Background
Methods
Participants
Measurements
Body mass index and its classification
Metabolic syndrome (MetS)
Death ascertainment
Covariates
Statistical analysis
Results
Underweight | Low normal | Normal | Overweight | Obese1 | Obese2 | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
No. of deaths | Person years (× 103) | Death rate | RR | No. of deaths | Person years (× 103) | Death rate | RR | No. of deaths | Person years (× 103) | Death rate | RR | No. of deaths | Person years (×103) | Death rate | RR | No. of deaths | Person years (× 103) | Death rate | RR | No. of deaths | Person years (× 103) | Death rate | RR | |
Overall | ||||||||||||||||||||||||
20–39 | 93 | 201.9 |
4.6
| 313 | 683.9 |
4.6
| 180 | 324.3 | 5.6 | 170 | 276.9 | 6.1 | 84 | 97.4 | 8.6 | 67 | 43.4 | 15.4 | ||||||
40–49 | 37 | 18.7 | 19.8 | 215 | 159.4 |
13.5
| 205 | 143.3 | 14.3 | 267 | 162.5 | 16.4 | 127 | 62.0 | 20.4 | 68 | 23.4 | 29.1 | ||||||
50–59 | 70 | 9.5 | 73.7 | 420 | 94.2 | 44.6 | 474 | 114.6 | 41.4 | 589 | 147.9 |
39.8
| 300 | 61.5 | 48.8 | 116 | 22.0 | 52.7 | ||||||
60–69 | 165 | 8.7 | 189.7 | 729 | 59.7 | 122.1 | 741 | 69.2 | 107.1 | 916 | 91.0 |
100.7
| 408 | 36.8 | 100.9 | 157 | 12.7 | 123.6 | ||||||
≥ 70 | 222 | 4.5 | 493.3 | 715 | 20.4 | 350.5 | 560 | 20.2 | 277.2 | 702 | 26.6 |
263.9
| 292 | 10.5 | 278.1 | 98 | 3.4 | 288.2 | ||||||
With MetS | ||||||||||||||||||||||||
20–39 | 4 | 0.8 | 50.0 | 11.6 (0.2–21.9) | 11 | 10.9 | 10.1 | 2.3 (0.9–3.6) | 15 | 19.2 | 7.8 | 1.5 (0.7–2.3) | 44 | 45.1 | 9.8 | 1.8 (1.3–2.4) | 37 | 36.5 | 10.1 | 1.5 (1.0–2.0) | 42 | 24.9 | 16.9 | 1.4 (1.0–1.9) |
40–49 | 3 | 0.3 | 100.0 | 5.5 (0–12.8) | 25 | 7.2 | 34.7 | 2.8 (1.7–3.9) | 33 | 16.7 | 19.8 | 1.5 (1.0–2.0) | 91 | 43.2 | 21.1 | 1.6 (1.2–1.9) | 77 | 30.0 | 25.7 | 1.5 (1.2–1.8) | 45 | 15.0 | 30.0 | 1.4 (1.0–1.8) |
50–59 | 3 | 0.3 | 100.0 | 1.5 (0–3.2) | 76 | 10.0 | 76.0 | 1.9 (1.5–2.4) | 138 | 24.7 | 55.9 | 1.6 (1.3–1.9) | 258 | 54.7 | 47.2 | 1.5 (1.3–1.6) | 196 | 35.5 | 55.2 | 1.5 (1.3–1.8) | 74 | 14.7 | 50.3 | 0.9 (0.7–1.1) |
60–69 | 16 | 0.6 | 266.7 | 1.5 (0.8–2.3) | 166 | 10.6 | 156.6 | 1.4 (1.2–1.6) | 266 | 21.3 | 124.9 | 1.3 (1.1–1.5) | 478 | 44.4 | 107.7 | 1.2 (1.1–1.3) | 286 | 24.1 | 118.7 | 1.2 (1.1–1.4) | 119 | 9.4 | 126.6 | 1.3 (1.0–1.5) |
≥ 70 | 33 | 0.4 | 825.0 | 1.9 (1.4–2.8) | 219 | 4.9 | 446.9 | 1.5 (1.3–1.7) | 246 | 8.2 | 300.0 | 1.2 (1.1–1.4) | 416 | 14.9 | 279.2 | 1.3 (1.2–1.5) | 208 | 7.3 | 284.9 | 1.7 (1.4–1.9) | 75 | 2.5 | 300.0 | 0.9 (0.7–1.1) |
Without MetS | ||||||||||||||||||||||||
20–39 | 86 | 198.4 | 4.3 | 289 | 653.1 | 4.4 | 150 | 288.4 | 5.2 | 112 | 211.8 | 5.3 | 35 | 52.7 | 6.6 | 18 | 15.2 | 11.8 | ||||||
40–49 | 33 | 18.0 | 18.3 | 182 | 145.9 | 12.5 | 158 | 117.3 | 13.5 | 141 | 103.8 | 13.6 | 45 | 26.0 | 17.3 | 13 | 6.0 | 21.7 | ||||||
