{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:34:44Z","timestamp":1791473684421,"version":"4.3.4"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":57,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kadoorie Charitable Foundation in Hong Kong","award":["088158\/Z\/09\/Z"],"award-info":[{"award-number":["088158\/Z\/09\/Z"]}]},{"name":"Kadoorie Charitable Foundation in Hong Kong","award":["104085\/Z\/14\/Z"],"award-info":[{"award-number":["104085\/Z\/14\/Z"]}]},{"name":"Kadoorie Charitable Foundation in Hong Kong","award":["212946\/Z\/18\/Z"],"award-info":[{"award-number":["212946\/Z\/18\/Z"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Higher body mass index (BMI) is associated with higher incidence of cardiovascular and some non-cardiovascular diseases (CVDs\/non-CVDs). However, uncertainty remains about its associations with mortality, particularly at lower BMI levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The prospective China Kadoorie Biobank recruited &amp;gt;512\u200a000 adults aged 30\u201379\u00a0years in 2004\u201308 and genotyped a random subset of 76\u200a000 participants. In conventional and Mendelian randomization (MR) analyses, Cox regression yielded adjusted hazard ratios (HRs) associating measured and genetically predicted BMI levels with incident risks of major vascular events (MVEs; conventional\/MR 68\u200a431\/23\u200a621), ischaemic heart disease (IHD; 50\u200a698\/12\u200a177), ischaemic stroke (IS; 42\u200a427\/11\u200a897) and intracerebral haemorrhage (ICH; 7644\/4712), and with mortality risks of CVD (15\u200a427\/6781), non-CVD (26\u200a915\/4355) and all causes (42\u200a342\/6784), recorded during \u223c12\u00a0years of follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, the mean BMI was 23.8 (standard deviation: 3.2) kg\/m2 and 13% had BMIs of &amp;lt;20\u2009kg\/m2. Measured and genetically predicted BMI showed positive log-linear associations with MVE, IHD and IS, but a shallower positive association with ICH in conventional analyses. Adjusted HRs per 5\u2009kg\/m2 higher genetically predicted BMI were 1.50 (95% CI 1.41\u20131.58), 1.49 (1.38\u20131.61), 1.42 (1.31\u20131.54) and 1.64 (1.58\u20131.69) for MVE, IHD, IS and ICH, respectively. These were stronger than associations in conventional analyses [1.21 (1.20\u20131.23), 1.28 (1.26\u20131.29), 1.31 (1.29\u20131.33) and 1.14 (1.10\u20131.18), respectively]. At BMIs of \u226520\u2009kg\/m2, there were stronger positive log-linear associations of BMI with CVD, non-CVD and all-cause mortality in MR than in conventional analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among relatively lean Chinese adults, higher genetically predicted BMI was associated with higher risks of incident CVDs. Excess mortality risks at lower BMI in conventional analyses are likely not causal and may reflect residual reverse causality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyae125","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T11:30:21Z","timestamp":1728559821000},"source":"Crossref","is-referenced-by-count":9,"title":["Conventional and genetic associations of BMI with major vascular and non-vascular disease incidence and mortality in a relatively lean Chinese population: U-shaped relationship revisited"],"prefix":"10.1093","volume":"53","author":[{"given":"Andri","family":"Iona","sequence":"first","affiliation":[{"name":"Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford , 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