Association between body mass index and cardiovascular disease mortality in east Asians and south Asians: pooled analysis of prospective data from the Asia Cohort Consortium

被引：228

作者：

Chen, Yu ^{[1
]}

Copeland, Wade K. ^{[2
]}

Vedanthan, Rajesh ^{[3
]}

Grant, Eric ^{[4
]}

Lee, Jung Eun ^{[5
]}

Gu, Dongfeng ^{[6
,7
,8
,9
]}

Gupta, Prakash C. ^{[10
]}

Ramadas, Kunnambath ^{[11
]}

Inoue, Manami ^{[12
,14
]}

Tsugane, Shoichiro ^{[12
]}

Tamakoshi, Akiko ^{[13
]}

Gao, Yu-Tang ^{[15
]}

Yuan, Jian-Min ^{[16
,17
]}

Shu, Xiao-Ou ^{[18
]}

Ozasa, Kotaro ^{[4
]}

Tsuji, Ichiro ^{[19
]}

Kakizaki, Masako ^{[19
]}

Tanaka, Hideo ^{[20
]}

Nishino, Yoshikazu ^{[21
]}

Chen, Chien-Jen ^{[22
,23
]}

Wang, Renwei ^{[16
]}

Yoo, Keun-Young ^{[24
]}

Ahn, Yoon-Ok ^{[24
]}

Ahsan, Habibul ^{[25
,26
,27
]}

Pan, Wen-Harn ^{[23
,28
,29
]}

Chen, Chung-Shiuan ^{[30
]}

Pednekar, Mangesh S. ^{[10
]}

Sauvaget, Catherine ^{[31
]}

Sasazuki, Shizuka ^{[12
]}

Yang, Gong ^{[18
]}

Koh, Woon-Puay ^{[32
,33
]}

Xiang, Yong-Bing ^{[15
]}

Ohishi, Waka ^{[34
]}

Watanabe, Takashi ^{[35
]}

Sugawara, Yumi ^{[35
]}

Matsuo, Keitaro ^{[20
,45
]}

You, San-Lin ^{[22
,36
]}

Park, Sue K. ^{[24
,37
]}

Kim, Dong-Hyun ^{[38
]}

Parvez, Faruque ^{[39
]}

Chuang, Shao-Yuan ^{[28
]}

Ge, Wenzhen ^{[1
]}

Rolland, Betsy ^{[2
]}

McLerran, Dale ^{[2
]}

Sinha, Rashmi ^{[40
]}

Thornquist, Mark ^{[2
]}

Kang, Daehee ^{[24
,37
]}

Feng, Ziding ^{[44
]}

Boffetta, Paolo ^{[41
,42
]}

Zheng, Wei ^{[18
]}

机构：

[1] NYU, Sch Med, Dept Populat Hlth, New York, NY USA

[2] Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98109 USA

[3] Icahn Sch Med Mt Sinai, Zena & Michael Wiener Cardiovasc Inst, New York, NY USA

[4] Radiat Effects Res Fdn, Dept Epidemiol, Hiroshima, Japan

[5] Sookmyung Womens Univ, Dept Food & Nutr, Seoul, South Korea

[6] Chinese Acad Med Sci, Dept Evidence Based Med, Beijing 100730, Peoples R China

[7] Chinese Acad Med Sci, Dept Populat Genet & Prevent, Fu Wai Hosp, Beijing 100730, Peoples R China

[8] Chinese Acad Med Sci, Cardiovasc Inst, Beijing 100730, Peoples R China

[9] Peking Union Med Coll, Beijing 100021, Peoples R China

[10] Healis Sekhsaria Inst Publ Hlth, Navi Mumbai, India

[11] Reg Canc Ctr, Div Radiat Oncol, Trivandrum 695011, Kerala, India

[12] Natl Canc Ctr, Res Ctr Canc Prevent & Screening, Epidemiol & Prevent Div, Tokyo 104, Japan

