General and Abdominal Adiposity and Mortality in Mexico City A Prospective Study of 150 000 Adults
Por:
Gnatiuc, Louisa, Alegre-Diaz, Jesus, Wade, Rachel, Ramirez-Reyes, Raul, Tapia-Conyer, Roberto, Garcilazo-Avila, Adrian, Chiquete, Erwin, Gonzales-Carballo, Carlos, Solano-Sanchez, Martha, Clarke, Robert, Collins, Rory, Herrington, William G., Hill, Michael, Lewington, Sarah, Peto, Richard, Emberson, Jonathan R., Kuri-Morales, Pablo
Publicada:
17 sep 2019
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 A(1c) 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/m 2 (SD, 4.1 kg/m(2)) in men and 29.6 kg/m(2) (SD,
5.1 kg/m(2)) in women. The association of BMI at recruitment with
all-cause mortality was J-shaped, with the minimum at 25 to <27.5
kg/m(2). Above 25 kg/m(2), each 5-kg/m(2) 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.
Filiaciones:
Gnatiuc, Louisa:
Nuffield Dept Populat Hlth, Clin Trial Serv Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Nuffield Dept Populat Hlth, Epidemiol Studies Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Alegre-Diaz, Jesus:
Univ Nacl Autonoma Mexico, Fac Med, Ave Univ 3000, Mexico City 04510, DF, Mexico
Wade, Rachel:
Nuffield Dept Populat Hlth, MRC Populat Hlth Res Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Ramirez-Reyes, Raul:
Univ Nacl Autonoma Mexico, Fac Med, Ave Univ 3000, Mexico City 04510, DF, Mexico
Tapia-Conyer, Roberto:
Univ Nacl Autonoma Mexico, Fac Med, Ave Univ 3000, Mexico City 04510, DF, Mexico
Garcilazo-Avila, Adrian:
Univ Nacl Autonoma Mexico, Fac Med, Ave Univ 3000, Mexico City 04510, DF, Mexico
Chiquete, Erwin:
Salvador Zubiran Natl Inst Med Sci & Nutr, Vasco de Quiroga 15,Belisario Dominguez Secc 16, Mexico City 14080, DF, Mexico
Gonzales-Carballo, Carlos:
Univ Nacl Autonoma Mexico, Fac Med, Ave Univ 3000, Mexico City 04510, DF, Mexico
Solano-Sanchez, Martha:
Univ Nacl Autonoma Mexico, Fac Med, Ave Univ 3000, Mexico City 04510, DF, Mexico
Clarke, Robert:
Nuffield Dept Populat Hlth, Clin Trial Serv Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Nuffield Dept Populat Hlth, Epidemiol Studies Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Collins, Rory:
Nuffield Dept Populat Hlth, Clin Trial Serv Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Nuffield Dept Populat Hlth, Epidemiol Studies Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Herrington, William G.:
Nuffield Dept Populat Hlth, MRC Populat Hlth Res Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Hill, Michael:
Nuffield Dept Populat Hlth, MRC Populat Hlth Res Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Lewington, Sarah:
Nuffield Dept Populat Hlth, MRC Populat Hlth Res Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Peto, Richard:
Nuffield Dept Populat Hlth, Clin Trial Serv Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Nuffield Dept Populat Hlth, Epidemiol Studies Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Emberson, Jonathan R.:
Nuffield Dept Populat Hlth, MRC Populat Hlth Res Unit, Richard Doll Bldg,Old Rd Campus,Roosevelt Dr, Oxford OX3 7LF, England
Kuri-Morales, Pablo:
Univ Nacl Autonoma Mexico, Fac Med, Ave Univ 3000, Mexico City 04510, DF, Mexico
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