Table 4.
Included studies reporting mortality risk from CV events/total knee arthroplasty/stroke in populations with obesity or OWRC
| Study | Year | Country | Comorbidity | BMI (kg/m2) | Risk | Mortality | Note | ||
|---|---|---|---|---|---|---|---|---|---|
| Batsis et al. [69] | 2014 | USA | Not reported | ≥ 30.0 | HR 0.90 (95% CI 0.57–1.43) | CV | Relative to normal weight (BMI 18.5–25.0) | ||
| Crotti et al. [71] | 2018 | Italy | Not reported | 30.0–39.9 | HR 1.01 (95% CI 0.75–1.35) | CV | Relative to normal weight (BMI 18.5–24.9) | ||
| ≥ 40 | HR 1.32 (95% CI 0.53–3.28) | ||||||||
| Perotto et al. [70] | 2013 | Italy | T2D | 26.8–30.0 (< 65 years old) | HR 1.29 (95% CI 0.62–2.65) | CV | Relative to BMI < 24.2 | ||
| > 30.0 (< 65 years old) | HR 0.83 (95% CI 0.39–1.74) | ||||||||
| 26.8–30.0 (≥ 65 years old) | HR 0.86 (95% CI 0.64–1.19) | ||||||||
| > 30.0 (≥ 65 years old) | HR 0.67 (95% CI 0.45–0.95) | ||||||||
| Ratwatte et al. [72] | 2021 | Australia | Not reported | 30.0–39.9 | OR 0.42 (95% CI 0.25–0.72) | CV (in-hospital mortality for acute coronary syndrome) | Relative to normal weight (BMI 18.5–24.9) | ||
| > 40.0 | OR 0.97 (95% CI 0.45–2.1) | ||||||||
| 30.0–39.9 | OR 0.37 (95% CI 0.15–0.91) | CV (6 months post hospitalization for acute coronary syndrome) | |||||||
| > 40.0 | OR 0.88 (95% CI 0.22–3.54) | ||||||||
| Bhaskaran et al. [73] | 2018 | UK | Not reported | 30.0–34.9 | HR 1.27 (95% CI 1.25–1.30) | CV | Relative to BMI 22.5–24.9 | ||
| 35.0–39.9 | HR 1.65 (95% CI 1.60–1.70) | ||||||||
| ≥ 40.0 | HR 2.49 (95% CI 2.37–2.61) | ||||||||
| Boggs et al. [74] | 2011 | USA | Not reported | 30.0–34.9 | HR 2.77 (95% CI 1.62–4.73) | CV | Relative to BMI 20.0–24.9 | ||
| 35.0–49.9 | HR 3.90 (95% CI 2.29–6.64) | ||||||||
| Borgeraas et al. [53] | 2014 | Norway | Not reported | ≥ 30.0 (male) | HR 1.19 (95% CI 0.76–1.85) | CV | Relative to normal weight (BMI 18.5–24.9) | ||
| ≥ 30.0 (female) | HR 0.43 (95% CI 0.14–1.28) | ||||||||
| Champagne-Langabeer et al. [75] | 2017 | USA | Not reported | 30.0–34.9 | OR 1.20 (95% CI 0.46–3.11) | CV | Relative to normal weight (BMI 18.5–24.9) | ||
| 35.0–39.9 | OR 0.65 (95% CI 0.14–3.06) | ||||||||
| ≥ 40.0 | OR 3.83 (95% CI 1.02–14.41) | ||||||||
| Czernichow et al. [78] | 2011 | UK | Not reported | 20.0–35.0 | HR 1.10 (95% CI 1.05–1.16) | CV | HR for one higher standard deviation in BMI | ||
| Das et al. [79] | 2011 | USA | Not reported | 35.0–<40.0 | HR 1.10 (95% CI 0.95–1.26) | CV | Relative to BMI 30.0 to <35.0 | ||
| ≥ 40.0 | HR 1.64 (95% CI 1.32–2.03) | ||||||||
