Relation of body fat mass and fat-free mass to total mortality: results from 7 prospective cohort studies
Fat mass and fat-free mass may play independent roles in mortality risk but available studies on body composition have yielded inconsistent results. The aim was to determine the relations of body fat mass and fat-free mass to risk of mortality. In pooled data from 7 prospective cohorts encompassing...
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| Vydáno v: | The American journal of clinical nutrition Ročník 113; číslo 3; s. 639 |
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| Médium: | Journal Article |
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01.03.2021
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| ISSN: | 1938-3207, 1938-3207 |
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| Abstract | Fat mass and fat-free mass may play independent roles in mortality risk but available studies on body composition have yielded inconsistent results.
The aim was to determine the relations of body fat mass and fat-free mass to risk of mortality.
In pooled data from 7 prospective cohorts encompassing 16,155 individuals aged 20 to 93 y (median, 44 y), we used Cox regression and restricted cubic splines to estimate HRs and 95% CIs for the relation of body composition, measured by bioelectrical impedance analysis, to total mortality. We adjusted for age, study, sex, ethnicity, history of diabetes mellitus, education, smoking, physical activity, and alcohol consumption.
During a median follow-up period of 14 y (range, 3-21 y), 1347 deaths were identified. After mutual adjustment for fat mass and fat-free mass, fat mass showed a J-shaped association with mortality (overall P value < 0.001; P for nonlinearity = 0.003). Using a fat mass index of 7.3 kg/m2 as the reference, a high fat mass index of 13.0 kg/m2 was associated with an HR of 1.56 (95% CI: 1.30, 1.87). In contrast, fat-free mass showed an inverse association with mortality (overall P value < 0.001; P for nonlinearity = 0.001). Compared with a low fat-free mass index of 16.1 kg/m2, a high fat-free mass of 21.9 kg/m2 was associated with an HR of 0.70 (95% CI: 0.56, 0.87).
Fat mass and fat-free mass show opposing associations with mortality. Excess fat mass is related to increased mortality risk, whereas fat-free mass protects against risk of mortality. These findings suggest that body composition provides important prognostic information on an individual's mortality risk not provided by traditional proxies of adiposity such as BMI. |
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| AbstractList | Fat mass and fat-free mass may play independent roles in mortality risk but available studies on body composition have yielded inconsistent results.BACKGROUNDFat mass and fat-free mass may play independent roles in mortality risk but available studies on body composition have yielded inconsistent results.The aim was to determine the relations of body fat mass and fat-free mass to risk of mortality.OBJECTIVEThe aim was to determine the relations of body fat mass and fat-free mass to risk of mortality.In pooled data from 7 prospective cohorts encompassing 16,155 individuals aged 20 to 93 y (median, 44 y), we used Cox regression and restricted cubic splines to estimate HRs and 95% CIs for the relation of body composition, measured by bioelectrical impedance analysis, to total mortality. We adjusted for age, study, sex, ethnicity, history of diabetes mellitus, education, smoking, physical activity, and alcohol consumption.METHODSIn pooled data from 7 prospective cohorts encompassing 16,155 individuals aged 20 to 93 y (median, 44 y), we used Cox regression and restricted cubic splines to estimate HRs and 95% CIs for the relation of body composition, measured by bioelectrical impedance analysis, to total mortality. We adjusted for age, study, sex, ethnicity, history of diabetes mellitus, education, smoking, physical activity, and alcohol consumption.During a median follow-up period of 14 y (range, 3-21 y), 1347 deaths were identified. After mutual adjustment for fat mass and fat-free mass, fat mass showed a J-shaped association with mortality (overall P value < 0.001; P for nonlinearity = 0.003). Using a fat mass index of 7.3 kg/m2 as the reference, a high fat mass index of 13.0 kg/m2 was associated with an HR of 1.56 (95% CI: 1.30, 1.87). In contrast, fat-free mass showed an inverse association with mortality (overall P value < 0.001; P for nonlinearity = 0.001). Compared with a low fat-free mass index of 16.1 kg/m2, a high fat-free mass of 21.9 kg/m2 was associated with an HR of 0.70 (95% CI: 0.56, 0.87).RESULTSDuring a median follow-up period of 14 y (range, 3-21 y), 1347 deaths were identified. After mutual adjustment for fat mass and fat-free mass, fat mass showed a J-shaped association with mortality (overall P value < 0.001; P for nonlinearity = 0.003). Using a fat mass index of 7.3 kg/m2 as the reference, a high fat mass index