title: Underweight as a risk factor for respiratory death in the Whitehall cohort study: exploring reverse causality using a 45-year follow-up.
abstract: Underweight adults have higher rates of respiratory death than the normal weight but it is unclear whether this association is causal or reflects illness-induced weight loss (reverse causality). Evidence from a 45-year follow-up of underweight participants for respiratory mortality in the Whitehall study (N=18 823; 2139 respiratory deaths) suggests that excess risk among the underweight is attributable to reverse causality. The age-adjusted and smoking-adjusted risk was 1.55-fold (95% CI 1.32 to 1.83) higher among underweight compared with normal weight participants, but attenuated in a stepwise manner to 1.14 (95% CI 0.76 to 1.71) after serial exclusions of deaths during the first 5-35 years of follow-up (P(trend)<0.001).
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Shipley
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Bell
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Brunner
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
authors.forename: G David
authors.initials: GD
authors.lastname: Batty
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK Centre for Research in Epidemiology and Population Health, INSERM, Villejuif, France.
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
mesh_terms: D000328:Adult; D000368:Aged; D015984:Causality; D002908:Chronic Disease / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012140:Respiratory Tract Diseases / Q000401:mortality*; D012307:Risk Factors; D013851:Thinness
keywords: COPD epidemiology