TY - JOUR
T1 - Body mass index, diabetes, and mortality in french women
T2 - Explaining away a "paradox"
AU - Lajous, Martin
AU - Bijon, Anne
AU - Fagherazzi, Guy
AU - Boutron-Ruault, Marie Christine
AU - Balkau, Beverley
AU - Clavel-Chapelon, Françoise
AU - Hernán, Miguel A.
PY - 2014/1
Y1 - 2014/1
N2 - BACKGROUND:: Obesity is associated with increased mortality in the general population but, paradoxically, with decreased mortality in persons with diabetes. METHODS:: Among 88,373 French women participating in the E3N-EPIC study who were free of diabetes in 1990, we estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality for body mass index (BMI) levels by diabetes status. RESULTS:: During an average 16.7 years of follow-up, 2421 cases of diabetes were identified and 3750 deaths occurred. For overweight/obese versus normal-weight women, the HR of mortality was 1.42 (95% CI = 1.32-1.53) in women without diabetes and 0.69 (0.40-1.18) in women with incident diabetes. As BMI increased, mortality among women without diabetes increased and that among women with diabetes decreased. CONCLUSIONS:: We found the obesity "paradox" among women with and without incident diabetes in the same population. Selection bias may be a simple explanation for this "paradox."
AB - BACKGROUND:: Obesity is associated with increased mortality in the general population but, paradoxically, with decreased mortality in persons with diabetes. METHODS:: Among 88,373 French women participating in the E3N-EPIC study who were free of diabetes in 1990, we estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality for body mass index (BMI) levels by diabetes status. RESULTS:: During an average 16.7 years of follow-up, 2421 cases of diabetes were identified and 3750 deaths occurred. For overweight/obese versus normal-weight women, the HR of mortality was 1.42 (95% CI = 1.32-1.53) in women without diabetes and 0.69 (0.40-1.18) in women with incident diabetes. As BMI increased, mortality among women without diabetes increased and that among women with diabetes decreased. CONCLUSIONS:: We found the obesity "paradox" among women with and without incident diabetes in the same population. Selection bias may be a simple explanation for this "paradox."
UR - http://www.scopus.com/inward/record.url?scp=84890123720&partnerID=8YFLogxK
U2 - 10.1097/EDE.0000000000000031
DO - 10.1097/EDE.0000000000000031
M3 - Article
C2 - 24270963
AN - SCOPUS:84890123720
SN - 1044-3983
VL - 25
SP - 10
EP - 14
JO - Epidemiology
JF - Epidemiology
IS - 1
ER -