All cause mortality and body mass index in a young Asian occupational cohort without baseline metabolic syndrome components.
BACKGROUND
The aim was to investigate associations between underweight, overweight and obesity and all cause, cancer and cardiovascular disease (CVD) mortality, excluding subjects with known CVD, diabetes, hypertension and components of the metabolic syndrome (MetS) at baseline.


METHODS
The study population consisted of examinees participating in a health screening in Korea from 2002 to 2013. Data were analyzed in 162,194 subjects (in a retrospective cohort study design-median (interquartile range (IQR) follow-up 4.9 (1.8-8.5years))). The outcomes were all cause mortality, cancer and CVD.


RESULTS
The mean (age range) and median age (IQR) at baseline were 36.9(20.0-85.3) and 35.2 (30.8-40.6) years. There were 436 deaths during follow-up. For men and women together, the fully adjusted HR for underweight and all cause mortality, cancer and CVD was 1.53 (95% CIs 1.06-2.20), 1.21 (95% CIs 0.68-2.14) and 1.34 (95% CIs 0.40-4.49) respectively. In contrast, the fully adjusted HR for overweight/obesity combined and all cause mortality was 0.77 (95%CIs 0.63-0.95) and there were non significant trends towards decreased cancer and CVD mortality. The association between overweight/obesity and all cause mortality was similar for men and women considered separately and for overweight and obesity as separate BMI categories. Smoking did not seem to explain the increased HR in the underweight BMI category.


CONCLUSIONS
In a young metabolically healthy adult cohort, underweight was associated with increased all cause mortality and overweight/obesity was associated with decreased all cause mortality if CVD, diabetes, hypertension and components of the metabolic syndrome (MetS) are excluded.
Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: kcmd.sung@samsung.com.
Ki-Chul
KC
Sung
Department of Occupational and Environmental Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Seungho
S
Ryu
Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Jong-Young
JY
Lee
Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
SungHo
S
Lee
Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
EunSun
E
Cheong
Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
Jang-Young
JY
Kim
Centre for Population Health Sciences, University of Edinburgh, UK.
Sarah H
SH
Wild
Nutrition and Metabolism Unit, IDS Building, Southampton General Hospital (University of Southampton), MP 887, Southampton, UK. Electronic address: c.d.byrne@soton.ac.uk.
Christopher D
CD
Byrne
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D016272:Occupational Health; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
All cause mortality; Metabolic syndrome; Mortality rates; Obesity; Smoking; Underweight