of 13.0 kg/m2 was associated with an HR of 1.56 (95% CI: 1.30, 1.87). In contrast, fat-free mass showed an inverse association with mortality (overall P value < 0.001; P for nonlinearity = 0.001). Compared with a low fat-free mass index of 16.1 kg/m2, a high fat-free mass of 21.9 kg/m2 was associated with an HR of 0.70 (95% CI: 0.56, 0.87).Fat mass and fat-free mass show opposing associations with mortality. Excess fat mass is related to increased mortality risk, whereas fat-free mass protects against risk of mortality. These findings suggest that body composition provides important prognostic information on an individual's mortality risk not provided by traditional proxies of adiposity such as BMI.CONCLUSIONSFat mass and fat-free mass show opposing associations with mortality. Excess fat mass is related to increased mortality risk, whereas fat-free mass protects against risk of mortality. These findings suggest that body composition provides important prognostic information on an individual's mortality risk not provided by traditional proxies of adiposity such as BMI. Fat mass and fat-free mass may play independent roles in mortality risk but available studies on body composition have yielded inconsistent results. The aim was to determine the relations of body fat mass and fat-free mass to risk of mortality. In pooled data from 7 prospective cohorts encompassing 16,155 individuals aged 20 to 93 y (median, 44 y), we used Cox regression and restricted cubic splines to estimate HRs and 95% CIs for the relation of body composition, measured by bioelectrical impedance analysis, to total mortality. We adjusted for age, study, sex, ethnicity, history of diabetes mellitus, education, smoking, physical activity, and alcohol consumption. During a median follow-up period of 14 y (range, 3-21 y), 1347 deaths were identified. After mutual adjustment for fat mass and fat-free mass, fat mass showed a J-shaped association with mortality (overall P value < 0.001; P for nonlinearity = 0.003). Using a fat mass index of 7.3 kg/m2 as the reference, a high fat mass index of 13.0 kg/m2 was associated with an HR of 1.56 (95% CI: 1.30, 1.87). In contrast, fat-free mass showed an inverse association with mortality (overall P value < 0.001; P for nonlinearity = 0.001). Compared with a low fat-free mass index of 16.1 kg/m2, a high fat-free mass of 21.9 kg/m2 was associated with an HR of 0.70 (95% CI: 0.56, 0.87). Fat mass and fat-free mass show opposing associations with mortality. Excess fat mass is related to increased mortality risk, whereas fat-free mass protects against risk of mortality. These findings suggest that body composition provides important prognostic information on an individual's mortality risk not provided by traditional proxies of adiposity such as BMI. |
| Author | Fischer, Beate Felix, Stephan B Völzke, Henry Sedlmeier, Anja M Dörr, Marcus Peters, Annette Thorand, Barbara Weber, Andrea Ittermann, Till Baumeister, Sebastian E Leitzmann, Michael F |
| Author_xml | – sequence: 1 givenname: Anja M surname: Sedlmeier fullname: Sedlmeier, Anja M organization: Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany – sequence: 2 givenname: Sebastian E surname: Baumeister fullname: Baumeister, Sebastian E organization: Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany – sequence: 3 givenname: Andrea surname: Weber fullname: Weber, Andrea organization: Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany – sequence: 4 givenname: Beate surname: Fischer fullname: Fischer, Beate organization: Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany – sequence: 5 givenname: Barbara surname: Thorand fullname: Thorand, Barbara organization: German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany – sequence: 6 givenname: Till surname: Ittermann fullname: Ittermann, Till organization: Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany – sequence: 7 givenname: Marcus surname: Dörr fullname: Dörr, Marcus organization: DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany – sequence: 8 givenname: Stephan B surname: Felix fullname: Felix, Stephan B organization: DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany – sequence: 9 givenname: Henry surname: Völzke fullname: Völzke, Henry organization: DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany – sequence: 10 givenname: Annette surname: Peters fullname: Peters, Annette organization: German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany – sequence: 11 givenname: Michael F surname: Leitzmann fullname: Leitzmann, Michael F organization: Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany |
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| Keywords | mortality fat-free mass body composition obesity fat mass |
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| Title | Relation of body fat mass and fat-free mass to total mortality: results from 7 prospective cohort studies |
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