Underweight as a risk factor for respiratory death in the Whitehall cohort study: exploring reverse causality using a 45-year follow-up

Mika Kivimäki, Martin J Shipley, Joshua A Bell, Eric J Brunner, G David Batty, Archana Singh-Manoux

Research output: Contribution to journalArticle (Academic Journal)peer-review

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).

Original languageEnglish
Pages (from-to)84-5
Number of pages2
JournalThorax
Volume71
Issue number1
DOIs
Publication statusPublished - Jan 2016

Keywords

  • Adult
  • Aged
  • Causality
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Population Surveillance
  • Respiratory Tract Diseases
  • Risk Factors
  • Thinness

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