed for MEDLINE]
Free PMC Article

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