Association of body mass index and mortality in Japanese diabetic men and women based on self-reports

The Japan collaborative cohort (JACC) study

For the JACC Study Group

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The association between body mass index (BMI) and mortality among Asian diabetic people, especially with respect to the obesity paradox (ie, higher BMI is associated with lower mortality risk), remains unresolved. Methods: We followed a cohort of 3851 self-reported Japanese diabetics (2115 men and 1736 women) in the Japan Collaborative Cohort Study from 1988-1990 through 2009. Individuals were aged 40 to 79 years and free from a history of cardiovascular disease, cancer, renal disease, or tuberculosis. BMI was grouped into the following four categories: <20.0, 20.0-22.9, 23.0-24.9, and ≥25.0 kg/m2. Results: During 54 707 person-years of follow-up, 1457 deaths from all causes, 445 from cardiovascular disease, 421 from cancer, 43 from renal disease, and 148 from infectious disease were documented. Mortality from all causes, cardiovascular disease, cancer, and renal disease showed L-shaped associations with BMI. Compared to diabetics with BMI of 20.0-22.9 kg/m2, those with BMIs of 23.0-24.9 kg/m2 and ≥25.0 kg/m2 had lower risks of mortality from infectious disease (ie, obesity paradox). The multivariable HRs for mortality from infectious disease were 0.50 (95% confidence interval, 0.31-0.81) and 0.51 (95% confidence interval, 0.32-0.82) among participants with BMIs of 23.0-24.9 kg/m2 and ≥25.0 kg/m2, respectively. Similar results were observed after stratification by smoking status and age and exclusion of early deaths. Conclusions: We observed L-shaped associations between BMI and mortality from all causes, cardiovascular disease, cancer, and renal disease, while the association between BMI and mortality from infectious disease manifested the obesity paradox.

Original languageEnglish
Pages (from-to)553-558
Number of pages6
JournalJournal of epidemiology
Volume25
Issue number8
DOIs
Publication statusPublished - 01-01-2015

Fingerprint

Self Report
Japan
Body Mass Index
Cohort Studies
Kidney Neoplasms
Mortality
Communicable Diseases
Cardiovascular Diseases
Obesity
Confidence Intervals
Cause of Death
Tuberculosis
Smoking

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

@article{f6612067d1a745b69a04a69abeb8b3c2,
title = "Association of body mass index and mortality in Japanese diabetic men and women based on self-reports: The Japan collaborative cohort (JACC) study",
abstract = "Background: The association between body mass index (BMI) and mortality among Asian diabetic people, especially with respect to the obesity paradox (ie, higher BMI is associated with lower mortality risk), remains unresolved. Methods: We followed a cohort of 3851 self-reported Japanese diabetics (2115 men and 1736 women) in the Japan Collaborative Cohort Study from 1988-1990 through 2009. Individuals were aged 40 to 79 years and free from a history of cardiovascular disease, cancer, renal disease, or tuberculosis. BMI was grouped into the following four categories: <20.0, 20.0-22.9, 23.0-24.9, and ≥25.0 kg/m2. Results: During 54 707 person-years of follow-up, 1457 deaths from all causes, 445 from cardiovascular disease, 421 from cancer, 43 from renal disease, and 148 from infectious disease were documented. Mortality from all causes, cardiovascular disease, cancer, and renal disease showed L-shaped associations with BMI. Compared to diabetics with BMI of 20.0-22.9 kg/m2, those with BMIs of 23.0-24.9 kg/m2 and ≥25.0 kg/m2 had lower risks of mortality from infectious disease (ie, obesity paradox). The multivariable HRs for mortality from infectious disease were 0.50 (95{\%} confidence interval, 0.31-0.81) and 0.51 (95{\%} confidence interval, 0.32-0.82) among participants with BMIs of 23.0-24.9 kg/m2 and ≥25.0 kg/m2, respectively. Similar results were observed after stratification by smoking status and age and exclusion of early deaths. Conclusions: We observed L-shaped associations between BMI and mortality from all causes, cardiovascular disease, cancer, and renal disease, while the association between BMI and mortality from infectious disease manifested the obesity paradox.",
author = "{For the JACC Study Group} and Yasuhiko Kubota and Hiroyasu Iso and Akiko Tamakoshi and Mitsuru Mori and Fumio Sakauchi and Ichiro Tsuji and Yosikazu Nakamura and Haruo Mikami and Michiko Kurosawa and Yoshiharu Hoshiyama and Naohito Tanabe and Koji Tamakoshi and Kenji Wakai and Shinkan Tokudome and Koji Suzuki and Shuji Hashimoto and Koji Suzuki and Shuji Hashimoto and Takashi Kawamura and Yoshiyuki Watanabe and Kotaro Ozasa and Tsuneharu Miki and Chigusa Date and Kiyomi Sakata and Yoichi Kurozawa and Takesumi Yoshimura and Yoshihisa Fujino and Akira Shibata and Naoyuki Okamoto and Hideo Shio",
year = "2015",
month = "1",
day = "1",
doi = "10.2188/jea.JE20150011",
language = "English",
volume = "25",
pages = "553--558",
journal = "Journal of Epidemiology",
issn = "0917-5040",
publisher = "Japan Epidemiology Association",
number = "8",

}

Association of body mass index and mortality in Japanese diabetic men and women based on self-reports : The Japan collaborative cohort (JACC) study. / For the JACC Study Group.