| Eeg-Olofsson et al. [80] | 2014 | Sweden | T2D | 25.0–27.4 | HR 0.79 (95% CI 0.65–0.96) | CV | Relative to normal weight (BMI 18.5–24.9) | ||
| 27.5–29.9 | HR 0.92 (95% CI 0.76–1.11) | ||||||||
| 30.0–34.9 | HR 1.16 (95% CI 0.97–1.38) | ||||||||
| ≥ 35.0 | HR 1.55 (95% CI 1.26–1.90) | ||||||||
| Hotchkiss et al. [85] | 2013 | UK | Not reported | ≥ 30.0 (male) | HR 1.13 (95% CI 0.69–1.86) | CV | Relative to normal weight (BMI 18.5–25.0) | ||
| ≥ 30.0 (female) | HR 1.51 (95% CI 0.90–2.56) | ||||||||
| Kjøllesdal et al. [86] | 2019 | Norway | Not reported | ≥ 30.0 | HR 1.66 (95% CI 1.53–1.74) | CV | Relative to BMI < 25.0 | ||
| Kjøllesdal et al. [87] | 2018 | Norway | Not reported | ≥ 30.0 (male, early adulthood) | HR 2.70 (95% CI 1.88–3.78) | CV | Relative to normal weight (BMI 18.5–25.0) | ||
| ≥ 30.0 (male, midlife) | HR 1.46 (95% CI 1.25–1.70) | ||||||||
| ≥ 30.0 (female, early adulthood) | HR 1.81 (95% CI 0.82–3.97) | ||||||||
| ≥ 30.0 (female, midlife) | HR 1.21 (95% CI 0.78–1.89) | ||||||||
| Ma et al. [81] | 2011 | USA | Not reported | 30.0–<35.0 | HR 2.98 (95% CI 2.30–3.87) | CV | Relative to BMI 18.5 to <20.0 | ||
| ≥ 35.0 | HR 5.25 (95% CI 3.89–7.07) | ||||||||
| Ma et al. [82] | 2013 | USA | Not reported | 30.0–34.9 (never smoked) | HR 3.22 (95% CI 2.11–4.91) (age 18–44) | HR 1.94 (95% CI 1.51–2.49) (age 45–64) | HR 1.16 (95% CI 1.06–1.28) (age 65–99) | CV | Relative to normal weight (BMI 18.5–24.9) never smoked |
| 30.0–34.9 (former smoker) | HR 3.68 (95% CI 2.09–6.50) (age 18–44) | HR 2.50 (95% CI 2.05–3.05) (age 45–64) | HR 1.39 (95% CI 1.21–1.59) (age 65–99) | ||||||
| 30.0–34.9 (current smoker) | HR 7.00 (95% CI 4.66–10.51) (age 18–44) | HR 4.08 (95% CI 3.21–5.18) (age 45–64) | HR 2.21 (95% CI 1.76–2.76) (age 65–99) | ||||||
| ≥ 35.0 (never smoked) | HR 8.27 (95% CI 4.95–13.81) (age 18–44) | HR 3.26 (95% CI 2.49–4.28) (age 45–64) | HR 1.19 (95% CI 0.98–1.44) (age 65–99) | ||||||
| ≥ 35.0 (former smoker) | HR 5.39 (95% CI 2.68–10.83) (age 18–44) | HR 3.80 (95% CI 2.80–5.15) (age 45–64) | HR 1.68 (95% CI 1.36–2.07) (age 65–99) | ||||||
| ≥ 35.0 (current smoker) | HR 12.20 (95% CI 7.73–19.27) (age 18–44) | HR 4.99 (95% CI 3.36–7.42) (age 45–64) | HR 2.17 (95% CI 1.37–3.43) (age 65–99) | ||||||
| McAuley et al. [83] | 2014 | USA | Not reported | ≥ 30.0 | HR 1.76 (95% CI 1.17–2.67) | CV | Relative to normal weight (BMI 18.5–24.9) | ||
| Payvar et al. [84] | 2013 | USA | Not reported | > 40.0 | OR 1.14 (95% CI 1.04–1.25) | CV (all in-hospital mortality post percutaneous coronary intervention | Relative to BMI 20.0–25.0 | ||
