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2014 ; 69
(9
): 1162-9
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Obesity and 10-year mortality in very old African Americans and Yoruba-Nigerians:
exploring the obesity paradox
#MMPMID24694355
Clark DO
; Gao S
; Lane KA
; Callahan CM
; Baiyewu O
; Ogunniyi A
; Hendrie HC
J Gerontol A Biol Sci Med Sci
2014[Sep]; 69
(9
): 1162-9
PMID24694355
show ga
BACKGROUND: To compare the effect of obesity and related risk factors on 10-year
mortality in two cohorts of older adults of African descent; one from the United
States and one from Nigeria. METHODS: Study participants were community residents
aged 70 or older of African descent living in Indianapolis, Indiana (N = 1,269)
or Ibadan, Nigeria (1,197). We compared survival curves between the two cohorts
by obesity class and estimated the effect of obesity class on mortality in Cox
proportional hazards models controlling for age, gender, alcohol use, and smoking
history, and the cardiometabolic biomarkers blood pressure, triglycerides,
high-density lipoprotein, low-density lipoprotein, and C-reactive protein.
RESULTS: We found that underweight was associated with an increased risk of death
in both the Yoruba (hazards ratio = 1.35, 95% confidence interval: 1.12-1.63) and
African American samples (hazards ratio = 2.49, 95% confidence interval:
1.40-4.43) compared with those with normal weight. The overweight and obese
participants in both cohorts experienced survival similar to the normal weight
participants. Controlling for cardiometabolic biomarkers had little effect on the
obesity-specific hazard ratios in either cohort. CONCLUSIONS: Despite significant
differences across these two cohorts in terms of obesity and biomarker levels,
overall 10-year survival and obesity class-specific survival were remarkably
similar.