[13] Hokkaido Univ, Grad Sch Med, Dept Publ Hlth, Sapporo, Hokkaido, Japan

[14] Univ Tokyo, Grad Sch Med, AXA Dept Hlth & Human Secur, Tokyo, Japan

[15] Shanghai Canc Inst, Dept Epidemiol, Shanghai, Peoples R China

[16] Univ Pittsburgh, Inst Canc, Pittsburgh, PA USA

[17] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA

[18] Vanderbilt Univ, Sch Med, Dept Med,Div Epidemiol, Vanderbilt Epidemiol Ctr,Vanderbilt Ingram Canc C, Nashville, TN 37212 USA

[19] Tohoku Univ, Grad Sch Med, Dept Publ Hlth & Forens Med, Div Epidemiol, Sendai, Miyagi 980, Japan

[20] Aichi Canc Ctr Res Inst, Div Epidemiol & Prevent, Nagoya, Aichi, Japan

[21] Miyagi Canc Ctr Res Inst, Div Canc Epidemiol & Prevent, Sendai, Miyagi, Japan

[22] Acad Sinica, Genom Res Ctr, Taipei 115, Taiwan

[23] Natl Taiwan Univ, Coll Publ Hlth, Grad Inst Epidemiol & Prevent Med, Taipei 10764, Taiwan

[24] Seoul Natl Univ, Coll Med, Dept Prevent Med, Seoul, South Korea

[25] Univ Chicago, Ctr Comprehens Canc, Dept Hlth Studies, Chicago, IL 60637 USA

[26] Univ Chicago, Ctr Comprehens Canc, Dept Med, Chicago, IL 60637 USA

[27] Univ Chicago, Ctr Comprehens Canc, Dept Human Genet, Chicago, IL 60637 USA

[28] Natl Hlth Res Inst, Inst Populat Hlth Sci, Div Prevent Med & Hlth Serv Res, Miaoli, Taiwan

[29] Acad Sinica, Inst Biomed Sci, Taipei, Taiwan

[30] Tulane Univ, Sch Publ Hlth & Trop Med, Dept Epidemiol, New Orleans, LA USA

[31] Int Agcy Res Canc, Screening Grp, F-69372 Lyon, France

[32] Natl Univ Singapore, Duke NUS Grad Med Sch Singapore, Singapore 117548, Singapore

[33] Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore 117548, Singapore

[34] Radiat Effects Res Fdn, Dept Clin Studies, Hiroshima, Japan

[35] Tohoku Univ, Grad Sch Med, Dept Publ Hlth & Forens Med, Div Epidemiol, Sendai, Miyagi 980, Japan

[36] Fu Jen Catholic Univ, Dept Publ Hlth, Taipei, Taiwan

[37] Seoul Natl Univ, Grad Sch, Dept Biomed Sci, Canc Res Inst, Seoul, South Korea

[38] Hallym Univ, Coll Med, Dept Social & Prevent Med, Seoul, South Korea

[39] Columbia Univ, Mailman Sch Publ Hlth, Dept Environm Hlth Sci, New York, NY USA

[40] NCI, Div Canc Epidemiol & Genet, Bethesda, MD 20892 USA

[41] Icahn Sch Med Mt Sinai, Tisch Canc Inst & Inst Translat Epidemiol, New York, NY USA

[42] Int Prevent Res Inst, Lyon, France

[43] Massey Univ, Ctr Publ Hlth Res, Wellington, New Zealand

[44] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 USA

[45] Kyushu Univ, Fac Med Sci, Dept Prevent Med, Fukuoka 812, Japan

[46] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

来源：

BMJ-BRITISH MEDICAL JOURNAL | 2013年 / 347卷

基金：

新加坡国家研究基金会; 美国国家卫生研究院;

关键词：

CORONARY-HEART-DISEASE; INDIVIDUAL PATIENT DATA; ALL-CAUSE MORTALITY; MIDDLE-AGED MEN; FAT-FREE MASS; RISK-FACTORS; FOLLOW-UP; WEIGHT CHANGE; HEMORRHAGIC STROKE; ISCHEMIC-STROKE;

