TY - JOUR

T1 - Obesity and risk of infection

T2 - results from the Danish Blood Donor Study

AU - Kaspersen, Kathrine Agergård

AU - Pedersen, Ole Birger Vesterager

AU - Petersen, Mikkel Steen

AU - Hjalgrim, Henrik

AU - Rostgaard, Klaus

AU - Møller, Bjarne Kuno

AU - Juul-Sørensen, Cecilie

AU - Kotzé, Sebastian

AU - Dinh, Khoa Manh

AU - Erikstrup, Lise Tornvig

AU - Sørensen, Erik

AU - Thørner, Lise Wegner

AU - Burgdorf, Kristoffer Sølvsten

AU - Ullum, Henrik

AU - Erikstrup, Christian

PY - 2015/7

Y1 - 2015/7

N2 - BACKGROUND: It is well known that obesity complicates the course of several diseases. However, it is unknown whether obesity affects the risk of infection among healthy individuals.METHODS: We included 37,808 healthy participants from the Danish Blood Donor Study, who completed a questionnaire on health-related items. Obesity was defined as a body mass index ≥ 30 kg/m(2). Infections among participants were identified by relevant ICD-10 codes in the Danish National Patient Register and Anatomical Therapeutic Chemical (ATC) codes in the Danish Prescription Register. Multivariable Cox proportional hazards analysis with age as the underlying timescale was used as the statistical model.RESULTS: During 113,717 person-years of observation, 1,233 participants were treated for infection at a hospital. Similarly, during 58,411 person-years of observation, 15,856 participants filled at least one prescription of antimicrobials. Obesity was associated with risk of hospital-based treatment for infection (women: hazard ratio [HR] = 1.5, 95% confidence interval [CI] = 1.1, 1.9; men: HR = 1.5, 95% CI = 1.2, 1.9). For specific infections, obesity was associated with increased risk of abscesses (both sexes), infections of the skin and subcutaneous tissue (men), and respiratory tract infections and cystitis (women). Similarly, obesity was associated with filled prescriptions of antimicrobials overall (women: HR = 1.22, 95% CI = 1.14, 1.30; men: HR = 1.23, 95% CI: 1.15, 1.33) and particularly with phenoxymethylpenicillin, macrolides, dicloxacillin and flucloxacillin, and broad-spectrum penicillins.CONCLUSIONS: In a large cohort of healthy individuals, obesity was associated with risk of infection. This result warrants further studies of metabolism and the immune response.

AB - BACKGROUND: It is well known that obesity complicates the course of several diseases. However, it is unknown whether obesity affects the risk of infection among healthy individuals.METHODS: We included 37,808 healthy participants from the Danish Blood Donor Study, who completed a questionnaire on health-related items. Obesity was defined as a body mass index ≥ 30 kg/m(2). Infections among participants were identified by relevant ICD-10 codes in the Danish National Patient Register and Anatomical Therapeutic Chemical (ATC) codes in the Danish Prescription Register. Multivariable Cox proportional hazards analysis with age as the underlying timescale was used as the statistical model.RESULTS: During 113,717 person-years of observation, 1,233 participants were treated for infection at a hospital. Similarly, during 58,411 person-years of observation, 15,856 participants filled at least one prescription of antimicrobials. Obesity was associated with risk of hospital-based treatment for infection (women: hazard ratio [HR] = 1.5, 95% confidence interval [CI] = 1.1, 1.9; men: HR = 1.5, 95% CI = 1.2, 1.9). For specific infections, obesity was associated with increased risk of abscesses (both sexes), infections of the skin and subcutaneous tissue (men), and respiratory tract infections and cystitis (women). Similarly, obesity was associated with filled prescriptions of antimicrobials overall (women: HR = 1.22, 95% CI = 1.14, 1.30; men: HR = 1.23, 95% CI: 1.15, 1.33) and particularly with phenoxymethylpenicillin, macrolides, dicloxacillin and flucloxacillin, and broad-spectrum penicillins.CONCLUSIONS: In a large cohort of healthy individuals, obesity was associated with risk of infection. This result warrants further studies of metabolism and the immune response.

KW - Abscess

KW - Adolescent

KW - Adult

KW - Aged

KW - Anti-Bacterial Agents

KW - Anti-Infective Agents

KW - Blood Donors

KW - Body Mass Index

KW - Cohort Studies

KW - Cystitis

KW - Denmark

KW - Dicloxacillin

KW - Female

KW - Floxacillin

KW - Humans

KW - Incidence

KW - Infection

KW - Macrolides

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Obesity

KW - Penicillin V

KW - Penicillins

KW - Proportional Hazards Models

KW - Respiratory Tract Infections

KW - Risk Factors

KW - Sex Factors

KW - Soft Tissue Infections

KW - Surveys and Questionnaires

KW - Young Adult

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1097/EDE.0000000000000301

DO - 10.1097/EDE.0000000000000301

M3 - Journal article

C2 - 25978794

VL - 26

SP - 580

EP - 589

JO - Epidemiology

JF - Epidemiology

SN - 1044-3983

IS - 4

ER -