Supplementary Material for: Weight change over 4 years and risk of cardiovascular diseases in Chinese: The China Health and Retirement Longitudinal Study

Abstract Introduction: Previous studies had reported the impact of weight changes in middle age on the incidence of cardiovascular disease (CVD), but the results were inconsistent. In present study, we aimed to investigated the impact of a 4-year weight change on the risk of CVD in middle-aged and elderly Chinese individuals. Methods: Using nationally representative data from the China Health and Retirement Longitudinal Study, 7,530 participants (age: 58.2 ± 8.9 years) were included. Weight change was calculated by subtracting weight at baseline from that at 4-year follow-up. Weight change over 4 years was divided into five categories (loss ≥5 kg; loss 2–5 kg; stable (change ≤ 2 kg); gain 2–5 kg; and gain ≥5 kg). Results: During the follow-up period, a total of 758 respondents experienced CVD (including 319 stroke and 477 cardiac events). The multivariable ORs of CVD for gain ≥5 kg compared to stable weight (change ≤2 kg) was 1.50 (95% CI, 1.14–1.97) versus 1.41(1.09-1.83) for losing ≥5 kg. Multivariable-adjusted logistic regression model with restricted cubic splines showed a U-shaped association between weight change and the risk of CVD (p for nonlinearity <0.001). The significant associations did not change in subgroup and sensitivity analysis. Weight change was also associated with higher risk of stroke and cardiac events. Conclusion: Weight changes (weight gain or loss more than 5kg) during middle age was associated with an increased risk of CVD in middle-aged and elderly Chinese individuals.