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. 2022 Nov 30;58(12):1768.
doi: 10.3390/medicina58121768.

Associations between Body Mass Index, Waist Circumference, and Myocardial Infarction in Older Adults Aged over 75 Years: A Population-Based Cohort Study

So Yoon Han  1 , Nan Hee Kim  2 , Do Hoon Kim  3 , Yang Hyun Kim  3 , Yong Kyu Park  4 , Seon Mee Kim  3
Affiliations

Associations between Body Mass Index, Waist Circumference, and Myocardial Infarction in Older Adults Aged over 75 Years: A Population-Based Cohort Study

So Yoon Han et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Body mass index (BMI) is widely used as a standard screening method for obesity and an indicator of related diseases. However, its inability to distinguish between lean body mass and body fat limits its utility. This limitation may be more prominent in older populations, wherein age-related sarcopenia and increased visceral fat due to the redistribution of adipose tissue may preclude a precise estimation of obesity. Many studies suggest that waist circumference (WC) is more strongly related to obesity-related diseases. There are also different opinions on whether the obesity paradox is real or a result of confusing interpretations. This study seeks to determine the association between myocardial infarction (MI), BMI, and WC in older adults and to determine if BMI and WC can reliably predict the risk of cardiovascular disease. Materials and Methods: We conducted a cohort study of older Korean adults aged over 75 years registered in the National Health Insurance System Senior database. Results: The results from the analysis using model 5, which was adjusted for each study variable, showed that the lower the BMI, the higher the hazard ratio (HR) of MI and vice versa. On the other hand, groups with lower than normal WC showed lower HR; even if it was higher, the difference was not statistically significant. Those with abdominal obesity tended to have an increased HR of MI. Conclusions: This study found that HR for MI has a negative relationship with BMI, whereas it has a positive relationship with WC. Furthermore, WC is a more appropriate indicator for predicting the risk of MI in the older population.

Keywords: body mass index; coronary artery disease; myocardial infarction; older adults; waist circumference.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Graph representing hazard ratio for MI by groups listed in Supplementary Table S1. (a) p for trend TDL 0 = 0.025/TDL 1 = 0.007, (b) p for trend TDL 0 = 0.025/TDL 1 = 0.025. T, hypertension; D, diabetes; L, hyperlipidemia.
Figure 2
Figure 2
Graph representing hazard ratio for MI listed in Supplementary Table S2. (a) p for trend < 0.001, (b) p for trend = 0.003. HR, hazard ratio; MI, myocardial infarction.
See this image and copyright information in PMC

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