The association between weight fluctuation and all-cause mortality: A systematic review and meta-analysis.

BACKGROUND

Many observational studies have reported an association between weight fluctuation and all-cause mortality. However, the conclusions obtained from these studies have been unclear.

OBJECTIVE

The current meta-analysis aimed to clarify the association between weight fluctuation and all-cause mortality.

DATA SOURCE

We electronically searched PubMed, Embase, and Web of Science for articles reporting an association between weight fluctuation and all-cause mortality that were published before April 30, 2018.

STUDY APPRAISAL AND SYNTHESIS METHODS

The methodological quality of each study was appraised using the modified Newcastle Ottawa Quality Assessment Scale. The hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were extracted from the included studies and pooled using random-effect models. Meta-regression approaches were also performed to explore sources of between-study heterogeneity.

RESULTS

A total of 15 studies were eligible for the current meta-analysis. The pooled overall HR for all-cause mortality in the group with the greatest weight fluctuations compared with the most stable weight category was 1.45 (95% CI: 1.29-1.63). Considerable between-study heterogeneity was observed, some of which was partially explained by the different follow-up durations used by the included studies. Moreover, publication bias that inflated the risk of all-cause mortality was detected using Egger's test (P = .001).

CONCLUSION

Weight fluctuation might be associated with an increased risk of all-cause mortality.