Conventional and genetic associations of BMI with major vascular and non-vascular disease incidence and mortality in a relatively lean Chinese population: U-shaped relationship revisited

作者：Andri Iona, Fiona Bragg, Zammy Fairhurst-Hunter, Iona Y. Millwood, Neil Wright, Kuang Lin, Ling Yang, Huaidong Du, Yiping Chen, Pei Pei, Liang Cheng, Dan Schmidt, Daniel Avery, Canqing Yu, Jun Lv, Robert Clarke, Robin Walters, Liming Li, Sarah Parish, Zhengming Chen, China Kadoorie Biobank Collaborative Group, Junshi Chen, Zhengming Chen, Robert Clarke, Rory Collins, Yu Guo, Liming Li, Chen Wang, Jun Lv, Richard Peto, Robin Walters, Daniel Avery, Derrick Bennett, Ruth Boxall, Ka Hung Chan, Yu‐Mei Chang, Yiping Chen, Zhengming Chen, Johnathan Clarke, Robert Clarke, Huaidong Du, Ahmed Edris Mohamed, Zammy Fairhurst-Hunter, Hannah Fry, Simon Gilbert, Alex Hacker, Mike Hill, Michael V. Holmes, Pek Kei Im, Andri Iona, Maria Kakkoura, Christiana Kartsonaki, Kuang Lin, Mohsen Mazidi, Iona Y. Millwood, Sam Morris, Qunhua Nie, Alfred Pozarickij, Paul Ryder, Saredo Said, Sam Sansome, Dan Schmidt, Paul Sherliker, Rajani Sohoni, Becky Stevens, Iain Turnbull, Robin Walters, Lin Wang, Neil Wright, Ling Yang, Xiaoming Yang, Pang Yao, Yu Guo, Xiao Han, Can Hou, Qingmei Xia, Chao Liu, Jun Lv, Pei Pei, Canqing Yu, Naying Chen, Duo Liu, Zhenzhu Tang, Ningyu Chen, Qilian Jiang, Jian Lan, Mingqiang Li, Yun Liu, Fanwen Meng, Jinhuai Meng, Rong Pan, Yulu Qin, Ping Wang, Sisi Wang, Liuping Wei, Liyuan Zhou, Caixia Dong, Pengfei Ge, Xiaolan Ren, Zhongxiao Li, Enke Mao, Tao Wang, Hui Zhang, Xi Zhang, Jinyan Chen, Ximin Hu, Xiaohuan Wang, Zhendong Guo, Huimei Li, Yilei Li, Min Weng, Shukuan Wu, Shichun Yan, Mingyuan Zou, Xue Zhou, Ziyan Guo, Quan Kang, Yanjie Li, Bo Yu, Qinai Xu, Liang Chang, Lei Fan, Shixian Feng, Ding Zhang, Gang Zhou, Yulian Gao, Tianyou He, Pan He, Chen Hu, Huarong Sun, Xukui Zhang, Biyun Chen, Zhongxi Fu, Yuelong Huang, Huilin Liu, Qiaohua Xu, Yin Li, Huajun Long, Xin Xu, Hao Zhang, Libo Zhang, Jian Su, Ran Tao, Ming Wu, Jie Yang, Jinyi Zhou, Yonglin Zhou, Yihe Hu, Yujie Hua, Jianrong Jin Fang Liu, Jingchao Liu, Yan Lu, Liangcai Ma, Aiyu Tang, Jun Zhang, Liang Cheng, Huaidong Du, Ruqin Gao, Feifei Li, Shanpeng Li, Yongmei Liu, Feng Ning, Zengchang Pang, Xiaohui Sun, Xiaocao Tian, Shaojie Wang, Yaoming Zhai, Hua Zhang, Wei Hou, Jun Lv, Junzheng Wang, Xiaofang Chen, Xianping Wu, Ningmei Zhang, Weiwei Zhou, Xiaofang Chen, Jianguo Li, Jiaqiu Liu, Guojin Luo, Qiang Sun, Xunfu Zhong, Weiwei Gong, Ruying Hu, Hao Wang, Wan Meng, Canqing Yu, Lingli Chen, Qijun Gu, Dongxia Pan, Chunmei Wang, Kaixu Xie, Xiaoyi Zhang, Shuya Li, Haiqiang Qin, Yongjun Wang, Qiling Chen, Jihua Wang, Xiaojia Sun, Lei Wang, Xun Wang, Liming Zhang, Shanshan Zhou, Hongyuan Chen, Lixia Chen, Haiyan Gou, Weizhi Wang, Yanmei Zhu, Yulan Zhu, Ning Zhang, Xin Cheng, Qiang Dong, Yi Dong, Kun Fang, Yiting Mao, Yu An, Peiling Chen, Yinghua Chen, Zhihong Liu, Lihua Zhang Xiaohong Chen, Naixin Jv, Xiaojiu Li, Liyang Liu, Yun Lu, Xiaona Xing, Shihao You, Xiaoli Cheng, Chaojun Gua, Jinping Jiang, Jingyi Liu, Shumei Ma, Xuefeng Yang, Xiaomo Du, Jian Xu, Xuecheng Yang, Xiaodi Zhao, Zilong Hao, Ming Liu, Deren Wang, Xiaoting Li, Lili Hui, Zhanling Liao, Feng Liu, Chunning Feng, Dejiang Ji, Fengxia Qu, Wenwen Yuan, Xin Fu, Jing Ding, Peng Du, Lirong Jin, Yueshi Mao, Xin Wang · 发表于：International Journal of Epidemiology · 年份：2024 · DOI：10.1093/ije/dyae125 · 被引用次数：7 · 研究领域：Genetic Associations and Epidemiology、Adipokines, Inflammation, and Metabolic Diseases、Diabetes, Cardiovascular Risks, and Lipoproteins

BACKGROUND: Higher body mass index (BMI) is associated with higher incidence of cardiovascular and some non-cardiovascular diseases (CVDs/non-CVDs). However, uncertainty remains about its associations with mortality, particularly at lower BMI levels. METHODS: The prospective China Kadoorie Biobank recruited >512 000 adults aged 30-79 years in 2004-08 and genotyped a random subset of 76 000 participants. In conventional and Mendelian randomization (MR) analyses, Cox regression yielded adjusted hazard ratios (HRs) associating measured and genetically predicted BMI levels with incident risks of major vascular events (MVEs; conventional/MR 68 431/23 621), ischaemic heart disease (IHD; 50 698/12 177), ischaemic stroke (IS; 42 427/11 897) and intracerebral haemorrhage (ICH; 7644/4712), and with mortality risks of CVD (15 427/6781), non-CVD (26 915/4355) and all causes (42 342/6784), recorded during ∼12 years of follow-up. RESULTS: Overall, the mean BMI was 23.8 (standard deviation: 3.2) kg/m2 and 13% had BMIs of <20 kg/m2. Measured and genetically predicted BMI showed positive log-linear associations with MVE, IHD and IS, but a shallower positive association with ICH in conventional analyses. Adjusted HRs per 5 kg/m2 higher genetically predicted BMI were 1.50 (95% CI 1.41-1.58), 1.49 (1.38-1.61), 1.42 (1.31-1.54) and 1.64 (1.58-1.69) for MVE, IHD, IS and ICH, respectively. These were stronger than associations in conventional analyses [1.21 (1.20-1.23), 1.28 (1.26-1.29), 1.31 (1.29...