Estimating the influence of body mass index (BMI) on mortality using offspring BMI as an instrumental variable.
Journal
International journal of obesity (2005)
ISSN: 1476-5497
Titre abrégé: Int J Obes (Lond)
Pays: England
ID NLM: 101256108
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
16
11
2020
accepted:
27
08
2021
revised:
12
08
2021
pubmed:
10
9
2021
medline:
19
2
2022
entrez:
9
9
2021
Statut:
ppublish
Résumé
High body mass index (BMI) is an important predictor of mortality but estimating underlying causality is hampered by confounding and pre-existing disease. Here, we use information from the offspring to approximate parental BMIs, with an aim to avoid biased estimation of mortality risk caused by reverse causality. The analyses were based on information on 9674 offspring-mother and 9096 offspring-father pairs obtained from the 1958 British birth cohort. Parental BMI-mortality associations were analysed using conventional methods and using offspring BMI as a proxy, or instrument, for their parents' BMI. In the conventional analysis, associations between parental BMI and all-cause mortality were U-shaped (P Analyses using offspring BMI as a proxy for parental BMI suggest that the apparent adverse consequences of low BMI are considerably overestimated and adverse consequences of overweight are underestimated in conventional epidemiological studies.
Identifiants
pubmed: 34497352
doi: 10.1038/s41366-021-00962-8
pii: 10.1038/s41366-021-00962-8
pmc: PMC7612209
mid: EMS133684
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
77-84Subventions
Organisme : Medical Research Council
ID : MC_UU_12013/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00011/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0601653
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 059480
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12013/9
Pays : United Kingdom
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
Références
Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4:579–91.
doi: 10.1038/nrc1408
Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373:1083–96.
doi: 10.1016/S0140-6736(09)60318-4
Flegal KM, Graubard BI, Williamson DF, Gail MH. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA. 2007;298:2028–37.
doi: 10.1001/jama.298.17.2028
Winter JE, MacInnis RJ, Wattanapenpaiboon N, Nowson CA. BMI and all-cause mortality in older adults: a meta-analysis. Am J Clin Nutr. 2014;99:875–90.
doi: 10.3945/ajcn.113.068122
Rose G. The strategy of preventive medicine. Oxford: Oxford University Press; 1992.
Seidell JC, Visscher TL, Hoogeveen RT. Overweight and obesity in the mortality rate data: current evidence and research issues. Med Sci Sports Exerc. 1999;31:S597–601.
doi: 10.1097/00005768-199911001-00018
Berrigan D, Troiano RP, Graubard BI. BMI and mortality: the limits of epidemiological evidence. Lancet. 2016;388:734–6.
doi: 10.1016/S0140-6736(16)30949-7
Global BMI Mortality Collaboration Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388:776–86.
doi: 10.1016/S0140-6736(16)30175-1
Joshy G, Korda RJ, Bauman A, Van Der Ploeg HP, Chey T, Banks E. Investigation of methodological factors potentially underlying the apparently paradoxical findings on body mass index and all-cause mortality. PLoS ONE. 2014;9:e88641.
doi: 10.1371/journal.pone.0088641
Patel AV, Hildebrand JS, Gapstur SM. Body mass index and all-cause mortality in a large prospective cohort of white and black US adults. PLoS ONE. 2014;9:e109153.
doi: 10.1371/journal.pone.0109153
Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309:71–82.
doi: 10.1001/jama.2012.113905
Hughes V. The big fat truth. Nature. 2013;497:428–30.
pubmed: 23698426
Kendrick M. Why being “overweight” means you live longer: the way scientists twist the facts. The Independent; 2015, UK.
Flegal KM, Ioannidis JPA, Doehner W. Flawed methods and inappropriate conclusions for health policy on overweight and obesity: the Global BMI Mortality Collaboration meta-analysis. J Cachexia, Sarcopenia Muscle. 2019;10:9–13.
doi: 10.1002/jcsm.12378
Hyppönen E, Mulugeta A, Zhou A, Vimaleswaran KS. A data-driven approach for studying the role of body mass in multiple diseases: a phenome-wide registry-based case-control study in the UK Biobank. Lancet Digit Health. 2019;1:11.
Wade KH, Carslake D, Sattar N, Davey Smith G, Timpson NJ. BMI and mortality in UK Biobank: revised estimates using Mendelian randomization. Obesity. 2018;26:1796–806.
doi: 10.1002/oby.22313
Wade KH, Davey Smith G. Adiposity and cardiometabolic outcomes: what can meta-analyses of Mendelian randomization studies contribute? JAMA Netw Open. 2018;1:e183778.
doi: 10.1001/jamanetworkopen.2018.3778
Davey Smith G, Sterne JA, Fraser A, Tynelius P, Lawlor DA, Rasmussen F. The association between BMI and mortality using offspring BMI as an indicator of own BMI: large intergenerational mortality study. BMJ. 2009;339:b5043.
doi: 10.1136/bmj.b5043
Cawley J. An instrumental variables approach to measuring the effect of body weight on employment disability. Health Serv Res. 2000;35:1159–79.
pubmed: 11130815
pmcid: 1089168
Didelez V, Meng S, Sheehan NA. Assumptions of IV methods for observational epidemiology. Stat Sci. 2010;25:22–40.
doi: 10.1214/09-STS316
Power C, Pouliou T, Li L, Cooper R, Hypponen E. Parental and offspring adiposity associations: insights from the 1958 British birth cohort. Ann Hum Biol. 2011;38:390–9.