50–59 | 60 | 8.8 | 68.2 | 313 | 78.7 | 39.8 | 281 | 80.3 | 35.0 | 255 | 79.0 | 32.3 | 72 | 20.1 | 35.8 | 29 | 5.1 | 56.9 | ||||||
60–69 | 135 | 7.5 | 180.0 | 488 | 44.5 | 109.7 | 394 | 41.1 | 95.9 | 327 | 37.1 | 88.1 | 90 | 9.3 | 96.8 | 22 | 2.2 | 100.0 | ||||||
≥ 70 | 169 | 3.8 | 444.7 | 409 | 13.9 | 294.2 | 245 | 10.1 | 242.6 | 190 | 9.0 | 211.1 | 35 | 2.1 | 166.7 | 14 | 0.4 | 350.0 |
Model 1 HR | Model 2 HR | Model 3 HR | 95% CI | Prevalence (%) | PAR (%) | |
---|---|---|---|---|---|---|
Overall (n = 377,929, death = 9490) | ||||||
Underweight (vs. normal BMI) |
0.77***
|
1.54***
|
1.69***
| (1.51–1.90) | 8.43 | 5.50 |
Low normal (vs. normal BMI) |
0.74***
|
1.11***
|
1.19***
| (1.11–1.28) | 33.80 | 6.04 |
Normal BMI | 1 | 1 | 1 | – | 22.10 | – |
Overweight (vs. normal BMI) |
1.17***
| 0.97 |
0.82***
| (0.76–0.89) | 23.17 | −4.35 |
Obese1 (vs. normal BMI) |
1.39***
|
1.12**
|
0.88**
| (0.79–0.97) | 8.89 | −1.08 |
Obese2 (vs. normal BMI) |
1.52***
|
1.45***
| 1.12 | (0.98–1.28) | 3.61 | 0.43 |
High BP (vs. normal BP) |
3.86***
|
1.32***
|
1.26***
| (1.19–1.34) | 30.22 | 7.29 |
High FG (vs. normal FG) |
2.57***
|
1.25***
|
1.18***
| (1.12–1.24) | 30.17 | 5.15 |
High WC (vs. normal WC) |
2.50***
|
1.13***
|
1.24***
| (1.15–1.33) | 18.47 | 4.24 |
Dyslipidemia vs. normal TG/HDL |
1.36***
|
1.12***
|
1.14***
| (1.08–1.20) | 42.89 | 5.66 |
20–39 (n = 209,291, death = 907) | ||||||
Underweight (vs. normal BMI) | 0.85 | 1.12 | 0.94 | (0.68–1.30) | 12.67 | −0.77 |
Low normal (vs. normal BMI) |
0.82*
| 0.97 | 1.00 | (0.80–1.25) | 41.22 | 0.00 |
Normal BMI | 1 | 1 | 1 | – | 19.80 | – |
Overweight (vs. normal BMI) | 1.11 | 0.99 | 0.85 | (0.65–1.10) | 17.19 | −2.65 |
Obese1 (vs. normal BMI) |
1.57***
|
1.35*
| 1.00 | (0.69–1.47) | 6.21 | 0.00 |
Obese2 (vs. normal BMI) |
2.87***
|
2.60***
|
1.65*
| (1.04–2.60) | 2.92 | 1.86 |
High BP (vs. normal BP) |
1.57***
|
1.37***
| 1.17 | (0.97–1.43) | 16.85 | 2.78 |
High FG (vs. normal FG) |
1.42***
|
1.18*
| 1.10 | (0.91–1.34) | 19.15 | 1.88 |
High WC (vs. normal WC) |
2.10***
|
1.70***
| 1.33 | (0.97–1.82) | 10.20 | 3.26 |
Dyslipidemia vs. normal TG/HDL |
1.38***
|
1.23**
|
1.19*
| (1.01–1.41) | 37.91 | 6.72 |
40–49 (n = 70,143, death = 919) | ||||||
Underweight (vs. normal BMI) |
1.44*
|
1.60**
|
1.66*
| (1.10–2.50) | 3.57 | 2.30 |
Low normal (vs. normal BMI) | 0.96 | 1.08 | 1.15 | (0.91–1.44) | 28.60 | 4.11 |
Normal BMI | 1 | 1 | 1 | – | 24.81 | – |
Overweight (vs. normal BMI) | 1.15 | 1.05 | 0.92 | (0.73–1.17) | 28.16 | −2.30 |
Obese1 (vs. normal BMI) |
1.43**
|
1.26*
| 1.11 | (0.80–1.53) | 10.80 | 1.17 |
Obese2 (vs. normal BMI) |
2.03***
|
1.79***
| 1.43 | (0.95–2.16) | 4.07 | 1.72 |
High BP (vs. normal BP) |
1.61***
|
1.43***
|
1.28**