D O I：

10.1136/bmj.f5446

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objective To evaluate the association between body mass index and mortality from overall cardiovascular disease and specific subtypes of cardiovascular disease in east and south Asians. Design Pooled analyses of 20 prospective cohorts in Asia, including data from 835 082 east Asians and 289 815 south Asians. Cohorts were identified through a systematic search of the literature in early 2008, followed by a survey that was sent to each cohort to assess data availability. Setting General populations in east Asia (China, Taiwan, Singapore, Japan, and Korea) and south Asia (India and Bangladesh). Participants 1 124 897 men and women (mean age 53.4 years at baseline). Main outcome measures Risk of death from overall cardiovascular disease, coronary heart disease, stroke, and (in east Asians only) stroke subtypes. Results 49 184 cardiovascular deaths (40 791 in east Asians and 8393 in south Asians) were identified during a mean follow-up of 9.7 years. East Asians with a body mass index of 25 or above had a raised risk of death from overall cardiovascular disease, compared with the reference range of body mass index (values 22.5-24.9; hazard ratio 1.09 (95% confidence interval 1.03 to 1.15), 1.27 (1.20 to 1.35), 1.59 (1.43 to 1.76), 1.74 (1.47 to 2.06), and 1.97 (1.44 to 2.71) for body mass index ranges 25.0-27.4, 27.5-29.9, 30.0-32.4, 32.5-34.9, and 35.0-50.0, respectively). This association was similar for risk of death from coronary heart disease and ischaemic stroke; for haemorrhagic stroke, the risk of death was higher at body mass index values of 27.5 and above. Elevated risk of death from cardiovascular disease was also observed at lower categories of body mass index (hazard ratio 1.19 (95% confidence interval 1.02 to 1.39) and 2.16 (1.37 to 3.40) for body mass index ranges 15.0-17.4 and <15.0, respectively), compared with the reference range. In south Asians, the association between body mass index and mortality from cardiovascular disease was less pronounced than that in east Asians. South Asians had an increased risk of death observed for coronary heart disease only in individuals with a body mass index greater than 35 (hazard ratio 1.90, 95% confidence interval 1.15 to 3.12). Conclusions Body mass index shows a U shaped association with death from overall cardiovascular disease among east Asians: increased risk of death from cardiovascular disease is observed at lower and higher ranges of body mass index. A high body mass index is a risk factor for mortality from overall cardiovascular disease and for specific diseases, including coronary heart disease, ischaemic stroke, and haemorrhagic stroke in east Asians. Higher body mass index is a weak risk factor for mortality from cardiovascular disease in south Asians.

引用

页数：19

共 91 条

[1]

Health Effects of Arsenic Longitudinal Study (HEALS): Description of a multidisciplinary epidemiologic investigation [J].

Ahsan, H ;

Chen, Y ;

Parvez, F ;

Argos, M ;

Hussain, AI ;

Momotaj, H ;

Levy, D ;

Van Geen, A ;

Geoffrey, HA ;

Graziano, J .

JOURNAL OF EXPOSURE SCIENCE AND ENVIRONMENTAL EPIDEMIOLOGY, 2006, 16 (02) :191-205

[2]

[Anonymous], 2004, ATLAS HEART DIS STRO

[3]

[Anonymous], 2013, Global database on body mass index

[4]

Risk factors for intracerebral hemorrhage in the general population - A systematic review [J].

Ariesen, MJ ;

Claus, SP ;

Rinkel, GJE ;

Algra, A .

STROKE, 2003, 34 (08) :2060-2065

[5]

ETHNIC-DIFFERENCES IN MORTALITY FROM ISCHEMIC-HEART-DISEASE AND CEREBROVASCULAR-DISEASE IN ENGLAND AND WALES [J].

BALARAJAN, R .

BMJ-BRITISH MEDICAL JOURNAL, 1991, 302 (6776) :560-564

[6]

Body mass, tobacco smoking, alcohol drinking and risk of cancer of the small intestine-a pooled analysis of over 500 000 subjects in the Asia Cohort Consortium [J].

