Obesity and loss of disease-free years owing to major non-communicable diseases: a multicohort study
Mark Hamer; Maria Nordin; Joni V Lindbohm; G David Batty; Tea Lallukka; Markku Koskenvuo; Markus Jokela; Mika Kivimäki; Joshua A Bell; Archana Singh-Manoux; Linda L Magnusson Hanson; Jane E Ferrie; Ida E H Madsen; Reiner Rugulies; Ossi Rahkonen; Tuula Oksanen; Sari Stenholm; Solja T Nyberg; Marie Zins; Martin J Shipley; Jussi Vahtera; Constanze Leineweber; Marianna Virtanen; Katriina Heikkilä; Lars Alfredsson; Marcel Goldberg; Peter J M Westerholm; Jaana Pentti; Töres Theorell; Eleonor I Fransson; Sakari Suominen; Olli Pietiläinen; Anders Knutsson; Hugo Westerlund
Obesity and loss of disease-free years owing to major non-communicable diseases: a multicohort study
Mark Hamer
Maria Nordin
Joni V Lindbohm
G David Batty
Tea Lallukka
Markku Koskenvuo
Markus Jokela
Mika Kivimäki
Joshua A Bell
Archana Singh-Manoux
Linda L Magnusson Hanson
Jane E Ferrie
Ida E H Madsen
Reiner Rugulies
Ossi Rahkonen
Tuula Oksanen
Sari Stenholm
Solja T Nyberg
Marie Zins
Martin J Shipley
Jussi Vahtera
Constanze Leineweber
Marianna Virtanen
Katriina Heikkilä
Lars Alfredsson
Marcel Goldberg
Peter J M Westerholm
Jaana Pentti
Töres Theorell
Eleonor I Fransson
Sakari Suominen
Olli Pietiläinen
Anders Knutsson
Hugo Westerlund
ELSEVIER SCI LTD
Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2021042720105
https://urn.fi/URN:NBN:fi-fe2021042720105
Tiivistelmä
Background Obesity increases the risk of several chronic diseases, but the extent to which the obesity-related loss of disease-free years varies by lifestyle category and across socioeconomic groups is unclear. We estimated the number of years free from major non-communicable diseases in adults who are overweight and obese, compared with those who are normal weight.Methods We pooled individual-level data on body-mass index (BMI) and non-communicable diseases from men and women with no initial evidence of these diseases in European cohort studies from the Individual-Participant-Data Meta-Analysis in Working Populations consortium. BMI was assessed at baseline (1991-2008) and non-communicable diseases (incident type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease) were ascertained via linkage to records from national health registries, repeated medical examinations, or self-report. Disease-free years from age 40 years to 75 years associated with underweight (BMI <18.5 kg/m(2)), overweight (>= 25 kg/m(2) to <30 kg/m(2)), and obesity (class I [mild] >= 30 kg/m(2) to < 35 kg/m(2); class II-III [severe] >= 35 kg/m(2)) compared with normal weight (>= 18.5 kg/m(2) to <25 kg/m(2)) were estimated.Findings Of 137 503 participants from ten studies, we excluded 6973 owing to missing data and 10 349 with prevalent disease at baseline, resulting in an analytic sample of 120 181 participants. Of 47 127 men, 211 (0.4%) were underweight, 21 468 (45.6%) normal weight, 20 738 (44.0%) overweight, 3982 (8.4%) class I obese, and 728 (1.5%) class II-III obese. The corresponding numbers among the 73 054 women were 1493 (2.0%), 44 760 (61.3%), 19 553 (26.8%), 5670 (7.8%), and 1578 (2.2%), respectively. During 1 328 873 person-years at risk (mean follow-up 11.5 years [range 6.3-18.6]), 8159 men and 8100 women developed at least one non-communicable disease. Between 40 years and 75 years, the estimated number of disease-free years was 29.3 (95% CI 28.8-29.8) in normal-weight men and 29.4 (28.7-30.0) in normal-weight women. Compared with normal weight, the loss of disease-free years in men was 1.8 (95% CI -1.3 to 4.9) for underweight, 1.1 (0.7 to 1.5) for overweight, 3.9 (2.9 to 4.9) for class I obese, and 8.5 (7.1 to 9.8) for class II-III obese. The corresponding estimates for women were 0.0 (-1.4 to 1.4) for underweight, 1.1 (0.6 to 1.5) for overweight, 2.7 (1.5 to 3.9) for class I obese, and 7.3 (6.1 to 8.6) for class II-III obese. The loss of disease-free years associated with class II-III obesity varied between 7.1 and 10.0 years in subgroups of participants of different socioeconomic level, physical activity level, and smoking habit.Interpretation Mild obesity was associated with the loss of one in ten, and severe obesity the loss of one in four potential disease-free years during middle and later adulthood. This increasing loss of disease-free years as obesity becomes more severe occurred in both sexes, among smokers and non-smokers, the physically active and inactive, and across the socioeconomic hierarchy. Copyright (c) 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Kokoelmat
- Rinnakkaistallenteet [19207]