| OR 1.22 (95% CI 1.08–1.39) | CV (mortality following percutaneous coronary intervention following presentation with STEMI) | ||||||||
| Iyen et al. [61] | 2021 | UK | Not reported | Trajectory 2: 33.7 → 34.9 | HR 1.44 (95% CI 1.31–1.58) | CV | (Trajectories over 10 years) Relative to trajectory 1: BMI 28.7 → 29.7 | ||
| Trajectory 3: 39.9 → 41.1 | HR 2.06 (95% CI 1.86–2.29) | ||||||||
| Trajectory 4: 49.1 → 49.8 | HR 3.31 (95% CI 2.84–3.86) | ||||||||
| Silventoinen et al. [67] | 2014 | Sweden | Not reported | ≥ 30.0 | HR 2.35 (95% CI 1.81–3.05) | CV | Relative to BMI 20.1–22.4 | ||
| HR 2.08 (95% CI 1.56–2.77) | Stroke | ||||||||
| Bo et al. [76] | 2012 | Italy | Not reported | > 30.0 (insulin resistant) | HR 2.43 (95% CI 1.57–3.29) | CV | Relative to BMI < 25.0, insulin sensitive | ||
| > 30.0 (insulin sensitive) | HR 2.95 (95% CI 1.03–3.98) | ||||||||
| Calori et al. [77] | 2011 | Italy | Not reported | ≥ 30.0 (insulin resistant) | HR 1.52 (95% CI 1.02–2.26) | CV | Relative to BMI < 30, insulin sensitive | ||
| ≥ 30.0 (insulin sensitive) | HR 1.04 (95% CI 0.32–3.30) | ||||||||
| Alvi et al. [62] | 2015 | USA | Not reported | 30.0–35.0 | OR 0.64 (95% CI 0.05–8.36) | Total knee arthroplasty | Relative to normal weight (BMI 18.5–25.0) | ||
| 35.0–40.0 | OR 1.56 (95% CI 0.21–11.50) | ||||||||
| > 40.0 | OR 0.90 (95% CI 0.09–9.54) | ||||||||
| Sing et al. [63] | 2016 | USA | Not reported | 8.5 → 40.0 | 0.03% trend in absolute risk of mortality across BMI increase | Total knee arthroplasty | |||
| Sundara et al. [64] | 2019 | USA | Not reported | 30.0–39.9 | OR 0.125 (95% CI 0.011–1.385) | Total knee arthroplasty | Relative to normal weight (BMI 18.5–24.9) | ||
| ≥ 40.0 | OR 0.000 (95% CI 0.000) | ||||||||
| Andersen et al. [65] | 2015 | Denmark | Not reported | ≥ 30.0 | HR 0.53 (95% CI 0.49–0.57) | Stroke | Relative to normal weight (BMI 18.5–24.9) | ||
| Hoffman et al. [66] | 2020 | USA | Not reported | 30–39.9 | OR 0.62 (95% CI 0.56–0.69) | Stroke | Relative to BMI < 30.0 | ||
| ≥ 40.0 | OR 0.76 (95% CI 0.66–0.88) | ||||||||
| Skolarus et al. [68] | 2014 | USA | Not reported | 33.0–34.0 | HR 0.75a | Stroke | Relative to BMI 24 | ||
| 35.0–36.0 | HR 0.6a | ||||||||
| 37.0–38.0 | HR 0.5a | ||||||||
| 39.0–41.0 | HR 1.0a | ||||||||
| ≥ 42.0 | HR 1.5a | ||||||||
BMI body mass index, CI confidence interval, CV cardiovascular, HR hazard ratio, OR odds ratio, STEMI ST-elevation myocardial infarction, T2D type 2 diabetes
aEstimated results taken from graph (not tabulated)