1 Body-Mass Index and Mortality in Korean Men and Women Sun Ha Jee, Ph.D., Jae Woong Sull, Ph.D., Jung yong Park, Ph.D., Sang-Yi Lee, M.D. From the Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul N Engl J Med vol. 355 no ;355: 발표자 : 내과 전공의 나승연

2 Background Obesity diverse health risks, the role of body weight as a risk factor for death The American Cancer Society, lowest among men with a BMI of 23.5 to 24.9 and women with a BMI of 22.0 to 23.4 The China, lowest among men with a BMI of 24.0 to 24.9 and women with a BMI of 25.0 to 26.9

3 Background World Health Organization (WHO) a new BMI cutoff of 23.0 in Asia A prospective cohort study BMI and the risk of death from any cause and from specific diseases in more than 1 million Koreans in the Korean Cancer Prevention Study (KCPS).

4 82,372 Deaths from any cause 48,731 Specific disease Body weight and the risk of death in a 12-year prospective cohort study the ages of 30 and 95 years Yonsei University and the Johns Hopkins Bloomberg School. 1,213, and 1995 December 31, 2004 (29,123 from cancer, 16,426 from atherosclerotic cardiovascular disease, and 3362 from respiratory disease) Methods

5 Results

6 Table 1. Baseline Characteristics of the Study Population.

7 Table 2. Differences in Baseline Systolic Blood Pressure and Clinical Chemical Analyses, According to BMI. < vs 4.7> vs 26.8> vs 2.4

8 Figure 1.Hazard Ratios for Death from Any Cause and from Any Cause Except Respiratory, According to BMI and Smoking History to to 24.9, 20.0 to 26.4

9 Figure 2. Hazard Ratios for Death from Cancer and from Atherosclerotic Cardiovascular and Respiratory Causes, According to BMI and Smoking History. 58,312 vs 24,060 22, , ,

10 Figure 2. Hazard Ratios for Death from Any Cause among Men and Women with No History of Smoking, According to Age Group and BMI.

11 Table 3. Hazard Ratios for Death from Atherosclerotic Cardiovascular Causes, According to BMI. Alcohol, Smoking, Physical activity Cholesterol, SBP, Blood glucose

12 Conclusion Underweight, overweight, and obese men and women had higher rates of death than men and women of normal weight. The association of BMI with death varied according to the cause of death and was modified by age, sex, and smoking history.

13 Discussion The relationship between death from any cause and BMI J-shaped pattern. BMI the risk of death from all the major diseases Similar patterns smoker VS non-smoker the J-shaped relationship Underweight to weight loss associated with illness due to an increase in respiratory causes.

14 Discussion Exclusion diagnoses of certain chronic diseases at enrollment, as well as during the first two years of follow-up. the illness causing rapid weight loss leads to death. Deaths from respiratory causes were due to tuberculosis in 19.3 percent of subjects, to pneumonia in 27.9 percent, to COPD in 27.8 percent, and to asthma in 24.7 percent.

15 Discussion To age, with little evidence of increased risk among obese subjects over the age of 65 years. Future burden of obesity as today’s obese children and young adults Asian populations a higher percentage of body fat than do Western populations at the same BMI level. less muscle mass and connective tissue. lower by 1.9 to 3.2 than that of white subjects.