Changes in Body Weight and Concurrent Changes in Cardiovascular Risk Profiles in Community Residents in Japan: the Hisayama Study

Abstract

Aim: We investigated the influence of weight change on concurrent changes in predicted cardiovascular disease (CVD) risk and individual CVD risk factors over time.

Methods: A total of 2,140 community-dwellers aged 40-74 years participated in both 2002 and 2007 health examinations. Obesity was defined as body mass index ≥ 25 kg/m². Weight trajectories were classified as: "stable obese" (obese at both examinations), "obese to nonobese" (obese in 2002 but nonobese in 2007), "nonobese to obese" (nonobese in 2002 but obese in 2007), or "stable nonobese" (nonobese at both examinations). We compared changes in the model-predicted risk for CVD and individual CVD risk factors across weight-change categories.

Results: The predicted risk for CVD increased during 5 years in all groups; the increment in the predicted risk for CVD was smallest in the obese to nonobese participants and steepest in the nonobese to obese subjects. Compared with the stable obese participants, the obese to nonobese participants had greater favorable changes in waist circumferences, blood pressure, fasting plasma glucose, serum high-density lipoprotein cholesterol, serum triglycerides, and liver enzymes. For all these parameters, opposite trends were observed when comparing the nonobese to obese participants with the stable nonobese group.

Conclusions: We demonstrated the favorable association of losing weight in obese people and avoiding excessive weight gain in nonobese people with global risk of future CVD and individual CVD risk factors in a real-world setting. The findings could improve behavioral lifestyle interventions that provide information on the health consequences of weight change at health checkups.

Keywords: Cardiometabolic risk factors; Longitudinal study; Weight change.

SupplementaryFig.1. Distribution of the predicted risk for cardiovascular disease in 2002 and 2007

IQR, interquartile range. CVD, cardiovascular disease. The predicted risk for CVD was calculated based on a previously published risk prediction model for 10-year cumulative risk for the development of CVD.

Fig.1. Change in the age- and sex-adjusted predicted risk for cardiovascular disease according to weight change status

Solid circles and vertical bars indicated the age- and sex-adjusted, back-transformed means and 95% confidence intervals of the predicted 10-year cumulative risk for cardiovascular disease. The predicted risks were presented according to weight status groups: stable nonobese ( n =1,462), nonobese to obese ( n =78), obese to nonobese ( n =103), and stable obese ( n =497). Data were log-transformed for analysis and back-transformed for presentation. The asterisk indicates a significant difference ( p ＜0.05) in the estimates at each time point. The detailed data are shown in supplementary Table 1.