body mass index (BMI)
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Introduction
BMI = mass in kg/ height in m2
(weight (mass) in kg divided by square of height in meters)
Pathology
- low & high body mass index associated with increased mortality[4]
- including elderly > 65 years of age, i.e. U-shaped mortality vs BMI
- for BMI > 25, every 5-unit increase in BMI translates to:
- 30% increased risk for all-cause mortality
- 40% higher risk for death from cardiovascular disease
- 60-120% increase in mortality due to renal disease, liver disease or diabetes mellitus
- 10% increased risk for cancer-related deaths
- lower BMI associated with higher mortality after adjustment for adiposity[11]
- for BMI < 22, increased mortality is partly due to smoking
- overweight in midlife, compared with normal BMI, is associated with greater long-term morbidity, but similar longevity[16]
Risk of all-cause mortality by BMI[5]
BMI Hazzard Ratio 15.0-18.4.............. 1.5 18.5-19.9.............. 1.1 20.0-22.4.............. 1.0 22.5-24.9.............. 1.0 25.0-29.9.............. 1.1 30.0-34.9.............. 1.4 35.0-39.9.............. 1.9 40.0-49.9.............. 2.5
Different studies reach different conclusions:
- BMI 25-30 associated with lower mortality than BMI 18.5-25 kg/m2 (RR 0.76) & BMI 30-34 not associated with increased mortality[6][7]
- in the elderly, obesity may be paradoxically associated with a lower, not higher, mortality risk[10]
- BMI with lowest all-cause mortality in Danish increased from 23.7 in 1976-1978 to 27.0 in 2003-2013[12]
- Mortality rates lowest for BMIs between 27-29 kg/m2[15]
Genetics
- genetic variation in PPARG may influence body mass index
- genetic variations in FFAR4 define the body mass index quantitative trait locus 10 (BMIQ10)[8]
Indications
- health maintenance assessment
- evaluation of obesity
- evaluation of malnutrition
Reference interval
-..........-
BMI: 22-25 kg/m2 = normal BMI: 27-30 kg/m2 = mild obesity BMI: 30-35 kg/m2 = moderate obesity BMI: 35-40 kg/m2 = severe obesity BMI: >40 kg/m2 = morbid obesity
A BMI calculator is available on the internet[3]
waist/hip ratio may be a better predictor of cardiovascular risk
Notes
- post-menopausal women with normal BMI may be overweight[14]
More general terms
Additional terms
References
- ↑ Guide to Ambulatory Care, Brian Yee, Bristol Meyers Squibb, 1997
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 693-94
- ↑ 3.0 3.1 BMI calculator http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
- ↑ 4.0 4.1 Prospective Studies Collaboration Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies The Lancet 2009, Vol 373:(9669)1083-1096 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60318-4/abstract
- ↑ 5.0 5.1 Berrington de Gonzalez A et al Body-Mass Index and Mortality among 1.46 Million White Adults N Engl J Med. 2010 Dec 2;363(23):2211-9. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21121834 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1000367
- ↑ 6.0 6.1 Beleigoli AM et al Overweight and class I obesity are associated with lower 10-year risk of mortality in brazilian older adults: the bambui cohort study of ageing. PLoS One. 2012;7(12):e52111 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23251690
- ↑ 7.0 7.1 Flegal KM et al Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013 Jan 2;309(1):71-82 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23280227
Heymsfield SB, Cefalu WT. Does body mass index adequately convey a patient's mortality risk? PMID: https://www.ncbi.nlm.nih.gov/pubmed/23280230 - ↑ 8.0 8.1 OMIM https://mirror.omim.org/entry/607514
- ↑ Cereda E, Pedrolli C, Zagami A et al Body mass index and mortality in institutionalized elderly. J Am Med Dir Assoc. 2011 Mar;12(3):174-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21333917
- ↑ 10.0 10.1 Oreopoulos A, Kalantar-Zadeh K, Sharma AM, Fonarow GC. The obesity paradox in the elderly: potential mechanisms and clinical implications. Clin Geriatr Med. 2009 Nov;25(4):643-59, viii. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19944265
- ↑ 11.0 11.1 Padwal R, Leslie WD, Lix LM, Majumdar SR. Relationship among body fat percentage, body mass index, and all-cause mortality: A cohort study. Ann Intern Med 2016 Mar 8; PMID: https://www.ncbi.nlm.nih.gov/pubmed/26954388
- ↑ 12.0 12.1 Afzal S, Tybjaerg-Hansen A, Jensen GB, Nordestgaard BG, Change in Body Mass Index Associated With Lowest Mortality in Denmark, 1976-2013 JAMA. 2016;315(18):1989-1996. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27163987
- ↑ World Health Organization (WHO) Global Database on Body Mass Index http://apps.who.int/bmi/index.jsp?introPage=intro_3.html
- ↑ 14.0 14.1 Rubin R Postmenopausal Women With a "Normal" BMI Might Be Overweight or Even Obese. JAMA. Published online March 7, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29516084 https://jamanetwork.com/journals/jama/fullarticle/2674709
- ↑ 15.0 15.1 Talebraza S et al Geriatrics Evaluation & Management Tools American Geriatrics Society. 2021 https://geriatricscareonline.org/ProductAbstract/geriatrics-evaluation-management-tools/B007/
- ↑ 16.0 16.1 Khan SS, Krefman AE, Zhao L et al Association of Body Mass Index in Midlife With Morbidity Burden in Older Adulthood and Longevity. JAMA Netw Open. 2022;5(3):e222318 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35289856 PMCID: PMC8924714 Free PMC article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790100
- ↑ Winter JE, MacInnis RJ, Wattanapenpaiboon N, Nowson CA. BMI and all-cause mortality in older adults: a meta-analysis. Am J Clin Nutr 2014;99(4):875-890 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24452240