TY - JOUR
TI - Repeated measures of body mass index and C-reactive protein in relation
to all-cause mortality and cardiovascular disease: results from the
consortium on health and ageing network of cohorts in Europe and the
United States (CHANCES)
AU - O'Doherty, Mark G.
AU - Jorgensen, Torben
AU - Borglykke, Anders and
AU - Brenner, Hermann
AU - Schoettker, Ben
AU - Wilsgaard, Tom
AU - Siganos,
AU - Galatios
AU - Kavousi, Maryam
AU - Hughes, Maria
AU - Mueezzinler, Aysel
AU - and Holleczek, Bernd
AU - Franco, Oscar H.
AU - Hofman, Albert and
AU - Boffetta, Paolo
AU - Trichopoulou, Antonia
AU - Kee, Frank
JO - European Journal of Epidemiology
PY - 2014
VL - 29
TODO - 12
SP - 887-897
PB - Springer-Verlag
SN - 0393-2990, 1573-7284
TODO - 10.1007/s10654-014-9954-8
TODO - CHANCES; Ageing; C-reactive protein; Obesity; Cardiovascular disease;
Mortality
TODO - Obesity has been linked with elevated levels of C-reactive protein
(CRP), and both have been associated with increased risk of mortality
and cardiovascular disease (CVD). Previous studies have used a single
‘baseline’ measurement and such analyses cannot account for possible
changes in these which may lead to a biased estimation of risk. Using
four cohorts from CHANCES which had repeated measures in participants 50
years and older, multivariate time-dependent Cox proportional hazards
was used to estimate hazard ratios (HR) and 95 % confidence intervals
(CI) to examine the relationship between body mass index (BMI) and CRP
with all-cause mortality and CVD. Being overweight (a parts per thousand
yen25-< 30 kg/m(2)) or moderately obese (a parts per thousand yen30-<
35) tended to be associated with a lower risk of mortality compared to
normal (a parts per thousand yen18.5-< 25): ESTHER, HR (95 % CI) 0.69
(0.58-0.82) and 0.78 (0.63-0.97); Rotterdam, 0.86 (0.79-0.94) and 0.80
(0.72-0.89). A similar relationship was found, but only for overweight
in Glostrup, HR (95 % CI) 0.88 (0.76-1.02); and moderately obese in
Tromso, HR (95 % CI) 0.79 (0.62-1.01). Associations were not evident
between repeated measures of BMI and CVD. Conversely, increasing CRP
concentrations, measured on more than one occasion, were associated with
an increasing risk of mortality and CVD. Being overweight or moderately
obese is associated with a lower risk of mortality, while CRP,
independent of BMI, is positively associated with mortality and CVD
risk. If inflammation links CRP and BMI, they may participate in
distinct/independent pathways. Accounting for independent changes in
risk factors over time may be crucial for unveiling their effects on
mortality and disease morbidity.
ER -