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Obesity survival paradox in pneumonia: a meta-analysis

 Wei Nie  ;  Yi Zhang  ;  Sun Ha Jee  ;  Keum Ji Jung  ;  Bing Li,corresponding  ;  Qingyu Xiucorresponding 
 BMC MEDICINE, Vol.12 : 61, 2014 
Journal Title
Issue Date
Body Mass Index* ; Cohort Studies ; Confidence Intervals ; Databases, Factual ; Female ; Humans ; Obesity/complications ; Obesity/mortality* ; Observational Studies as Topic ; Overweight/complications ; Overweight/mortality ; Pneumonia/complications ; Pneumonia/mortality* ; Risk ; Risk Reduction Behavior
Body mass index ; Obesity ; Pneumonia ; Dose–response relationship ; Meta-analysis
BACKGROUND: It is unclear whether an 'obesity survival paradox' exists for pneumonia. Therefore, we conducted a meta-analysis to assess the associations between increased body mass index (BMI), pneumonia risk, and mortality risk. METHODS: Cohort studies were identified from the PubMed and Embase databases. Summary relative risks (RRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random effects model. RESULTS: Thirteen cohort studies on pneumonia risk (n = 1,536,623), and ten cohort studies on mortality (n = 1,375,482) were included. Overweight and obese individuals were significantly associated with an increased risk of pneumonia (RR = 1.33, 95% CI 1.04 to 1.71, P = 0.02, I(2) = 87%). In the dose-response analysis, the estimated summary RR of pneumonia per 5 kg/m(2) increase in BMI was 1.04 (95% CI 1.01 to 1.07, P = 0.01, I(2) = 84%). Inversely, overweight and obese subjects were significantly associated with reduced risk of pneumonia mortality (RR = 0.83, 95% CI 0.77 to 0.91, P < 0.01, I(2) = 34%). The estimated summary RR of mortality per 5 kg/m(2) increase in BMI was 0.95 (95% CI 0.93 to 0.98, P < 0.01, I(2) = 77%). CONCLUSIONS: This meta-analysis suggests that an 'obesity survival paradox' exists for pneumonia. Because this meta-analysis is based on observational studies, more studies are required to confirm the results.
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4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Jung, Keum Ji(정금지) ORCID logo https://orcid.org/0000-0003-4993-0666
Jee, Sun Ha(지선하) ORCID logo https://orcid.org/0000-0001-9519-3068
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