Association between body mass index and mortality among older Chinese: evidence from CHARLS
WANG Junping1, LU Zhaojun1, KOU Shuo1, ZHENG Weijun1, XIE Kaihong2, WANG Weihao1, RONG Chao2
1. School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China; 2. Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China
Abstract：Objective To investigate the association between body mass index ( BMI ) and mortality risk among older Chinese based on the China Health and Retirement Longitudinal Study ( CHARLS ). Methods The demographic features, BMI, prevalence of chronic diseases and mortality among the elderly at ages of 60 years and greater were captured from the CHARLS database from 2011 to 2018. A multivariable Cox proportional hazards regression model was used to examine the association between BMI and the risk of death. Results Totally 6 023 subjects were enrolled, including 3 006 men ( 50.09% ) and 3 017 women ( 49.91% ), and 68.69% of the participants ( 4 137 subjects ) were at ages of 60 to 69 years. There were 637 subjects ( 10.58% ) with underweight, 1 544 ( 25.63% ) with overweight, and 557 ( 9.25% ) with obesity. During the follow-up period ( 35 091 person-years ), 1 035 subjects died. Multivariable Cox proportional hazards regression analysis revealed an increased risk of mortality among the underweight elderly ( HR=1.496, 95%CI: 1.261-1.775 ) and a reduced risk of mortality among the obese elderly ( HR=0.671, 95%CI: 0.511-0.881 ) relative to the elderly with normal weight, after adjustment for age, gender, smoking, household registration, administration of anti-diabetic drugs, administration of anti-dyslipidemia drugs, and administration of anti-hypertensive drugs. Conclusion It is found that the risk of mortality among the Chinese elderly correlatives with BMI through the analysis of CHARLS data.
王俊苹, 卢肇骏, 寇硕, 郑卫军, 谢开红, 王炜豪, 荣超. 基于CHARLS的中国老年人体质指数与死亡风险研究[J]. 预防医学, 2022, 34(4): 346-349.
WANG Junping, LU Zhaojun, KOU Shuo, ZHENG Weijun, XIE Kaihong, WANG Weihao, RONG Chao. Association between body mass index and mortality among older Chinese: evidence from CHARLS. Preventive Medicine, 2022, 34(4): 346-349.
[1] 何梦洁,黄李春,苏丹婷,等. 浙江省成年人群肥胖流行现状[J]. 预防医学,2021,33(2):162-164. HE M J,HUANG L C,SU D T,et al.Prevalence of obesity among adults in Zhejiang Province[J].Prev Med,2021,33(2):162-164. [2] PICHE M E,POIRIER P,LEMIEUX I,et al.Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease:an update[J].Prog Cardiovasc Dis,2018,61(2):103-113. [3] BHASKARAN K,DOS-SANTOS-SILVA I,LEON D A,et al.Association of BMI with overall and cause-specific mortality:a population-based cohort study of 3.6 million adults in the UK[J].Lancet Diabetes Endocrinol,2018,6(12):944-953. [4] 张伟伟,吴同浩,马进,等.江苏省35~75岁居民肥胖和中心性肥胖现况调查[J].预防医学,2019,31(9):886-890,896. ZHANG W W,WU T H,MA J,et al.Cross-sectional study on obesity and central obesity among 35-75 year-old people in Jiangsu Province[J]. Prev Med,2019,31(9):886-890,896. [5] AFSHIN A,FOROUZANFAR M H,REITSMA M B,et al.Health effects of overweight and obesity in 195 countries over 25 years[J].N Engl J Med,2017,377(1):13-27. [6] BERRIGAN D,TROIANO R P,GRAUBARD B I.BMI and mortality:the limits of epidemiological evidence[J].Lancet,2016,388(10046):734-736. [7] Global BMI Mortality Collaboration.Body-mass index and all-cause mortality:individual-participant-data meta-analysis of 239 prospective studies in four continents[J].Lancet,2016,388(10046):776-786. [8] HYPPONEN E,CARSLAKE D,BERRY D J,et al.Estimating the influence of body mass index(BMI)on mortality using offspring BMI as an instrumental variable[J].Int J Obes,2022,46(1):77-84. [9] 童玉芬. 中国人口的最新动态与趋势——结合第七次全国人口普查数据的分析[J].中国劳动关系学院学报,2021,35(4):15-25. TONG Y F.Research on the latest dynamics and trends of population in China-an analysis combined with the seventh national census data[J].J China Univ Labor Relat,2021,35(4):15-25. [10] DORNER T E,RIEDER A.Obesity paradox in elderly patients with cardiovascular diseases[J].Int J Cardiol,2012,155(1):56-65. [11] O'SILLEBHAINP S,SUTIN A R,GERSTORF D.Body mass index,waist circumference,and mortality risks over 27 years of follow-up in old age[J].Ann Epidemiol,2020,46:20-23. [12] ZHENG W,MCLERRAN D F,ROLLAND B,et al.Association between body mass index and risk of death in more than 1 million Asians[J].N Engl J Med,2011,364(8):719-729. [13] SUN H,REN X X,CHEN Z C,et al.Association between body mass index and mortality in a prospective cohort of Chinese adults[J/OL].Medicine,2016,95(32)[2022-02-01].https://journals.lww.com/md-journal/Fulltext/2016/08090/Association_between_body_mass_index_and_mortality.10.aspx.DOI:10.1097/MD.0000000000004327. [14] WANG J,TAYLOR A W,ZHANG T,et al.Association between body mass index and all-cause mortality among oldest old Chinese[J].J Nutr Health Aging,2018,22(2):262-268. [15] 王悠清. 成人体质指数与死亡风险的前瞻性研究[D].杭州:浙江大学,2015. WANG Y Q.Association between body mass index and mortality in adults:a prospective study in China[D].Hangzhou:Zhejiang University,2015. [16] 翟屹,任泽萍,魏国华,等.山西营养与慢性病家庭队列人群体质指数与死亡率的关系[J].中华流行病学杂志,2019,40(4):433-439. ZHAI Y,REN Z P,WEI G H,et al.Body mass index and attribution to all-cause mortality in adults of family cohort of nutrition and chronic diseases in Shanxi province[J].Chin J Epidemiol,2019,40(4):433-439. [17] JAYEDI A,SHAB-BIDAR S.Nonlinear dose-response association between body mass index and risk of all-cause and cardiovascular mortality in patients with hypertension:a meta-analysis[J].Obes Res Clin Pract,2018,12(1):16-28. [18] CHENG F W,GAO X,MITCHELL D C,et al.Body mass index and all-cause mortality among older adults[J].Obesity,2016,24(10):2232-2239.