In: Journal of epidemiology, Vol. 25, No. 8, 01.01.2015, p. 553-558.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of body mass index and mortality in Japanese diabetic men and women based on self-reports

T2 - The Japan collaborative cohort (JACC) study

AU - For the JACC Study Group

AU - Kubota, Yasuhiko

AU - Iso, Hiroyasu

AU - Tamakoshi, Akiko

AU - Mori, Mitsuru

AU - Sakauchi, Fumio

AU - Tsuji, Ichiro

AU - Nakamura, Yosikazu

AU - Mikami, Haruo

AU - Kurosawa, Michiko

AU - Hoshiyama, Yoshiharu

AU - Tanabe, Naohito

AU - Tamakoshi, Koji

AU - Wakai, Kenji

AU - Tokudome, Shinkan

AU - Suzuki, Koji

AU - Hashimoto, Shuji

AU - Suzuki, Koji

AU - Hashimoto, Shuji

AU - Kawamura, Takashi

AU - Watanabe, Yoshiyuki

AU - Ozasa, Kotaro

AU - Miki, Tsuneharu

AU - Date, Chigusa

AU - Sakata, Kiyomi

AU - Kurozawa, Yoichi

AU - Yoshimura, Takesumi

AU - Fujino, Yoshihisa

AU - Shibata, Akira

AU - Okamoto, Naoyuki

AU - Shio, Hideo

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: The association between body mass index (BMI) and mortality among Asian diabetic people, especially with respect to the obesity paradox (ie, higher BMI is associated with lower mortality risk), remains unresolved. Methods: We followed a cohort of 3851 self-reported Japanese diabetics (2115 men and 1736 women) in the Japan Collaborative Cohort Study from 1988-1990 through 2009. Individuals were aged 40 to 79 years and free from a history of cardiovascular disease, cancer, renal disease, or tuberculosis. BMI was grouped into the following four categories: <20.0, 20.0-22.9, 23.0-24.9, and ≥25.0 kg/m2. Results: During 54 707 person-years of follow-up, 1457 deaths from all causes, 445 from cardiovascular disease, 421 from cancer, 43 from renal disease, and 148 from infectious disease were documented. Mortality from all causes, cardiovascular disease, cancer, and renal disease showed L-shaped associations with BMI. Compared to diabetics with BMI of 20.0-22.9 kg/m2, those with BMIs of 23.0-24.9 kg/m2 and ≥25.0 kg/m2 had lower risks of mortality from infectious disease (ie, obesity paradox). The multivariable HRs for mortality from infectious disease were 0.50 (95% confidence interval, 0.31-0.81) and 0.51 (95% confidence interval, 0.32-0.82) among participants with BMIs of 23.0-24.9 kg/m2 and ≥25.0 kg/m2, respectively. Similar results were observed after stratification by smoking status and age and exclusion of early deaths. Conclusions: We observed L-shaped associations between BMI and mortality from all causes, cardiovascular disease, cancer, and renal disease, while the association between BMI and mortality from infectious disease manifested the obesity paradox.

AB - Background: The association between body mass index (BMI) and mortality among Asian diabetic people, especially with respect to the obesity paradox (ie, higher BMI is associated with lower mortality risk), remains unresolved. Methods: We followed a cohort of 3851 self-reported Japanese diabetics (2115 men and 1736 women) in the Japan Collaborative Cohort Study from 1988-1990 through 2009. Individuals were aged 40 to 79 years and free from a history of cardiovascular disease, cancer, renal disease, or tuberculosis. BMI was grouped into the following four categories: <20.0, 20.0-22.9, 23.0-24.9, and ≥25.0 kg/m2. Results: During 54 707 person-years of follow-up, 1457 deaths from all causes, 445 from cardiovascular disease, 421 from cancer, 43 from renal disease, and 148 from infectious disease were documented. Mortality from all causes, cardiovascular disease, cancer, and renal disease showed L-shaped associations with BMI. Compared to diabetics with BMI of 20.0-22.9 kg/m2, those with BMIs of 23.0-24.9 kg/m2 and ≥25.0 kg/m2 had lower risks of mortality from infectious disease (ie, obesity paradox). The multivariable HRs for mortality from infectious disease were 0.50 (95% confidence interval, 0.31-0.81) and 0.51 (95% confidence interval, 0.32-0.82) among participants with BMIs of 23.0-24.9 kg/m2 and ≥25.0 kg/m2, respectively. Similar results were observed after stratification by smoking status and age and exclusion of early deaths. Conclusions: We observed L-shaped associations between BMI and mortality from all causes, cardiovascular disease, cancer, and renal disease, while the association between BMI and mortality from infectious disease manifested the obesity paradox.

UR - http://www.scopus.com/inward/record.url?scp=84938872771&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84938872771&partnerID=8YFLogxK

U2 - 10.2188/jea.JE20150011

DO - 10.2188/jea.JE20150011

M3 - Article

VL - 25

SP - 553

EP - 558

JO - Journal of Epidemiology

JF - Journal of Epidemiology

SN - 0917-5040

IS - 8

ER -