Consortium study of modifiable causes of death in Asians

简介（由申请人提供）：亚洲人占世界人口的60%以上。在过去的几十年里，慢性疾病，特别是心血管疾病和癌症的负担在亚洲国家大幅增加，这是不良生活方式改变的结果，包括身体活动减少、肥胖流行率增加、吸烟和大量饮酒。虽然上述每一个可改变的因素都与过早死亡有关，但这些因素对总死亡率和特定原因死亡率的总体影响尚不清楚，特别是在亚洲人群中。2008年，我们提出并成功完成了亚洲队列联盟（ACC）的第一个分析项目：通过汇总和协调来自亚洲国家18个队列研究的100多万受试者的数据，量化体重指数（BMI）与总死亡率和原因特异性死亡率之间的关系。在本应用中，我们建议扩大BMI合并项目，以解决与亚洲人中心性肥胖和其他可改变死亡原因相关的研究问题。我们提出以下具体目标：1)评估中心性肥胖（以腰臀比（WHR）衡量）与总死亡率和原因特异性死亡率之间的关系；2)量化主要可改变的生活方式因素，包括高BMI、高腰宽比、吸烟和过度饮酒对总死亡率和病因特异性死亡率的影响。我们的联盟解决了NCI的目标是“扩大中心、网络和联盟的能力”，目标是“创建和维持促进研究合作的基础设施”，正如NCI计划和优先事项中概述的那样。我们预计，ACC内部的分析将是朝着提高对癌症原因和机制的理解迈出的重要一步，并将加强联盟内部的合作，以进行进一步的汇总分析。拟议的研究将产生大量有价值的数据，为旨在应对新出现的慢性病流行病和减少亚洲国家过早死亡的政策和方案提供信息。

DESCRIPTION (provided by applicant): Asians constitute over 60% of the world's population. Over the past few decades, the burden of chronic diseases, particularly cardiovascular disease (CVD) and cancer, has increased substantially in Asian countries as a consequence of adverse lifestyle changes, including reduced physical activity, increased prevalence of obesity, cigarette smoking, and heavy alcohol consumption. Although each of the above modifiable factors has been linked to premature death, the overall impact of these factors on total and cause-specific mortality is unclear, particularly in the Asian populations. In 2008, we proposed, and have now successfully completed, the first analysis project in the Asia Cohort Consortium (ACC): to quantify the association between body mass index (BMI) and both total and cause-specific mortality by pooling and harmonizing data from over one million subjects across 18 cohort studies being conducted in Asian countries. In this application, we propose to expand the BMI pooling project to address study questions related to central obesity and other modifiable causes of death in Asians. We propose the following specific aims: 1) To evaluate the association between central obesity, as measured by waist-to-hip ratio (WHR), and both total and cause-specific mortality; and 2) To quantify the impact of major modifiable lifestyle factors, including high BMI, high WHR, cigarette smoking, and excessive alcohol drinking on both total and cause-specific mortality. Our consortium addresses the NCI objective to "expand the capacity of centers, networks, and consortia," and the goal to "create and sustain infrastructures that facilitate research collaboration" as outlined in the NCI Plans and Priorities. We anticipate that the analysis within the ACC will be a major step toward improving understanding of the causes and mechanisms of cancers and will enhance the collaboration within the consortium for further pooled analyses. The proposed study will generate substantial data that are valuable to inform policies and programs aimed at tackling the emerging epidemic of chronic diseases and to reduce premature death in Asian countries. PUBLIC HEALTH RELEVANCE: Project Narrative Although obesity (including central obesity), cigarette smoking, and excessive alcohol consumption are each known to increase mortality, the overall impact of these modifiable factors on mortality is unclear, particularly in the Asian population. The proposed study, with its large sample size and strong methodology, will allow us to investigate, systematically, these important questions. The results from this study will have important public health implications in disease prevention.