Causes of death in obesity:: Relevant increase in cardiovascular but not in all-cancer mortality

Background and Objective: To assess the relation between body mass index (BMI) and the risk of death from various causes in a prospective cohort study. Methods: In 6,192 obese patients (BMI >= 25kg/m(2)) with mean BMI 36.6 kg/m(2) (SD 6.1) and mean age 40.4 years (SD 12.9) who had been referred to the obesity clinic of the Heinfich-Heine-University Dusseldorf, Germany, between 1961 and 1994, there were 1,058 deaths from all causes during a median follow-up time of 14.8 years. We calculated standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) for death from predefined groups of diseases by using Germany as reference population. Results: In both sexes, risk of death from cardiovascular diseases (men: SMR = 2.2, CI 1.9-2.5; women: SMR = 1.6, Cl 1.5-1.8), from diabetes (men: SMR = 5.4, Cl 3.2-8.7; women: SMR = 3.5, CI 2.6-4.8), and in men from digestive diseases (SMR = 1.6, Cl 1.01-2.3) was significantly increased. In contrast to other studies, an association between obesity and all-cancer mortality could not be found. Only in morbidly obese women (BMI >= 40 kg/m(2)), all-cancer mortality was significantly increased (SMR = 1.5, CI 1.1-1.9). Conclusion: Obesity is associated with increased risk of death from cardiovascular diseases and diabetes in both sexes, and from diseases of the digestive system in men. (c) 2006 Elsevier Inc. All rights reserved.