Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK Krishnan Bhaskaran, PhD,

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Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK Krishnan Bhaskaran, PhD, Prof Isabel dos-Santos-Silva, PhD, Prof David A Leon, PhD, Ian J Douglas, PhD, Prof Liam Smeeth, PhD The Lancet Diabetes & Endocrinology Volume 6, Issue 12, Pages 944-953 (December 2018) DOI: 10.1016/S2213-8587(18)30288-2 Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 1 All-cause mortality and Level 1 cause-specific mortality outcomes in total study population (A) and in never-smokers only (B) We used a three-level hierarchical classification of causes of death as used by the Global Burden of Diseases, Injuries, and Risk Factors Study.16 All Level 1 outcomes (communicable diseases, non-communicable diseases, and injuries and external causes) were studied. 5-year exclusion period applied for person-time and events after a BMI record. Dashed vertical lines represent WHO BMI category thresholds of 18·5 kg/m2 (underweight to healthy), 25 kg/m2 (healthy weight to overweight), and 30 kg/m2 (overweight to obese). Estimates adjusted for age at BMI record, deprivation, calendar year, diabetes, alcohol status, and smoking (all as defined at date of BMI measure) and stratified for sex. The p values for overall association and p values for non-linearity were less than 0·0001 for all outcomes, in both full and never-smoker populations. HR=hazard ratio. The Lancet Diabetes & Endocrinology 2018 6, 944-953DOI: (10.1016/S2213-8587(18)30288-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 2 Association between BMI and Level 2 and Level 3 cause-specific mortality outcomes among never-smokers (organised by ICD-10 code) We used a three-level hierarchical classification of causes of death as used by the Global Burden of Diseases, Injuries, and Risk Factors Study.16 We studied all Level 2 non-communicable disease outcomes and selected Level 3 outcomes that were either common causes of death in the UK or were a priori expected to have important associations with BMI. 5-year exclusion period applied for person-time and events after a BMI record; estimates adjusted for age, deprivation, calendar year, diabetes, alcohol status (all as defined at date of BMI measure) and stratified for sex. HR=hazard ratio. ICD-10=International Classification of Diseases, 10th revision. The Lancet Diabetes & Endocrinology 2018 6, 944-953DOI: (10.1016/S2213-8587(18)30288-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 3 Association between BMI and all-cause mortality among never-smokers, by sex (A) and age (B) 5-year exclusion period applied for person-time and events after a BMI record; estimates adjusted for age, deprivation, calendar year, diabetes, and alcohol status (all as defined at date of BMI measure) and stratified by sex. HR=hazard ratio. The Lancet Diabetes & Endocrinology 2018 6, 944-953DOI: (10.1016/S2213-8587(18)30288-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions