Body Mass Index and Infective Endocarditis in Korean Population: Nation-Wide Cohort Study

• Published in: Obesity (Silver Spring, Md.) Vol. 30; pp. 209 - 210
• Main Authors: Kim, Yang-Hyun, Shin, Koh Eun
• Format: Journal Article
• Language: English
• Published: Silver Spring Blackwell Publishing Ltd 01.11.2022
• Subjects: Body mass index; Cohort analysis; Endocarditis; Obesity
• ISSN: 1930-7381; 1930-739X

Background: The association between body mass index (BMI) status and infective endocarditis (IE) has not been studied yet. Therefore, we aimed to investigate the relationship between BMI status and incidence of IE in Korean population. Methods: We analyzed 4,080,331 participants (mean age 47.12 ± 14.13 years) from the National Health Insurance database (mean follow up was 9.2 ±1.03 years). IE was defined by subjects who were hospitalized under the diagnosis using International Classification of Disease -10 codes. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the IE incidence according to five BMI levels were calculated using multivariable Cox proportional-hazards models. BMI levels were categorized into underweight, normal weight, obesity stage I, and obesity stage II. Results: During the 9-year follow up, the incidence rate of IE was 3.244 person per 100,000 person-year in underweight group, 2.023 in normal weight, 2.105 in overweight, 2.133 in obesity stage I, and 3.294 in obesity stage II. After adjusting for all covariates, overall HR for the incidence of IE increased among participants with IE risk factors in all BMI levels compared to the subjects without IE risk factors when normal weight with no IE risk group was designated as reference group. Increase in HR for the incidence of IE was observed only in underweight subjects in both total and no IE risk group (HR: 2.007 [95% CI, 1.456-2.767]; HR: 2.009 [95% CI, 1.451-2.782], respectively). In subgroup analysis, underweight increased HR for the incidence of IE in non-heavy drinkers, non-smokers, and non-regular exercise group. Conclusions: Underweight is associated with increased risk of developing IE, especially in the subjects without IE risk. Therefore, clinicians should pay more attention to the patients with underweight in Korean population when considering the risk of IE