Table 2. Hazard ratios (95% confidence intervals) of broadly defined cardiometabolic risks across BMI categories at accession among 731,014 US Army entrants, 2001–2011.
| BMI Category (kg/m2) | |||||||
|---|---|---|---|---|---|---|---|
| Outcome | Modela | Total Events | Underweight (<18.5) | Normal weight (18.5–<25) | Overweight (25–<30) | Obese (≥30) | Per kg/m2 |
| Metabolic syndrome (single ICD-9 code) | Events | 228 | 2 | 41 | 105 | 80 | |
| Follow-up Timeb | 690,411 | 16,038,189 | 9,970,038 | 2,782,406 | |||
| Crude Rateb | 0.0003 | 0.0003 | 0.001 | 0.003 | |||
| Model 1 | 1.10 (0.27–4.55) | 1 (ref.) | 4.19 (2.91–6.03) | 13.51 (9.12–20.01) | 1.29 (1.25–1.33) | ||
| Model 2 | 1.10 (0.27–4.53) | 1 (ref.) | 4.13 (2.87–5.94) | 13.36 (9.00–19.83) | 1.29 (1.25–1.33) | ||
| Model 3 | 1.15 (0.28–4.75) | 1 (ref.) | 3.68 (2.55–5.30) | 10.85 (7.29–16.15) | 1.26 (1.22–1.31) | ||
| Overweight/ Obesityc | Events | 5,361 | 54 | 5 307 | -- | -- | |
| Follow-up Timeb | 688,552 | 15,882,406 | -- | -- | |||
| Crude Rateb | 0.008 | 0.033 | -- | -- | |||
| Model 1 | 0.20 (0.16–0.27) | 1 (ref.) | -- | -- | 1.58 (1.55–1.61) | ||
| Model 2 | 0.21 (0.16–0.27) | 1 (ref.) | -- | -- | 1.58 (1.55–1.60) | ||
| Model 3 | 0.23 (0.18–0.30) | 1 (ref.) | -- | -- | 1.51 (1.48–1.54) | ||
| Impaired glucose/ insulin disorder | Events | 3,880 | 75 | 1,691 | 1,439 | 675 | |
| Follow-up Timeb | 688,563 | 16,001,619 | 9,944,631 | 2,772,559 | |||
| Crude Rateb | 0.011 | 0.011 | 0.014 | 0.024 | |||
| Model 1 | 0.98 (0.78–1.24) | 1 (ref.) | 1.41 (1.31–1.51) | 2.85 (2.59–3.12) | 1.10 (1.09–1.11) | ||
| Model 2 | 0.98 (0.78–1.23) | 1 (ref.) | 1.39 (1.30–1.50) | 2.76 (2.52–3.04) | 1.10 (1.09–1.11) | ||
| Model 3 | 1.05 (0.84–1.33) | 1 (ref.) | 1.18 (1.09–1.26) | 2.05 (1.86–2.25) | 1.07 (1.06–1.07) | ||
| Hypertension | Events | 26,373 | 241 | 9,455 | 11,195 | 5,482 | |
| Follow-up Timeb | 684,149 | 15,808,503 | 9,712,588 | 2,663,809 | |||
| Crude Rateb | 0.035 | 0.060 | 0.115 | 0.206 | |||
| Model 1 | 0.60 (0.53–0.69) | 1 (ref.) | 1.82 (1.77–1.87) | 3.35 (3.24–3.47) | 1.13 (1.13–1.14) | ||
| Model 2 | 0.60 (0.53–0.69) | 1 (ref.) | 1.85 (1.80–1.90) | 3.31 (3.20–3.42) | 1.13 (1.13–1.13) | ||
| Model 3 | 0.63 (0.56–0.72) | 1 (ref.) | 1.59 (1.54–1.63) | 2.44 (2.36–2.53) | 1.10 (1.09–1.10) | ||
| Dyslipidemia | Events | 13,404 | 132 | 4,685 | 5,855 | 2,732 | |
| Follow-up Timeb | 687,485 | 15,936,094 | 9,847,079 | 2,730,696 | |||
| Crude Rateb | 0.019 | 0.029 | 0.059 | 0.100 | |||
| Model 1 | 0.68 (0.58–0.81) | 1 (ref.) | 1.85 (1.78–1.92) | 3.24 (3.09–3.40) | 1.13 (1.12–1.13) | ||
| Model 2 | 0.69 (0.58–0.81) | 1 (ref.) | 1.81 (1.75–1.89) | 3.19 (3.04–3.35) | 1.13 (1.12–1.13) | ||
| Model 3 | 0.72 (0.60–0.85) | 1 (ref.) | 1.56 (1.50–1.62) | 2.36 (2.24–2.48) | 1.09 (1.09–1.10) | ||
Abbreviations: BMI, body mass index; ICD, International Classification of Diseases.
aModel adjustments as follows: Model 1 was adjusted for age at baseline (<20, 20–<30, 30–<40, 40+ years) and sex. Model 2 was adjusted as for Model 1, plus the following demographic covariates: race/ethnicity (white, black, Hispanic, Asian/Pacific Islander, Indian/Alaskan, other/unknown), educational attainment (<high school, some college/college, advanced degree, other/unknown), and marital status (never married, married, divorced/separated/widowed, other/unknown). Model 3 was adjusted as for Model 2, plus ICD-9 coding for behavioral risk factors (tobacco use, alcohol use) and other risk factors (depression, anxiety, posttraumatic stress disorder) reported prior to the outcome diagnosis.
bExpressed as/in 100 person-months.
cAmong those with body mass index <25 kg/m2 at baseline/accession, N = 408,216.