doi: 10.3109/03014460.2011.591827
Jackson JW, Swanson SA. Toward a clearer portrayal of confounding bias in instrumental variable applications. Epidemiology. 2015;26:498–504.
doi: 10.1097/EDE.0000000000000287
Smith GD. Assessing intrauterine influences on offspring health outcomes: can epidemiological studies yield robust findings? Basic Clin Pharmacol Toxicol. 2008;102:245–56.
doi: 10.1111/j.1742-7843.2007.00191.x
Power C, Atherton K, Thomas C. Maternal smoking in pregnancy, adult adiposity and other risk factors for cardiovascular disease. Atherosclerosis. 2010;211:643–8.
doi: 10.1016/j.atherosclerosis.2010.03.015
Ravelli AC, Der Meulen JH, Osmond C, Barker DJ, Bleker OP. Obesity at the age of 50 y in men and women exposed to famine prenatally. Am J Clin Nutr. 1999;70:811–6.
doi: 10.1093/ajcn/70.5.811
Butler NR, Bonham DG. Perinatal mortality. Edinburgh: E & S Livingstone; 1963.
Power C, Elliott J. Cohort profile: 1958 British birth cohort (National Child Development Study). Int J Epidemiol. 2006;35:34–41.
doi: 10.1093/ije/dyi183
Lake JK, Power C, Cole TJ. Child to adult body mass index in the 1958 British birth cohort: associations with parental obesity. Arch Dis Child. 1997;77:376–81.
doi: 10.1136/adc.77.5.376
Hyppönen E, Davey Smith G, Shepherd P, Power C. An intergenerational and lifecourse study of health and mortality risk in parents of the 1958 birth cohort: (I) methods and tracing. Public Health. 2005;119:599–607.
doi: 10.1016/j.puhe.2004.11.003
Hyppönen E, Davey Smith G, Shepherd P, Power C. An intergenerational and lifecourse study of health and mortality risk in parents of the 1958 birth cohort: (II) mortality rates and study representativeness. Public Health. 2005;119:608–15.
doi: 10.1016/j.puhe.2004.11.002
Angrist JD, Krueger AB. The effect of age at school entry on educational attainment: an application of instrumental variables with moments from two samples. J Am Stat Assoc. 1992;87:328–36.
doi: 10.1080/01621459.1992.10475212
Thomas DC, Lawlor DA, Thompson JR. Re: estimation of bias in nongenetic observational studies using “Mendelian triangulation” by Bautista et al. Ann Epidemiol. 2007;17:511–3.
doi: 10.1016/j.annepidem.2006.12.005
Greene WH. Econometric analysis. 7th ed. UK: Pearson; 2012.
Davies NM. An even clearer portrait of bias in observational studies? Epidemiology. 2015;26:505–8.
doi: 10.1097/EDE.0000000000000302
Yang Y, Dong J, Sun K, Zhao L, Zhao F, Wang L, et al. Obesity and incidence of lung cancer: a meta-analysis. Int J Cancer. 2013;132:1162–9.
doi: 10.1002/ijc.27719
Gao C, Patel CJ, Michailidou K, Peters U, Gong J, Schildkraut J, et al. Mendelian randomization study of adiposity-related traits and risk of breast, ovarian, prostate, lung and colorectal cancer. Int J Epidemiol. 2016;45:896–908.
doi: 10.1093/ije/dyw129
Carreras-Torres R, Haycock PC, Relton CL, Martin RM, Davey Smith G, Kraft P, et al. The causal relevance of body mass index in different histological types of lung cancer: a Mendelian randomization study. Sci Rep. 2016;6:31121.
doi: 10.1038/srep31121
Wade KH, Carslake D, Tynelius P, Davey Smith G, Martin RM. Variation of all-cause and cause-specific mortality with body mass index in one million Swedish parent-son pairs: an instrumental variable analysis. PLoS Med. 2019;16:e1002868.
doi: 10.1371/journal.pmed.1002868
Magnusson PK, Rasmussen F, Lawlor DA, Tynelius P, Gunnell D. Body mass index is inveresely associated with suicide mortality. A prospective cohort study of over 1 million men. Am J Epidemiol. 2006;163:1–8.
doi: 10.1093/aje/kwj002
Frayn KN, Kingman SM. Dietary sugars and lipid metabolism in humans. Am J Clin Nutr. 1995;62:250S–61S.
doi: 10.1093/ajcn/62.1.250S
Lipsett D, Madras BK, Wurtman RJ, Munro HN. Serum tryptophan level after carbohydrate ingestion: selective decline in non-albumin-bound tryptophan coincident with reduction in serum free fatty acids. Life Sci II. 1973;12:57–64.
doi: 10.1016/0024-3205(73)90027-1
Golomb BA, Tenkanen L, Alikoski T, Niskanen T, Manninen V, Huttunen M, et al. Insulin sensitivity markers: predictors of accidents and suicides in Helsinki Heart Study screenees. J Clin Epidemiol. 2002;55:767–73.
doi: 10.1016/S0895-4356(02)00407-9
Niemi AK, Hervonen A, Hurme M, Karhunen PJ, Jylha M, Majamaa K, et al. Mitochondrial DNA polymorphisms associated with longevity in a Finnish population. Hum Genet. 2003;112:29–33.
doi: 10.1007/s00439-002-0843-y
Macintyre S, Sooman A. Non-paternity and prenatal genetic screening. Lancet. 1991;338:869–71.
doi: 10.1016/0140-6736(91)91513-T