Weight Gain After 20 Years of Age is Associated with Unfavorable Lifestyle and Increased Prevalence of Metabolic Disorders

Figures & data

Figure 1 Study recruitment diagram. Patient selection for evaluating associations between lifestyle habits and adverse health outcomes in propensity score (PS)-matched subjects who gained ≥10 kg versus <10 kg after age 20 years is summarized in the study flowchart. The PS-matched analysis was conducted employing the following covariates: age, sex, and BMI at the time of the study. We used 0.1 times the pooled standard deviation of the logit of the PS as the caliper width for the PS matching.

Table 1 Characteristics of the Study Participants

	Weight Gain After 20 Years of Age		P value*
	<10kg (n=3601)	≥ 10kg (n=3601)
Gender (male/female)	1709/1892	1636/1965
Age (years)	64 (55–69)	63 (55–67)
BMI at the time of the study (kg/m2)	25.9 (24.5–27.2)	25.8 (24.5–27.3)
BMI at 20 years of age (kg/m2)	23.8 (22.4–25.6)	20.4 (19.2–21.7)	<0.001
Waist circumference (cm)	87.3 (83.5–91.7)	89.2 (85.4–93.5)	<0.001
Systolic blood pressure (mmHg)	129 (119–141)	130 (120–143)	0.007
Diastolic blood pressure (mmHg)	77 (70–84)	78 (71–84)	0.016
Hypertension, n (%)	1959 (54.4)	2085 (57.9)	0.003
Dyslipidemia, n (%)	2151 (59.7)	2405 (66.8)	<0.001
Type 2 Diabetes, n (%)	653 (18.1)	713 (19.8)	0.071
Chronic kidney disease, n (%)	794 (22.0)	830 (23.0)	0.310
Hyperuricemia, n (%)	443 (12.3)	527 (14.6)	0.004
Metabolic syndrome, n (%)	755 (21.0)	977 (27.1)	<0.001
Stroke, n (%)	79 (2.2)	80 (2.2)	0.936
Coronary heart disease, n (%)	97 (2.7)	95 (2.6)	0.884
Aneurysm of aorta, n (%)	22 (0.6)	25 (0.7)	0.661
Chronic heart failure, n (%)	13 (0.4)	18 (0.5)	0.368
Marital status, n (%)			0.007
Single	316 (8.9)	263 (7.4)^#
Divorced	137 (3.9)	171 (4.8)
Living with a spouse	2835 (79.8)	2827 (79.2)
Widowed	265 (7.5)	310 (8.7)
Education level, n (%)			<0.001
Completed elementary/middle school	1124 (31.6)	931 (26.2)^##
Completed high school	1514 (42.6)	1652 (46.6)^##
Completes university/college	916 (25.8)	965 (27.2)
Employment, n (%)	2062 (58.2)	1970 (55.5)	0.022

Notes: *Mann–Whitney U-test or chi-square test. Median values are shown (25th percentile-75th percentiles). ^#Adjusted residual >|1.96|, ^##adjusted residual>|2.58|.

Abbreviation: BMI, body mass index.

Table 2 The Comparison of the Number of Metabolic Syndrome Risk Factors by Weight Gain After 20 Years of Age

	Weight Gain After 20 Years of Age		P value*
	<10kg (n=3601)	≥ 10kg (n=3601)
0, n (%)	458 (54.4)	307 (8.5)^##	<0.001
1, n (%)	1018 (50.0)	802 (22.3)^##
2, n (%)	1154 (18.1)	1237 (34.4)^#
3, n (%)	758 (9.6)	962 (26.7)^##
4, n (%)	213 (12.3)	293 (8.1)^##

Notes: *Chi-square test or residual analysis. ^#Adjusted residual >|1.96|, ^##adjusted residual>|2.58|. Factors comprising metabolic syndrome; (1) a waist circumference of ≥85 cm in men and ≥90 cm in women, (2) dyslipidemia (triglycerides ≥150 mg/dL or HDL-C < 40 mg/dL) or current lipid-lowering medications, (3) high blood pressure (systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg) or current antihypertensive medications, and (4) hyperglycemia (fasting glucose ≥110 mg/dL) or current medications for diabetes mellitus.

