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Titre :
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Obesity. Cause-specific mortality in old age in relation to body mass index in middle age and in old age : follow-up of the whitehall cohort of male civil servants. Commentary. (2006)
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Auteurs :
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Elizabeth BREEZE ;
CHATURVEDI (Nish) / éd. : GBR. National Heart & Lung Institute. Imperial College at St Mary's. London. ;
CLARKE (Robert) : GBR. Clinical Trial Service Unit. University of Oxford. Oxford. ;
Shah EBRAHIM, éd. ;
Astrid-E FLETCHER ;
Rebecca Hardy, disc. ;
Diana KUH, disc. ;
Debbie-A LAWLOR, éd. ;
Michael-G MARMOT ;
Martin-J SHIPLEY ;
Mrc National Survey of Health and Development. Royal Free & University College Medical School. Department of Epidemiology and Public Health. London. GBR
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Type de document :
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Article
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Dans :
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International journal of epidemiology (vol. 35, n° 1, Janvier 2006)
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Pagination :
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169-180
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Langues:
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Anglais
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Mots-clés :
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Appareil respiratoire [pathologie]
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Appareil circulatoire [pathologie]
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Facteur risque
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Epidémiologie
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Anthropométrie
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Mortalité
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Adulte
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Homme
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Personne âgée
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Royaume Uni
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Europe
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Résumé :
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[BDSP. Notice produite par INIST-CNRS dR0xFvAY. Diffusion soumise à autorisation]. Background : The relevance of body mass index (BMI) to cause-specific mortality in old age is uncertain. Objectives : To examine cause-specific 5 year mortality in old age by BMI in old age and middle age (40-69 years). Methods : Cox proportional hazards for mortality rates among 4862 former male civil servants in relation to quartiles of BMI measured when screened in 1968-70 and when resurveyed in 1997-98 (median age 76 years). Results : The association between all-cause mortality after resurvey and BMI in old age was U-shaped with hazard ratios (HRs) of 1.3 (95% CI 1.1-1.5) for the lightest and heaviest categories relative to the middle two. Among'healthy'men the lightest (<22.7 kg/m2) had greatest all-cause mortality. The heaviest men (>26.6 kg/m2) had increased risk of cardiovascular disease (CVD) mortality in the first two years or for the whole period if never-smokers. Respiratory mortality was inversely associated with BMI in old age [adjusted HR for trend per BMI category increase 0.6 (0.5-0.7) ] but cancer mortality lacked a clear pattern. Net gain or loss of 10 kg or more between middle and old age was a strong predictor of all-cause and CVD mortality. Conclusions : The shape of the association between BMI in old age and mortality differs by cause of death. Major weight change over time is a warning signal for higher CVD mortality. Having BMI<22.7 kg/m2 in old age is associated with above-average mortality rates even if apparently healthy.
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