| (1.08–1.51) | 30.47 | 7.86 |
High FG (vs. normal FG) |
1.44***
|
1.27***
| 1.12 | (0.95–1.33) | 35.44 | 4.08 |
High WC (vs. normal WC) |
1.43***
|
1.22*
| 1.11 | (0.86–1.42) | 20.45 | 2.20 |
Dyslipidemia vs. normal TG/HDL |
1.17*
| 1.04 | 1.00 | (0.84–1.18) | 46.82 | 0.00 |
50–59 (n = 55,017, death = 1969) | ||||||
Underweight (vs. normal BMI) |
1.83***
|
1.74***
|
1.77***
| (1.28–2.43) | 2.21 | 1.67 |
Low normal (vs. normal BMI) | 1.09 | 1.08 |
1.19*
| (1.01–1.40) | 21.36 | 3.90 |
Normal BMI | 1 | 1 | 1 | – | 25.45 | – |
Overweight (vs. normal BMI) | 0.96 | 0.95 |
0.74***
| (0.63–0.87) | 32.58 | −9.26 |
Obese1 (vs. normal BMI) |
1.17*
|
1.16*
|
0.76*
| (0.62–0.95) | 13.48 | −3.34 |
Obese2 (vs. normal BMI) |
1.28*
|
1.36**
| 0.88 | (0.66–1.17) | 4.92 | −0.59 |
High BP (vs. normal BP) |
1.46***
|
1.46***
|
1.48***
| (1.32–1.67) | 50.32 | 19.45 |
High FG (vs. normal FG) |
1.39***
|
1.35***
|
1.17**
| (1.05–1.31) | 46.95 | 7.39 |
High WC (vs. normal WC) |
1.23***
|
1.23***
|
1.39***
| (1.19–1.62) | 31.63 | 10.98 |
Dyslipidemia vs. normal TG/HDL |
1.14**
| 1.09 | 1.09 | (0.97–1.23) | 49.40 | 4.26 |
60–69 (n = 32,644, death = 3116) | ||||||
Underweight (vs. normal BMI) |
1.77***
|
1.51***
|
1.74***
| (1.41–2.14) | 3.14 | 2.27 |
Low normal (vs. normal BMI) |
1.14*
| 1.09 | 1.14 | (1.00–1.29) | 21.59 | 2.93 |
Normal BMI | 1 | 1 | 1 | – | 24.97 | – |
Overweight (vs. normal BMI) | 0.94 | 0.95 |
0.82**
| (0.72–0.93) | 32.45 | −6.20 |
Obese1 (vs. normal BMI) | 1.03 | 1.07 | 0.85 | (0.72–1.02) | 13.15 | −2.01 |
Obese2 (vs. normal BMI) | 1.16 |
1.28**
| 1.00 | (0.79–1.26) | 4.69 | 0.00 |
High BP (vs. normal BP) |
1.19***
|
1.24***
|
1.22***
| (1.10–1.34) | 65.80 | 12.65 |
High FG (vs. normal FG) |
1.19***
|
1.22***
|
1.16**
| (1.06–1.27) | 52.60 | 7.76 |
High WC (vs. normal WC) | 0.95 | 1.05 |
1.17*
| (1.04–1.33) | 39.28 | 6.26 |
Dyslipidemia vs. normal TG/HDL |
1.12**
|
1.15***
|
1.14**
| (1.04–1.25) | 52.32 | 6.82 |
≥70 (n = 10,834, death = 2579) | ||||||
Underweight (vs. normal BMI) |
1.80***
|
1.58***
|
1.96***
| (1.61–2.39) | 5.63 | 5.13 |
Low normal (vs. normal BMI) |
1.27***
|
1.19**
|
1.32***
| (1.15–1.52) | 24.19 | 7.19 |
Normal BMI | 1 | 1 | 1 | – | 23.47 | – |
Overweight (vs. normal BMI) | 0.95 | 0.97 | 0.87 | (0.75–1.01) | 30.64 | −4.15 |
Obese1 (vs. normal BMI) | 0.96 | 1.02 | 0.90 | (0.74–1.10) | 12.13 | −1.23 |
Obese2 (vs. normal BMI) | 1.05 | 1.19 | 1.18 | (0.90–1.54) | 3.93 | 0.70 |
High BP (vs. normal BP) |
1.16**
|
1.20***
|
1.13*
| (1.01–1.28) | 77.69 | 9.17 |
High FG (vs. normal FG) |
1.22***
|
1.25***
|
1.26***
| (1.14–1.39) | 56.11 | 12.73 |
High WC (vs. normal WC) | 0.91 | 1.02 |
1.21**
| (1.06–1.39) | 45.31 | 8.69 |
Dyslipidemia vs. normal TG/HDL | 1.05 |
1.09*
|
1.19***
| (1.07–1.32) | 51.98 | 8.99 |