Association between fat mass and mortality: analysis of Mendelian randomization and lifestyle modification

被引:6
作者
Hu, Jinbo [1 ,2 ]
Chen, Xiangjun [1 ]
Yang, Jun [3 ,4 ]
Giovannucci, Edward [2 ]
Lee, Dong Hoon [2 ]
Luo, Wenjin [1 ]
Cheng, Qingfeng [1 ]
Gong, Lilin [1 ]
Wang, Zhihong [1 ]
Li, Qifu [1 ,5 ]
Yang, Shumin [1 ,5 ]
机构
[1] Chongqing Med Univ, Dept Endocrinol, Affiliated Hosp 1, Chongqing, Peoples R China
[2] Harvard TH Chan Sch Publ Hlth, Dept Nutr & Epidemiol, 665 Huntington Ave, Boston, MA USA
[3] Hudson Inst Med Res, Ctr Endocrinol & Metab, Clayton, Vic, Australia
[4] Monash Univ, Dept Med, Clayton, Vic, Australia
[5] Chongqing Med Univ, Affiliated Hosp 1, 1 Youyi St, Chongqing 400016, Peoples R China
来源
METABOLISM-CLINICAL AND EXPERIMENTAL | 2022年 / 136卷
基金
中国国家自然科学基金;
关键词
Fat mass; Mortality; Mendelian randomization; Lifestyle modification; ALL-CAUSE MORTALITY; INDEX; OBESITY; METAANALYSIS; OVERWEIGHT; ADULTS;
D O I
10.1016/j.metabol.2022.155307
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The association between fat mass and mortality has been equivocally shown to be linear, J-shaped, and U-shaped. We aimed to clarify this relationship based on Mendelian randomization (MR) analysis and lifestyle modification.Methods: This prospective analysis included 449,831 participants from UK Biobank. Linear MR analysis was used to estimate the linear relationship between fat mass and mortality. We assessed whole body fat mass by bio-impedance analysis at baseline and categorized subjects into five equal groups based on fat mass index (FMI). The association between FMI and mortality were investigated among whole population and in subgroups stratified by individual lifestyle factors, including diet, physical activity, smoking, alcohol, sleep and psycho-logical health.Findings: Linear MR analyses indicated a positive association between genetically predicted fat mass and all-cause mortality (HR 1.10, 95 % CI 1.08-1.12, P < 0.001). The association between FMI and all-cause mortality was manifested as J-shaped (HRs across FMI categories: 1.04, 1.00, 1.07, 1.21, 1.54), which was significantly modified by the number of low-risk lifestyle factors (P for interaction<0.001). When evaluating individual lifestyle factors, we observed a nonlinear relationship between FMI and all-cause mortality among participants who had high-risk lifestyle factors, while a linear relationship was observed among participants who had low-risk lifestyle factors, especially for those with adequate physical activity (HRs across FMI categories: 0.95, 1.00, 1.05, 1.17, 1.44) and who never smoked (0.96, 1.00, 1.03, 1.14, 1.51).Interpretation: Genetically determined fat mass is causally and linearly associated with mortality. The J-shape association between anthropometric FMI and mortality is caused by high-risk lifestyle factors.
引用
收藏
页数:9
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