Background
Methods
Study population
Measurement of waist circumference
Measurement of body mass index (BMI)
Ascertainment of outcome
Assessment of covariates
Statistical analysis
Results
Subjects
Characteristics | Overall | Men | Women | P-value for sex comparison |
---|---|---|---|---|
N = 14,237 | n = 6993 | n = 7244 | ||
Age, mean (SD) | 57.28 (9.25) | 57.35 (9.19) | 57.22 (9.32) | 0.39 |
Smoking, n(%)a | < 0.001 | |||
Never | 8496 (59.68) | 1778 (25.43) | 6718 (92.74) | |
Former | 1100 (7.73) | 970 (13.87) | 130 (1.79) | |
Current | 4640 (32.59) | 4244 (60.69) | 396 (5.47) | |
Alcohol use, n(%) | < 0.001 | |||
Never | 8448 (59.34) | 2298 (32.86) | 6150 (84.90) | |
Former | 802 (5.63) | 646 (9.24) | 156 (2.15) | |
Current | 4987 (35.03) | 4049 (57.90) | 938 (12.95) | |
BMI (kg/m2), n(%)b | < 0.001 | |||
<18.5 | 787 (5.53) | 390 (5.58) | 397 (5.48) | |
18.5 ~ 24.0 | 7066 (49.63) | 3801 (54.35) | 3265 (45.07) | |
24.0 ~ 28.0 | 4539 (31.88) | 2065 (29.53) | 2474 (34.15) | |
≥28.0 | 1797 (12.62) | 715 (10.22) | 1082 (14.94) | |
Waist (cm), n(%) | < 0.001 | |||
Normal | 5386 (37.83) | 3355 (47.98) | 2031 (28.04) | |
Pre-central Obese | 2504 (17.59) | 1197 (17.12) | 1307 (18.04) | |
Central Obese | 6347 (44.58) | 2441 (34.91) | 3906 (53.92) | |
Diabetes, n(%)c | 1496 (10.51) | 682 (9.75) | 814 (11.24) | 0.028 |
Hypertension, n(%) | 5170 (36.31) | 2467 (35.28) | 2703 (37.31) | 0.012 |
Hukou
d
| < 0.001 | |||
Urban | 2721 (19.11) | 1401 (20.03) | 1320 (18.22) | |
Rural | 10,029 (70.44) | 4789 (68.48) | 5240 (72.34) | |
Household expenditure e | 0.34 | |||
Bottom tertile | 4419 (31.04) | 2130 (30.46) | 2289 (31.60) | |
Middle tertile | 4811 (33.79) | 2380 (34.03) | 2431 (33.56) | |
Top tertile | 4957 (34.82) | 2462 (35.21) | 2495 (34.44) | |
Occupationf | < 0.001 | |||
Managers | 98 (0.69%) | 12 (0.17%) | 86 (1.31%) | |
Professionals | 165 (1.16%) | 59 (0.85%) | 106 (1.61%) | |
Technicians and associate professionals | 76 (0.53%) | 29 (0.42%) | 47 (0.71%) | |
Clerical support workers | 58 (0.41%) | 12 (0.17%) | 46 (0.7%) | |
Service and sales workers | 300 (2.11%) | 128 (1.84%) | 172 (2.61%) | |
Skilled agricultural, forestry and fishery workers | 6999 (49.16%) | 3609 (51.95%) | 3390 (51.54%) | |
Craft and related trades workers | 625 (4.39%) | 163 (2.35%) | 462 (7.02%) | |
Plant and machine operators, and assemblers | 254 (1.78%) | 57 (0.82%) | 197 (2.99%) | |
Elementary occupations | 294 (2.07%) | 119 (1.71%) | 175 (2.66%) | |
Retirement | 4621 (32.46%) | 2736 (39.38%) | 1885 (28.66%) | |
Not elsewhere classified | 35 (0.25%) | 23 (0.33%) | 12 (0.18%) | |
Hearing loss | 1972 (13.85) | 885 (12.66) | 1087 (15.01) | < 0.001 |
