Sex-specific All-cause Mortality is Associated with Adiposity in the Malaysian Elders Longitudinal Research (MELoR) Study

Sep 29, 2026

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Sex-specific associations between adiposity and all-cause mortality in Malaysian adults remain insufficiently clarified, particularly regarding whether muscle strength modifies this relationship. This longitudinal MELoR study recruited individuals aged ≥55 years between 2013 and 2015 and assessed BMI, %BF, WHR, and waist circumference, with vital status follow-up through June 2022. Results showed adiposity-related mortality differences by sex, especially higher risk in men with higher %BF and altered WHR patterns, while muscle strength did not explain these findings; WC showed limited predictive value.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background

Methods

Results

Conclusion

Key Words

Introduction

Sex-specific All-cause Mortality is Associated with Adiposity in the Malaysian Elders Longitudinal Research (MELoR) Study Nurul NabilahAkmal Hashim1, Sumaiyah Mat1,2, Phyo Kyaw Myint3,4, MirelaDelibegovic4, Sheng Hui Kioh1,5, Shahrul BahyahKamaruzzaman1,6, NoranNaqiahHairi1,7, Selina Khoo8, Ai-Vyrn Chin1,6, MawPinTan1,6,9 1Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 2Physiotherapy Program and Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Bangi, Malaysia 3Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, University of Aberdeen, UK 4Aberdeen Cardiovascular and Diabetes Centre, Institute of Medical Sciences, University of Aberdeen, UK 5Department of Chiropractic, Centre for Complementary and Alternative Medicine (CCAM), International Medical University, Kuala Lumpur, Malaysia 6Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 7Centre for Epidemiology & Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia 8Faculty of Sport and Exercise Sciences, Universiti Malaya, Kuala Lumpur, Malaysia 9Faculty of Healthcare and Medical Sciences, Sunway University, Petaling Jaya, Malaysia Corresponding Author: MawPinTan, MD Department of Medicine, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia [Email: mptan@ummc.edu.my](Email: mptan@ummc.edu.my)[ ](Email: mptan@ummc.edu.my)ORCID: [https://orcid.org/0000-0002-3400-8540](https://orcid.org/0000-0002-3400-8540) [Received: October 17](Received: October 17), [2024](2024) Revised: February 28, 2025 Accepted: September 29, 2025 Background: While adiposity has been found to be protective against adverse outcomes in older adults, the role of muscle in this association remains underexplored. This study sought to evaluate sex-specific mortality associated with available adiposity indices in older adults and the potential role of muscle strength in this relationship. Methods: Individuals aged ≥55 years were recruited from 2013 to 2015. Adiposity indices obtained were body mass index (BMI), percentage body fat (%BF), waist-to-hip ratio (WHR), and waist circumference (WC). Vital status up to June 2022 was determined through the National Registry Department. Results: Of the 1,347 included participants, mean age of 68.45±7.21 years, 57.1% female, and 11.2% deaths were recorded. Male who were underweight had increased mortality compared to male with normal BMI (hazard ratio [HR]=3. 17, 95% confidence interval [CI] 1.35–7.47). Mortality was greater in male with %BF within the highest quartile (Q4) compared to the lowest quartile (Q1) (HR=4.72, 95% CI 2.07–10.78). Increased mortality in both male and female in Q4 for WHR compared to Q1 was influenced by age, as was increased mortality in female in Q4 for %BF. WC did not predict mortality in male or female. Increased mortality risk was present in male with normal muscle strength and increased %BF, and reduced muscle strength in male with low BMI. Conclusion: Adiposity measured with BMI, WHR and WC had limited value in determining mortality risk at 9-year follow-up among individuals aged ≥55 years. Increased mortality was, however, observed in male with higher %BF but this could not be attributed to muscle strength. Key Words: Aged, Body composition, Muscle strength, Obesity, Mortality INTRODUCTION Obesity has been a major health issue in developed nations such asthe United States for several decades, with alarge increase now also occurring in lower-and middle-income countries.1,2) According to the National Health and Morbidity Survey 2019, 50.1% of Malay- sian are now overweight or obese.3) The negative consequences of obesity on health and quality of life within the general population, particularly among t

FAQs

What was the study’s main goal regarding adiposity and mortality?

To evaluate sex-specific all-cause mortality associated with available adiposity indices in older adults and assess the potential role of muscle strength in that relationship.

Which adiposity measures were analyzed in the MELoR study?

Body mass index (BMI), percentage body fat (%BF), waist-to-hip ratio (WHR), and waist circumference (WC) were used as adiposity indices.

What did the results show about mortality prediction by waist circumference (WC)?

WC did not predict mortality in either men or women in this follow-up period.

Sep 29, 2026

Uploaded by Fahsai