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. 2024 Oct 10;16(20):3433.
doi: 10.3390/nu16203433.

Complementary Role of BMI and EOSS in Predicting All-Cause and Cause-Specific Mortality in People with Overweight and Obesity

Fabio Bioletto  1 , Valentina Ponzo  2 , Ilaria Goitre  2 , Beatrice Stella  2 , Farnaz Rahimi  3 , Mirko Parasiliti-Caprino  1 , Fabio Broglio  1 , Ezio Ghigo  1 , Simona Bo  2   3
Affiliations

Complementary Role of BMI and EOSS in Predicting All-Cause and Cause-Specific Mortality in People with Overweight and Obesity

Fabio Bioletto et al. Nutrients. .

Abstract

Objective: To assess the complementary role of the Body Mass Index (BMI) and Edmonton Obesity Staging System (EOSS) in predicting all-cause and cause-specific mortality in people living with overweight and obesity (PLwOW/O).

Methods: A longitudinal analysis of prospectively collected data from the 1999-2018 cycles of the National Health and Nutrition Examination Survey (NHANES) was conducted. The association between BMI, EOSS, and mortality was evaluated through Cox regression models, adjusted for confounders.

Results: The analysis included 36,529 subjects; 5329 deaths occurred over a median follow-up of 9.1 years (range: 0-20.8). An increased mortality risk was observed for obesity class II and III (HR = 1.21, 95% CI 1.08-1.36, p = 0.001 and HR = 1.58, 95% CI 1.39-1.80, p < 0.001; compared to overweight), and for EOSS stage 2 and 3 (HR = 1.36, 95% CI 1.16-1.58, p < 0.001 and HR = 2.66, 95% CI 2.26-3.14, p < 0.001; compared to stage 0/1). The prognostic role of BMI was more pronounced in younger patients, males, and non-Black individuals, while that of EOSS was stronger in women. Both BMI and EOSS independently predicted cardiovascular- and diabetes-related mortality. EOSS stage 3 was the only predictor of death from malignancy or renal causes.

Conclusions: BMI and EOSS independently predict all-cause and cause-specific mortality in PLwOW/O. Their integrated use seems advisable to best define the obesity-related mortality risk.

Keywords: EOSS; body mass index; mortality; obesity.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the participant selection from the NHANES 1999–2018 cohorts.
See this image and copyright information in PMC

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