Hearing loss
Waist circumference and hearing loss
Categories of Waist Circumference‡ | ||||
---|---|---|---|---|
Normal | Pre-central Obese | Central Obese | ||
Whole cohort | ||||
Cases | 829 | 336 | 807 | |
Deaths | 364 | 112 | 275 | |
Case/PYs(1000) | 29.32 (27.39,31.39) | 25.45 (22.87,28.32) | 24.55 (22.91, 26.30) | |
Unadjusted HR (95%CI) | 1.00 (Ref) | 0.86(0.76,0.98) * | 0.83(0.76,0.92)* | |
Unadjusted SHR (95%CI) § | 1.00 (Ref) | 0.88(0.78,1.00) | 0.85(0.77,0.93)* | |
Multivariate-adjusted HR† (95%CI) | 1.00 (Ref) | 0.93(0.81,1.07) | 0.84(0.75,0.94)* | |
Multivariate-adjusted SHR† (95%CI)§ | 1.00 (Ref) | 0.95(0.83,1.08) | 0.87(0.78,0.98)* | |
Men | ||||
Cases | 502 | 155 | 228 | |
Deaths | 266 | 64 | 137 | |
Case/PYs(1000) | 28.66(26.26,31.28) | 25.13 (21.47,29.42) | 18.49 (16.24,21.06) | |
Unadjusted HR (95%CI) | 1.00 (Ref) | 0.88(0.73,1.05) | 0.65(0.55,0.76)* | |
Unadjusted SHR (95%CI) § | 1.00 (Ref) | 0.89(0.75,1.07) | 0.66(0.56,0.77)* | |
Multivariate-adjusted HR† (95%CI) | 1.00 (Ref) | 1.01(0.83,1.23) | 0.76(0.63,0.91)* | |
Multivariate-adjusted SHR† (95%CI)§ | 1.00 (Ref) | 1.04(0.86,1.26) | 0.78(0.65,0.94)* | |
Women | ||||
Cases | 327 | 181 | 579 | |
Deaths | 98 | 48 | 138 | |
Case/PYs(1000) | 30.40 (27.28,33.88) | 25.72 (22.24,29.76) | 28.19 (25.98,30.58) | |
Unadjusted HR (95%CI) | 1.00 (Ref) | 0.84(0.70,1.01) | 0.92(0.80,1.05) | |
Unadjusted SHR (95%CI) § | 1.00 (Ref) | 0.85(0.71,1.02) | 0.93(0.81,1.06) | |
Multivariate-adjusted HR† (95%CI) | 1.00 (Ref) | 0.87(0.72, 1.06) | 0.89(0.76, 1.03) | |
Multivariate-adjusted SHR†(95%CI)§ | 1.00 (Ref) | 0.88(0.72,1.06) | 0.91(0.79,1.06) |
BMI and hearing loss
Categories of BMI | ||||
---|---|---|---|---|
Underweight < 18.5 | Normal 18.5-<24.0 | Overweight 24.0-<28.0 | Obese ≥ 28.0 | |
Whole cohort | ||||
Cases | 172 | 1060 | 538 | 198 |
Deaths | 98 | 401 | 175 | 61 |
Case/PYs(1000) | 43.42(37.39,50.42) | 28.53 (26.87,30.30) | 22.69(20.85,24.69) | 21.17 (18.42,24.34) |
Unadjusted HR (95%CI) | 1.54(1.31,1.80)* | 1.00 (Ref) | 0.79(0.71,0.87)* | 0.74(0.63,0.86)* |
Unadjusted SHR (95%CI) § | 1.45(1.24,1.70)* | 1.00 (Ref) | 0.80(0.72,0.89)* | 0.75(0.65,0.87)* |
Multivariate-adjusted HR† (95%CI) | 1.25(1.05,1.49)* | 1.00 (Ref) | 0.84(0.74,0.94)* | 0.82(0.69,0.96)* |
Multivariate-adjusted SHR† (95%CI)§ | 1.18(0.99,1.40) | 1.00 (Ref) | 0.85(0.76,0.96)* | 0.85(0.72,1.00) |
Men | ||||
Cases | 84 | 538 | 205 | 56 |
Deaths | 61 | 265 | 95 | 39 |
Case/PYs(1000) | 44.86(36.22,55.55) | 27.00(24.81,29.38) | 19.46(16.97,22.31) | 15.57 (11.98,20.24) |
Unadjusted HR (95%CI) | 1.70(1.35,2.13)* | 1.00 (Ref) | 0.72(0.61,0.84)* | 0.58(0.44,0.76)* |
