Diabetes, Cardiovascular Disease, and Mortality in Relation to Weight Patterns During Middle Age Characterized by Functional Principal Components Analysis

Waring, Molly E.

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Year:: 2009
Contributor:: Waring, Molly E. (creator); Lapane, Kate (director); Eaton, Charles (reader); Lasater, Thomas (reader); Brown University. Division of Biology and Medicine. Epidemiology (sponsor)
Genre:: theses
Subject:: epidemiology; obesity; diabetes; cardiovascular disease; mortality
Extent:: xiv, 72 p.
DOI: https://doi.org/10.7301/Z01N7ZDJ

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Abstract:: Overweight, obesity, weight gain, and weight cycling are associated with increased health risk. The purpose of this dissertation was to characterize weight trajectories during middle age using functional data methods to further our understanding of how weight impacts health. Participants included a subset of the Framingham Heart Study original cohort limited-access dataset. First, we characterized weight patterns during middle age and describe correlates of these weight patterns. We conducted a functional principal components analysis of body mass index (BMI) from 40 to 55 years. Scores from the principal component functions defined weight patterns as overall weight status, weight changes, and weight cycling. Being overweight or obese at age 25 years was the most consistent correlate of weight patterns during middle age for both men and women. Second, we quantified the effect of overall weight status and weight cycling during middle age on incident cardiovascular disease (CVD) and mortality. Using principal component function scores from a functional principal components analysis of BMI from 40 to 55 years, we jointly categorized overall weight status and weight cycling. Compared to an overall normal weight trajectory without weight cycling, normal weight with cycling, overweight without cycling, overweight with cycling, and obese trajectories were associated with increased rates of coronary heart disease, cerebrovascular accidents, and CVD events. These weight patterns were also associated with increased CVD mortality but only obesity and overweight/cycling were associated with increased all-cause mortality. Third, we quantified the effect of overall weight status and weight cycling during middle age on incident diabetes. While there was a strong effect of overall weight status, weight cycling did not increase rates of diabetes among either adults with overall normal weight or overall overweight trajectories. Our findings support recommendations of weight loss among overweight and obese adults for the prevention of diabetes and CVD and suggest that cycles of weight loss and regain may not increase disease risk among overweight middle-aged adults. Functional data methods may be useful for evaluating the health effects of weight changes during other life periods or describing changes in other physiological parameters.
Notes:: Thesis (Ph.D.) -- Brown University (2009)

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Rights: In Copyright
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Citation

Waring, Molly E., "Diabetes, Cardiovascular Disease, and Mortality in Relation to Weight Patterns During Middle Age Characterized by Functional Principal Components Analysis" (2009). Biology and Medicine Theses and Dissertations, Epidemiology Theses and Dissertations. Brown Digital Repository. Brown University Library. https://doi.org/10.7301/Z01N7ZDJ

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