Body mass index and mortality in China: a 15-year prospective study of 220 000 men.
BACKGROUND: In China, there have been few large prospective studies of the associations of body mass index (BMI) with overall and cause-specific mortality that have simultaneously controlled for biases that can be caused by pre-existing disease and smoking. METHODS: Prospective cohort study of 224 0...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2012
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| _version_ | 1826306149776883712 |
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| author | Chen, Z Yang, G Offer, A Zhou, M Smith, M Peto, R Ge, H Yang, L Whitlock, G |
| author_facet | Chen, Z Yang, G Offer, A Zhou, M Smith, M Peto, R Ge, H Yang, L Whitlock, G |
| author_sort | Chen, Z |
| collection | OXFORD |
| description | BACKGROUND: In China, there have been few large prospective studies of the associations of body mass index (BMI) with overall and cause-specific mortality that have simultaneously controlled for biases that can be caused by pre-existing disease and smoking. METHODS: Prospective cohort study of 224 064 men, of whom 40 700 died during follow-up between 1990-91 and 2006. Analyses restricted to 142 214 men aged 40-79 years at baseline with no disease history and, to further reduce bias from pre-existing disease, at least 5 years of subsequent follow-up, leaving 17 800 deaths [including 4165 stroke, 1297 coronary heart disease (CHD), 3121 chronic obstructive pulmonary disease (COPD)]. Adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) per 5 kg/m(2) calculated within either a lower (15 to <23.5 kg/m(2)) or higher (23.5 to <35 kg/m(2)) range. RESULTS: The association between BMI and all-cause mortality was U-shaped with the lowest mortality at ∼22.5-25 kg/m(2). In the lower range, 5 kg/m(2) higher BMI was associated with 14% lower mortality (HR 0.86, 95% CI 0.82-0.91); in the upper range, it was associated with 27% higher mortality (HR 1.27, 95% CI 1.15-1.40). The absolute excess mortality in the lower range was largely accounted for by excess mortality from specific smoking-related diseases: 54% by that for COPD, 12% other respiratory disease, 13% lung cancer, 11% stomach cancer. The excess mortality in the upper BMI range was largely accounted for by excess mortality from specific vascular diseases: 55% by that for stroke, 16% CHD. In this range, 5 kg/m(2) higher BMI was associated with ∼50% higher mortality from stroke (HR 1.61, 95% CI 1.36-1.92) and CHD (HR 1.48, 95% CI 1.12-1.95). CONCLUSIONS: For China, previous evidence may have overestimated the excess mortality at low BMI but underestimated that at high BMI. The main way obesity kills in China appears to be stroke. |
| first_indexed | 2024-03-07T06:43:33Z |
| format | Journal article |
| id | oxford-uuid:fa1d9031-7efa-499c-af99-c50fd202803d |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:43:33Z |
| publishDate | 2012 |
| record_format | dspace |
| spelling | oxford-uuid:fa1d9031-7efa-499c-af99-c50fd202803d2022-03-27T13:03:12ZBody mass index and mortality in China: a 15-year prospective study of 220 000 men.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fa1d9031-7efa-499c-af99-c50fd202803dEnglishSymplectic Elements at Oxford2012Chen, ZYang, GOffer, AZhou, MSmith, MPeto, RGe, HYang, LWhitlock, GBACKGROUND: In China, there have been few large prospective studies of the associations of body mass index (BMI) with overall and cause-specific mortality that have simultaneously controlled for biases that can be caused by pre-existing disease and smoking. METHODS: Prospective cohort study of 224 064 men, of whom 40 700 died during follow-up between 1990-91 and 2006. Analyses restricted to 142 214 men aged 40-79 years at baseline with no disease history and, to further reduce bias from pre-existing disease, at least 5 years of subsequent follow-up, leaving 17 800 deaths [including 4165 stroke, 1297 coronary heart disease (CHD), 3121 chronic obstructive pulmonary disease (COPD)]. Adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) per 5 kg/m(2) calculated within either a lower (15 to <23.5 kg/m(2)) or higher (23.5 to <35 kg/m(2)) range. RESULTS: The association between BMI and all-cause mortality was U-shaped with the lowest mortality at ∼22.5-25 kg/m(2). In the lower range, 5 kg/m(2) higher BMI was associated with 14% lower mortality (HR 0.86, 95% CI 0.82-0.91); in the upper range, it was associated with 27% higher mortality (HR 1.27, 95% CI 1.15-1.40). The absolute excess mortality in the lower range was largely accounted for by excess mortality from specific smoking-related diseases: 54% by that for COPD, 12% other respiratory disease, 13% lung cancer, 11% stomach cancer. The excess mortality in the upper BMI range was largely accounted for by excess mortality from specific vascular diseases: 55% by that for stroke, 16% CHD. In this range, 5 kg/m(2) higher BMI was associated with ∼50% higher mortality from stroke (HR 1.61, 95% CI 1.36-1.92) and CHD (HR 1.48, 95% CI 1.12-1.95). CONCLUSIONS: For China, previous evidence may have overestimated the excess mortality at low BMI but underestimated that at high BMI. The main way obesity kills in China appears to be stroke. |
| spellingShingle | Chen, Z Yang, G Offer, A Zhou, M Smith, M Peto, R Ge, H Yang, L Whitlock, G Body mass index and mortality in China: a 15-year prospective study of 220 000 men. |
| title | Body mass index and mortality in China: a 15-year prospective study of 220 000 men. |
| title_full | Body mass index and mortality in China: a 15-year prospective study of 220 000 men. |
| title_fullStr | Body mass index and mortality in China: a 15-year prospective study of 220 000 men. |
| title_full_unstemmed | Body mass index and mortality in China: a 15-year prospective study of 220 000 men. |
| title_short | Body mass index and mortality in China: a 15-year prospective study of 220 000 men. |
| title_sort | body mass index and mortality in china a 15 year prospective study of 220 000 men |
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