General and Abdominal Adiposity and Mortality in Mexico City: A Prospective Study of 150 000 Adults.
Journal
Annals of internal medicine
ISSN: 1539-3704
Titre abrégé: Ann Intern Med
Pays: United States
ID NLM: 0372351
Informations de publication
Date de publication:
17 09 2019
17 09 2019
Historique:
pubmed:
14
8
2019
medline:
17
6
2020
entrez:
13
8
2019
Statut:
ppublish
Résumé
Some reports suggest that body mass index (BMI) is not strongly associated with mortality in Hispanic populations. To assess the causal relevance of adiposity to mortality in Mexican adults, avoiding reverse causality biases. Prospective study. 2 Mexico City districts. 159 755 adults aged 35 years and older at recruitment, followed for up to 14 years. Participants with a hemoglobin A1c level of 7% or greater, diabetes, or other chronic diseases were excluded. BMI, waist-to-hip ratio, waist circumference, and cause-specific mortality. Cox regression, adjusted for confounders, yielded mortality hazard ratios (HRs) after at least 5 years of follow-up and before age 75 years. Among 115 400 participants aged 35 to <75 years at recruitment, mean BMI was 28.0 kg/m2 (SD, 4.1 kg/m2) in men and 29.6 kg/m2 (SD, 5.1 kg/m2) in women. The association of BMI at recruitment with all-cause mortality was J-shaped, with the minimum at 25 to <27.5 kg/m2. Above 25 kg/m2, each 5-kg/m2 increase in BMI was associated with a 30% increase in all-cause mortality (HR, 1.30 [95% CI, 1.24 to 1.36]). This association was stronger at ages 40 to <60 years (HR, 1.40 [CI, 1.30 to 1.49]) than at ages 60 to <75 years (HR, 1.24 [CI, 1.17 to 1.31]) but was not materially affected by sex, smoking, or other confounders. The associations of mortality with BMI and waist-to-hip ratio were similarly strong, and each was weakened only slightly by adjustment for the other. Waist circumference was strongly related to mortality and remained so even after adjustment for BMI and hip circumference. Analyses were limited to mortality. General, and particularly abdominal, adiposity were strongly associated with mortality in this Mexican population. Mexican Health Ministry, Mexican National Council of Science and Technology, Wellcome Trust, Medical Research Council, and Kidney Research UK.
Sections du résumé
Background
Some reports suggest that body mass index (BMI) is not strongly associated with mortality in Hispanic populations.
Objective
To assess the causal relevance of adiposity to mortality in Mexican adults, avoiding reverse causality biases.
Design
Prospective study.
Setting
2 Mexico City districts.
Participants
159 755 adults aged 35 years and older at recruitment, followed for up to 14 years. Participants with a hemoglobin A1c level of 7% or greater, diabetes, or other chronic diseases were excluded.
Measurements
BMI, waist-to-hip ratio, waist circumference, and cause-specific mortality. Cox regression, adjusted for confounders, yielded mortality hazard ratios (HRs) after at least 5 years of follow-up and before age 75 years.
Results
Among 115 400 participants aged 35 to <75 years at recruitment, mean BMI was 28.0 kg/m2 (SD, 4.1 kg/m2) in men and 29.6 kg/m2 (SD, 5.1 kg/m2) in women. The association of BMI at recruitment with all-cause mortality was J-shaped, with the minimum at 25 to <27.5 kg/m2. Above 25 kg/m2, each 5-kg/m2 increase in BMI was associated with a 30% increase in all-cause mortality (HR, 1.30 [95% CI, 1.24 to 1.36]). This association was stronger at ages 40 to <60 years (HR, 1.40 [CI, 1.30 to 1.49]) than at ages 60 to <75 years (HR, 1.24 [CI, 1.17 to 1.31]) but was not materially affected by sex, smoking, or other confounders. The associations of mortality with BMI and waist-to-hip ratio were similarly strong, and each was weakened only slightly by adjustment for the other. Waist circumference was strongly related to mortality and remained so even after adjustment for BMI and hip circumference.
Limitation
Analyses were limited to mortality.
Conclusion
General, and particularly abdominal, adiposity were strongly associated with mortality in this Mexican population.
Primary Funding Source
Mexican Health Ministry, Mexican National Council of Science and Technology, Wellcome Trust, Medical Research Council, and Kidney Research UK.
Identifiants
pubmed: 31404923
pii: 2748328
doi: 10.7326/M18-3502
pmc: PMC6949137
mid: EMS84192
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
397-405Subventions
Organisme : Wellcome Trust
ID : 058299
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U137686857
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U137686855
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12026/3
Pays : United Kingdom
Organisme : British Heart Foundation
ID : CH/1996001/9454
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R007764/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00017/2
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Références
Int J Obes (Lond). 2012 Aug;36(8):1121-6
pubmed: 21986709
N Engl J Med. 2017 Jul 6;377(1):13-27
pubmed: 28604169
N Engl J Med. 2011 Feb 24;364(8):719-29
pubmed: 21345101
Int J Epidemiol. 2006 Apr;35(2):243-9
pubmed: 16556648
Bull World Health Organ. 2005 Mar;83(3):171-7
pubmed: 15798840
Obesity (Silver Spring). 2013 Jul;21(7):1474-7
pubmed: 23596157
Obes Rev. 2016 Mar;17(3):262-75
pubmed: 26663309
JAMA Netw Open. 2019 Jul 3;2(7):e197337
pubmed: 31339542
Stat Med. 2004 Jan 15;23(1):93-104
pubmed: 14695642
Lancet Glob Health. 2018 Jul;6(7):e787-e794
pubmed: 29903379
N Engl J Med. 2016 Nov 17;375(20):1961-1971
pubmed: 27959614
Lancet. 2017 Sep 16;390(10100):1345-1422
pubmed: 28919119
Clin Chem. 2002 Sep;48(9):1627-9
pubmed: 12194959
PLoS One. 2015 Jul 31;10(7):e0133958
pubmed: 26230991
N Engl J Med. 2008 Nov 13;359(20):2105-20
pubmed: 19005195
Lancet. 2016 Aug 20;388(10046):776-86
pubmed: 27423262
Lancet. 2011 Mar 26;377(9771):1085-95
pubmed: 21397319
Lancet. 2009 Mar 28;373(9669):1083-96
pubmed: 19299006