Table 3 Odds Ratios of Metabolic Disorder Prevalences from Multivariable Logistic Regression Model Associated with Weight Gain ≥10kg After 20 Years of Age vs Weight Gain <10kg

Metabolic Disorders	OR (95% CI)
Hypertension	1.26 (1.095–1.350)
Dyslipidemia	1.341 (1.209–1.487)
Hyperuricemia	1.307 (1.121–1.523)
MetS	1.460 (1.293–1.648)
CKD	1.087 (0.962–1.228)
Type 2 Diabetes	1.100 (0.968–1.251)

Notes: Independent variables: gender, age, smoking status, habitual drinking, eating breakfast, walking time, sleep duration, marital status, formal education level, employment status.

Abbreviations: MetS, metabolic syndrome, CKD, chronic kidney disease.

Table 4 The Comparison of Lifestyle Factors by Weight Gain After 20 Years of Age

	Weight Gain After 20 Years of Age		P value*
	<10kg (n=3601)	≥ 10kg (n=3601)
Smoking status, n (%)			0.049
Never smokers	2326 (64.6)	2265 (62.9)
Former smokers	762 (21.2)	848 (23.5)^#
Current smokers	513 (14.2)	488 (13.6)
Habitual drinking, n (%)	1830/3581 (51.1)	1788/3594 (49.7)	0.252
Sleep, hours/day, n (%)			0.010
<5	153 (4.3)	190 (5.3)^#
5 - <7	2202 (61.1)	2225 (61.9)
7 - <9	1205 (33.5)	1119 (31.1)^#
≥ 9	39 (1.1)	59 (1.6)^#
Eating breakfast, n (%)			0.001
Skipping	299 (8.5)	381 (10.8)
Regularly	3217 (91.5)	3142 (89.2)
Walking time, hours/day, n (%)			<0.001
<1	1453 (42.6)	1623 (47.7)^##
1 - <3	1203 (35.3)	1120 (32.9)^#
3 - <5	386 (11.3)	354 (10.4)
≥ 5	365 (10.7)	305 (9.0)^#
Sitting time, hours/day, n (%)			<0.001
<1	454 (13.7)	427 (12.8)
1 – <3	1012 (30.6)	842 (25.3)^##
3 – <5	980 (29.6)	1022 (30.7)
≥ 5	865 (26.1)	1037 (31.2)^##

Notes: *Chi-square test or residual analysis. ^#Adjusted residual >|1.96|, ^##adjusted residual>|2.58|.

Table 5 Odds Ratios of Lifestyle Factors from Multivariable Logistic Regression Model Associated with Weight Gain ≥10kg After 20 Years of Age vs Weight Gain <10kg

	Model 1	Model 2
	OR (95% CI)	OR (95% CI)
Smoking status
Never smoker	1.00 (reference)	1.00 (reference)
Current smoker	0.986 (0.846–1.159)	0.974 (0.826–1.148)
Former smoker	1.217 (1.057–1.401)	1.163 (1.008–1.343)
Habitual drinking	0.934 (0.837–1.042)	0.914 (0.817–1.023)
Eating breakfast
Regularly	1.00 (reference)	1.00 (reference)
Skipping	1.264 (1.068–1.496)	1.252 (1.053–1.489)
Walking time, hours/day
<1	1.00 (reference)	1.00
1 – <3	0.834 (0.747–0.930)	0.828 (0.740–0.926)
3 – <5	0.821 (0.697–0.967)	0.818 (0.691–0.968)
≥ 5	0.771 (0.650–0.915)	0.821 (0.688–0.980)
Sleep, hours/day
<5	1.227 (0.972–1.549)	1.264 (0.994–1.607)
5 – <7	1.00 (reference)	1.00 (reference)
7 – <9	0.960 (0.863–1.069)	0.978 (0.876–1.092)
≥ 9	1.410 (0.914–2.172)	1.613 (1.018–2.557)

Notes: Model 1: independent variables: gender, age, BMI, smoking status, habitual drinking, eating breakfast, walking time, sleep duration. Model 2: independent variables: Model 1+ marital status, formal education level, employment status.