TitleUnderweight as a risk factor for respiratory death in the Whitehall cohort study: exploring reverse causality using a 45-year follow-up.
Publication TypeJournal Article
Year of Publication2016
AuthorsKivimäki, M, Shipley, MJ, Bell, JA, Brunner, EJ, Batty, GD, Singh-Manoux, A
JournalThorax
Volume71
Issue1
Pagination84-5
Date Published01/2016
ISSN1468-3296
KeywordsAdult, Aged, Causality, Chronic Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Population Surveillance, Respiratory Tract Diseases, Risk Factors, Thinness
Abstract
 

Underweight adults have higher rates of respiratory death than the normal weight but it is unclear whether this association is causal or reflects illness-induced weight loss (reverse causality). Evidence from a 45-year follow-up of underweight participants for respiratory mortality in the Whitehall study (N=18 823; 2139 respiratory deaths) suggests that excess risk among the underweight is attributable to reverse causality. The age-adjusted and smoking-adjusted risk was 1.55-fold (95% CI 1.32 to 1.83) higher among underweight compared with normal weight participants, but attenuated in a stepwise manner to 1.14 (95% CI 0.76 to 1.71) after serial exclusions of deaths during the first 5-35 years of follow-up (P(trend)<0.001).

DOI10.1136/thoraxjnl-2015-207449
Alternate JournalThorax
PubMed ID26253581
PubMed Central IDPMC4717419
Grant ListRG/13/2/30098 / / British Heart Foundation / United Kingdom
/ / Department of Health / United Kingdom
R01 AG034454 / AG / NIA NIH HHS / United States
MR/K026992/1 / / Medical Research Council / United Kingdom
MR/K013351 / / Medical Research Council / United Kingdom
RG13/2/30098 / / British Heart Foundation / United Kingdom
MR/K013351/1 / / Medical Research Council / United Kingdom
R01 AG013196 / AG / NIA NIH HHS / United States
R01AG034454 / AG / NIA NIH HHS / United States
R01AG013196 / AG / NIA NIH HHS / United States