General and abdominal adiposity and mortality in Mexico City: A prospective study of 150 000 adults

Louisa Gnatiuc, Jesus Alegre-Díaz, Rachel Wade, Raúl Ramirez-Reyes, Roberto Tapia-Conyer, Adrián Garcilazo-Ávila, Erwin Chiquete, Carlos Gonzáles-Carballo, Martha Solano-Sanchez, Robert Clarke, Rory Collins, William G. Herrington, Michael Hill, Sarah Lewington, Richard Peto, Jonathan R. Emberson, Pablo Kuri-Morales

Resultado de la investigación: Contribución a una revistaArtículo de revisión

Resumen

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 con-founders, 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 con-founders. 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.

Idioma originalInglés
Páginas (desde-hasta)397-405
Número de páginas9
PublicaciónAnnals of Internal Medicine
Volumen171
N.º6
DOI
EstadoPublicada - 17 sep 2019

Huella dactilar

Adiposity
Mexico
Prospective Studies
Mortality
Body Mass Index
Waist-Hip Ratio
Waist Circumference
Hispanic Americans
Causality
Population
Hip
Hemoglobins
Chronic Disease
Smoking

Citar esto

Gnatiuc, L., Alegre-Díaz, J., Wade, R., Ramirez-Reyes, R., Tapia-Conyer, R., Garcilazo-Ávila, A., ... Kuri-Morales, P. (2019). General and abdominal adiposity and mortality in Mexico City: A prospective study of 150 000 adults. Annals of Internal Medicine, 171(6), 397-405. https://doi.org/10.7326/M18-3502
Gnatiuc, Louisa ; Alegre-Díaz, Jesus ; Wade, Rachel ; Ramirez-Reyes, Raúl ; Tapia-Conyer, Roberto ; Garcilazo-Ávila, Adrián ; Chiquete, Erwin ; Gonzáles-Carballo, Carlos ; Solano-Sanchez, Martha ; Clarke, Robert ; Collins, Rory ; Herrington, William G. ; Hill, Michael ; Lewington, Sarah ; Peto, Richard ; Emberson, Jonathan R. ; Kuri-Morales, Pablo. / General and abdominal adiposity and mortality in Mexico City : A prospective study of 150 000 adults. En: Annals of Internal Medicine. 2019 ; Vol. 171, N.º 6. pp. 397-405.
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title = "General and abdominal adiposity and mortality in Mexico City: A prospective study of 150 000 adults",
abstract = "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 con-founders, 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 con-founders. 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.",
author = "Louisa Gnatiuc and Jesus Alegre-D{\'i}az and Rachel Wade and Ra{\'u}l Ramirez-Reyes and Roberto Tapia-Conyer and Adri{\'a}n Garcilazo-{\'A}vila and Erwin Chiquete and Carlos Gonz{\'a}les-Carballo and Martha Solano-Sanchez and Robert Clarke and Rory Collins and Herrington, {William G.} and Michael Hill and Sarah Lewington and Richard Peto and Emberson, {Jonathan R.} and Pablo Kuri-Morales",
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Gnatiuc, L, Alegre-Díaz, J, Wade, R, Ramirez-Reyes, R, Tapia-Conyer, R, Garcilazo-Ávila, A, Chiquete, E, Gonzáles-Carballo, C, Solano-Sanchez, M, Clarke, R, Collins, R, Herrington, WG, Hill, M, Lewington, S, Peto, R, Emberson, JR & Kuri-Morales, P 2019, 'General and abdominal adiposity and mortality in Mexico City: A prospective study of 150 000 adults', Annals of Internal Medicine, vol. 171, n.º 6, pp. 397-405. https://doi.org/10.7326/M18-3502

General and abdominal adiposity and mortality in Mexico City : A prospective study of 150 000 adults. / Gnatiuc, Louisa; Alegre-Díaz, Jesus; Wade, Rachel; Ramirez-Reyes, Raúl; Tapia-Conyer, Roberto; Garcilazo-Ávila, Adrián; Chiquete, Erwin; Gonzáles-Carballo, Carlos; Solano-Sanchez, Martha; Clarke, Robert; Collins, Rory; Herrington, William G.; Hill, Michael; Lewington, Sarah; Peto, Richard; Emberson, Jonathan R.; Kuri-Morales, Pablo.

En: Annals of Internal Medicine, Vol. 171, N.º 6, 17.09.2019, p. 397-405.

Resultado de la investigación: Contribución a una revistaArtículo de revisión

TY - JOUR

T1 - General and abdominal adiposity and mortality in Mexico City

T2 - A prospective study of 150 000 adults

AU - Gnatiuc, Louisa

AU - Alegre-Díaz, Jesus

AU - Wade, Rachel

AU - Ramirez-Reyes, Raúl

AU - Tapia-Conyer, Roberto

AU - Garcilazo-Ávila, Adrián

AU - Chiquete, Erwin

AU - Gonzáles-Carballo, Carlos

AU - Solano-Sanchez, Martha

AU - Clarke, Robert

AU - Collins, Rory

AU - Herrington, William G.

AU - Hill, Michael

AU - Lewington, Sarah

AU - Peto, Richard

AU - Emberson, Jonathan R.

AU - Kuri-Morales, Pablo

PY - 2019/9/17

Y1 - 2019/9/17

N2 - 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 con-founders, 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 con-founders. 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.

AB - 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 con-founders, 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 con-founders. 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.

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U2 - 10.7326/M18-3502

DO - 10.7326/M18-3502

M3 - Artículo de revisión

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AN - SCOPUS:85072543878

VL - 171

SP - 397

EP - 405

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

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