Boffetta, P. ;

Hazelton, W. D. ;

Chen, Y. ;

Sinha, R. ;

Inoue, M. ;

Gao, Y. T. ;

Koh, W. P. ;

Shu, X. O. ;

Grant, E. J. ;

Tsuji, I. ;

Nishino, Y. ;

You, S. L. ;

Yoo, K. Y. ;

Yuan, J. M. ;

Kim, J. ;

Tsugane, S. ;

Yang, G. ;

Wang, R. ;

Xiang, Y. B. ;

Ozasa, K. ;

Nagai, M. ;

Kakizaki, M. ;

Chen, C. J. ;

Park, S. K. ;

Shin, A. ;

Ahsan, H. ;

Qu, C. X. ;

Lee, J. E. ;

Thornquist, M. ;

Rolland, B. ;

Feng, Z. ;

Zheng, W. ;

Potter, J. D. .

ANNALS OF ONCOLOGY, 2012, 23 (07) :1894-1898

[7]

Body Mass Index and Diabetes in Asia: A Cross-Sectional Pooled Analysis of 900,000 Individuals in the Asia Cohort Consortium [J].

Boffetta, Paolo ;

McLerran, Dale ;

Chen, Yu ;

Inoue, Manami ;

Sinha, Rashmi ;

He, Jiang ;

Gupta, Prakash Chandra ;

Tsugane, Shoichiro ;

Irie, Fujiko ;

Tamakoshi, Akiko ;

Gao, Yu-Tang ;

Shu, Xiao-Ou ;

Wang, Renwei ;

Tsuji, Ichiro ;

Kuriyama, Shinichi ;

Matsuo, Keitaro ;

Satoh, Hiroshi ;

Chen, Chien-Jen ;

Yuan, Jian-Min ;

Yoo, Keun-Young ;

Ahsan, Habibul ;

Pan, Wen-Harn ;

Gu, Dongfeng ;

Pednekar, Mangesh Suryakant ;

Sasazuki, Shizuka ;

Sairenchi, Toshimi ;

Yang, Gong ;

Xiang, Yong-Bing ;

Nagai, Masato ;

Tanaka, Hideo ;

Nishino, Yoshikazu ;

You, San-Lin ;

Koh, Woon-Puay ;

Park, Sue K. ;

Shen, Chen-Yang ;

Thornquist, Mark ;

Kang, Daehee ;

Rolland, Betsy ;

Feng, Ziding ;

Zheng, Wei ;

Potter, John D. .

PLOS ONE, 2011, 6 (06)

[8]

Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels - A meta-analysis of 21 cohort studies including more than 300,000 persons [J].

Bogers, Rik P. ;

Bemelmans, Wanda J. E. ;

Hoogenveen, Rudolf T. ;

Boshuizen, Hendriek C. ;

Woodward, Mark ;

Knekt, Paul ;

van Dam, Rob M. ;

Hu, Frank B. ;

Visscher, Tommy L. S. ;

Menotti, Alessandro ;

Thorpe, Roland J., Jr. ;

Jamrozik, Konrad ;

Calling, Susanna ;

Strand, Bjorn Heine ;

Shipley, Martin J. .

ARCHIVES OF INTERNAL MEDICINE, 2007, 167 (16) :1720-1728

[9]

Triglycerides and risk of hemorrhagic stroke vs. ischemic vascular events: The Three-City Study [J].

Bonaventure, Audrey ;

Kurth, Tobias ;

Pico, Fernando ;

Barberger-Gateau, Pascale ;

Ritchie, Karen ;

Stapf, Christian ;

Tzourio, Christophe .

ATHEROSCLEROSIS, 2010, 210 (01) :243-248

[10]

Body mass index and weight change since 20 years of age and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based Study [J].

Chei, C. L. ;

Iso, H. ;

Yamagishi, K. ;

Inoue, M. ;

Tsugane, S. .

INTERNATIONAL JOURNAL OF OBESITY, 2008, 32 (01) :144-151

← 1 2 3 4 5 6 7 8 9 10 →