Unadjusted SHR (95%CI) § | 1.57(1.24,1.97)* | 1.00 (Ref) | 0.73(0.62,0.86)* | 0.58(0.44,0.77)* |
Multivariate-adjusted HR† (95%CI) | 1.39(1.08,1.79)* | 1.00 (Ref) | 0.85(0.71,1.02) | 0.69(0.51,0.94)* |
Multivariate-adjusted SHR† (95%CI)§ | 1.29(1.00,1.66)* | 1.00 (Ref) | 0.87(0.73,1.04) | 0.72(0.53,0.97)* |
Women | ||||
Cases | 88 | 522 | 333 | 142 |
Deaths | 37 | 136 | 80 | 22 |
Case/PYs(1000) | 42.14(34.19,51.93) | 30.31(27.82,33.03) | 25.26(22.69,28.13) | 24.67 (20.93,29.08) |
Unadjusted HR (95%CI) | 1.39(1.11,1.74)* | 1.00 (Ref) | 0.82(0.72,0.94)* | 0.81(0.67,0.97)* |
Unadjusted SHR (95%CI) § | 1.33(1.07,1.66)* | 1.00 (Ref) | 0.83(0.72,0.95)* | 0.83(0.69,0.99)* |
Multivariate-adjusted HR† (95%CI) | 1.17(0.91,1.49) | 1.00 (Ref) | 0.83(0.71,0.96)* | 0.87(0.71,1.07) |
Multivariate-adjusted SHR† (95%CI)§ | 1.11(0.88,1.40) | 1.00 (Ref) | 0.84(0.72,0.97)* | 0.91(0.75,1.11) |
Joint categories of waist circumference and BMI
Categories of Waist Circumference‡ | |||
---|---|---|---|
Normal | Pre-central Obese | Central Obese | |
Whole cohort | |||
Underweight | 1.26(1.04,1.52)* | 1.17(0.58,2.36) | 1.19(0.38,3.71) |
Normal weight | 1.00 (Ref) | 1.01(0.86,1.19) | 0.99(0.83,1.19) |
Overweight | 0.95(0.66,1.36) | 0.82(0.65,1.04) | 0.83(0.72,0.96)* |
Obese | / | 1.44(0.60,3.49) | 0.82(0.69,0.99) |
Men | |||
Underweight | 1.43(1.10,1.85)* | 1.37 (0.34,5.52) | / |
Normal weight | 1.00 (Ref) | 1.09(0.85,1.38) | 1.07(0.77,1.49) |
Overweight | 1.23(0.81,1.87) | 1.01(0.75,1.36) | 0.75(0.60,0.95)* |
Obese | / | 1.33(0.43,4.17) | 0.70(0.51,0.97)* |
Women | |||
Underweight | 1.14(0.87,1.50) | 1.11(0.49,2.51) | 1.25(0.40,3.93) |
Normal weight | 1.00 (Ref) | 0.95(0.76,1.20) | 0.96(0.77,1.20) |
Overweight | 0.58(0.28,1.17) | 0.62(0.42,0.90)* | 0.85(0.71,1.03) |
Obese | / | 1.80(0.44,7.28) | 0.86(0.68,1.08) |
Competing risk analysis
Categories of Waist Circumference‡ | |||
---|---|---|---|
Normal | Pre-central Obese | Central Obese | |
Whole cohort | |||
Underweight | 1.18(0.98,1.42) | 1.12(0.56,2.23) | 1.33(0.38,4.72) |
Normal weight | 1.00 (Ref) | 1.01(0.86,1.19) | 1.00(0.84,1.20) |
Overweight | 0.98(0.69,1.40) | 0.84(0.67,1.06) | 0.85(0.74,0.98)* |
Obese | / | 1.51(0.62,3.68) | 0.86(0.72,1.03) |
Men | |||
Underweight | 1.32(1.02,1.72)* | 1.30(0.31,5.35) | / |
Normal weight | 1.00 (Ref) | 1.09(0.86,1.38) | 1.09(0.79,1.51) |
Overweight | 1.26(0.83,1.93) | 1.05(0.78,1.42) | 0.77(0.61,0.97)* |
Obese | / | 1.40(0.44,4.45) | 0.73(0.53,1.01) |
Women | |||
Underweight | 1.08(0.83,1.40) | 1.05(0.47,2.35) | 1.39(0.36,5.34) |
Normal weight | 1.00 (Ref) | 0.95(0.76,1.18) | 0.96(0.77,1.20) |
Overweight | 0.59(0.30,1.19) | 0.62(0.43,0.89)* | 0.87(0.72,1.04) |
Obese | / | 1.83(0.48,6.98) | 0.90(0.72,1.12) |