BMI and Mortality in UK Biobank: Revised Estimates Using Mendelian Randomization.

BMI and Mortality in UK Biobank: Revised Estimates Using Mendelian Randomization.
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DOI:
10.1002/oby.22313
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发表时间:
2018-11
期刊:
Obesity (Silver Spring, Md.)
影响因子:
--
通讯作者:
Timpson NJ
Timpson NJ
中科院分区:
其他
文献类型:
--
作者:
Wade KH;Carslake D;Sattar N;Davey Smith G;Timpson NJ

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本研究的目的是获得BMI和死亡率之间因果关系的估计。采用孟德尔随机化(MR)和BMI相关的基因型变异来检验BMI对英国生物样本库中英国白色血统参与者全因和因特异性死亡率的因果效应。MR分析支持较高的BMI和较高的全因死亡率风险之间的因果关系(风险比[HR]/1 kg/m2:1.03; 95% CI:0.99 - 1.07)和心血管疾病死亡率(HR:1.10; 95% CI:1.01 - 1.19),尤其是冠心病(HR:1.12; 95% CI:1.00 - 1.25)和排除冠心病/卒中/主动脉瘤的患者(HR:1.24; 95% CI:1.03 - 1.48),胃癌(HR:1.18; 95% CI:0.87 - 1.62)和食管癌(HR:1.22; 95% CI:0.98 - 1.53),以及肺癌死亡率风险降低(HR:0.96; 95% CI:0.85 - 1.08)。性别分层支持较高BMI增加膀胱癌死亡风险(男性)但降低呼吸系统疾病死亡风险(男性)的因果作用。通过MR分析可以看到BMI与死亡率之间的J形观察相关性,但死亡率最小化的BMI较低,并且在较大的BMI范围内相关性较平坦。结果支持较高的BMI在增加全因死亡率和几种特定原因的死亡率风险中的因果作用。
The aim of this study was to obtain estimates of the causal relationship between BMI and mortality. Mendelian randomization (MR) with BMI‐associated genotypic variation was used to test the causal effect of BMI on all‐cause and cause‐specific mortality in UK Biobank participants of White British ancestry. MR analyses supported a causal association between higher BMI and greater risk of all‐cause mortality (hazard ratio [HR] per 1 kg/m2: 1.03; 95% CI: 0.99‐1.07) and mortality from cardiovascular diseases (HR: 1.10; 95% CI: 1.01‐1.19), specifically coronary heart disease (HR: 1.12; 95% CI: 1.00‐1.25) and those excluding coronary heart disease/stroke/aortic aneurysm (HR: 1.24; 95% CI: 1.03‐1.48), stomach cancer (HR: 1.18; 95% CI: 0.87‐1.62), and esophageal cancer (HR: 1.22; 95% CI: 0.98‐1.53), and a decreased risk of lung cancer mortality (HR: 0.96; 95% CI: 0.85‐1.08). Sex stratification supported the causal role of higher BMI increasing bladder cancer mortality risk (males) but decreasing respiratory disease mortality risk (males). The J‐shaped observational association between BMI and mortality was visible with MR analyses, but the BMI at which mortality was minimized was lower and the association was flatter over a larger BMI range. Results support a causal role of higher BMI in increasing the risk of all‐cause mortality and mortality from several specific causes.
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