title: [Association between body mass index and both total and cause-specific mortality in China: findings from data through the China Kadoorie Biobank].
abstract: Objective:To evaluate the associations between body mass index (BMI) and both total and cause-specific mortality.Methods:After excluding participants with heart disease, stroke, cancer, chronic obstructive pulmonary disease, and diabetes at baseline study, 428 593 participants aged 30-79 in the China Kadoorie Biobank study were chosen for this study. Participants were categorized into 9 groups according to their BMI status. Cox regression analysis was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality on BMI.Results:Among 3 085 054 person-years of the follow-up program between 2004 and 2013 (median 7.2 years), a total of 7 862 men and 6 315 women died. After adjusting for known or potential confounders, an increased risks of all-cause deaths were shown among participants with a BMI less than 18.5 (HR=1.40, 95%CI: 1.31-1.50), between 18.5-20.4 (HR=1.11, 95%CI: 1.05-1.17), and more than 35.0 (HR=2.05, 95%CI: 1.60-2.61), when compared to those with BMI between 20.5-22.4. Ranges of BMI with lower risk of cause-specific mortality were: 18.5-23.9 for ischemic heart disease, <26.0 for cerebro-vascular disease, 26.0-34.9 for cancers, and 24.0-25.9 for respiratory diseases.Conclusions:In this large prospective study, both underweight and obesity were associated with the increased total and certain cause-specific mortality, which were independent from other risk factors of death. Programs related to extensive follow-up, thorough analysis BMI and the risks of incidence on major chronic diseases all need to be developed, in order to better understand the impact of BMI on human health.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
authors.forename: L X
authors.initials: LX
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
authors.forename: M Y
authors.initials: MY
authors.lastname: Fan
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
authors.forename: C Q
authors.initials: CQ
authors.lastname: Yu
authors.affiliation: Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Bian
authors.affiliation: Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Y L
authors.initials: YL
authors.lastname: Tan
authors.affiliation: Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: P
authors.initials: P
authors.lastname: Pei
authors.affiliation: China National Center for Food Safety Risk Assessment, Beijing 100022, China.
authors.forename: J S
authors.initials: JS
authors.lastname: Chen
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
authors.forename: J
authors.initials: J
authors.lastname: Lyu
authors.affiliation: Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
authors.forename: L M
authors.initials: LM
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D018070:Biological Specimen Banks; D015992:Body Mass Index; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality; D017202:Myocardial Ischemia / Q000401:mortality; D009369:Neoplasms / Q000401:mortality; D009765:Obesity / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000401:mortality; D013851:Thinness / Q000453:epidemiology*
keywords: Body mass index; Chronic disease; Mortality; Prospective study