Evidence map›Paper›PMID 30389323›Full record

ArticleThe lancet. Diabetes & endocrinology2018

Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK.

Krishnan Bhaskaran, Isabel Dos-Santos-Silva, David A Leon, Ian J Douglas, Liam Smeeth

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The lancet. Diabetes & endocrinology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 684 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
684citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

684 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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624 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Krishnan BhaskaranDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: krishnan.bhaskaran@lshtm.ac.uk.
Isabel Dos-Santos-SilvaDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
David A LeonDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway.
Ian J DouglasDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Liam SmeethDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Funding

Medical Research Council G0802403Wellcome Trust
6 · The paper itself

Abstract

backgroundBMI is known to be strongly associated with all-cause mortality, but few studies have been large enough to reliably examine associations between BMI and a comprehensive range of cause-specific mortality outcomes.

methodsIn this population-based cohort study, we used UK primary care data from the Clinical Practice Research Datalink (CPRD) linked to national mortality registration data and fitted adjusted Cox regression models to examine associations between BMI and all-cause mortality, and between BMI and a comprehensive range of cause-specific mortality outcomes (recorded by International Classification of Diseases, 10th revision [ICD-10] codes). We included all individuals with BMI data collected at age 16 years and older and with subsequent follow-up time available. Follow-up began at whichever was the latest of: start of CPRD research-standard follow up, the 5-year anniversary of the first BMI record, or on Jan 1, 1998 (start date for death registration data); follow-up ended at death or on March 8, 2016. Fully adjusted models were stratified by sex and adjusted for baseline age, smoking, alcohol use, diabetes, index of multiple deprivation, and calendar period. Models were fitted in both never-smokers only and the full study population. We also did an extensive range of sensitivity analyses. The expected age of death for men and women aged 40 years at baseline, by BMI category, was estimated from a Poisson model including BMI, age, and sex.

findings3 632 674 people were included in the full study population; the following results are from the analysis of never-smokers, which comprised 1 969 648 people and 188 057 deaths. BMI had a J-shaped association with overall mortality; the estimated hazard ratio per 5 kg/m

interpretationBMI had J-shaped associations with overall mortality and most specific causes of death; for mental and behavioural, neurological, and external causes, lower BMI was associated with increased mortality risk.

fundingWellcome Trust.

Indexed as

Body Mass IndexAdolescentAdultAgedAged, 80 and overCause of DeathFemaleFollow-Up StudiesHumansMaleMiddle AgedMortalityObesityOverweightPrognosisProspective Studies

Identifiers

PMID30389323
PMCPMC6249991

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.