Weight and mortality in Finnish men

Mortality rates of 22,995 Finnish men aged 25 and over followed up for a median of 12 years were analyzed in relation to body mass index (BMI) at the initial examination. All-cause mortality followed a "U"-shaped distribution, being greatest for the thinnest and fattest men at all ages, or about 1.5-fold for those with BMI less than 19.0 kg/m2 and BMI greater than or equal to 34.0 kg/m2, as compared with men of normal weight (BMI 22.0-24.9 kg/m2). Mortality from cardiovascular diseases (CVD) increased with increasing BMI beyond the normal range. This depended mostly on the association of BMI with the biological risk factors of CVD. Mortality rates from CVD were also elevated among thin men under age 55, which could not be explained by the effect of the biological variables. Mortality rates from non-cardiovascular diseases, including cancers were inversely related to BMI among men of all ages. The high overall mortality of thin men was partly but not entirely attributable to smoking, low social class and antecedent disease. We conclude that both thinness and overweight are detrimental to longevity, but through differing mechanisms and disease patterns.     

Lifestyle and mortality among Norwegian men

Information on six different habits (cigarette smoking, physical activity, frequency of alcohol and of fruit/vegetable consumption, and daily bread and potato consumption) was obtained by two postal surveys (1964 and 1967) among Norwegian men. The answers were related to mortality among 10,187 respondents ages 35-74 years at the start of the follow-up period (1967-1978). Analyses, stratified by age, place of residence, marital status, and socioeconomic group, showed an association between the six variables and observed/expected deaths, as well as odds ratio estimates. A health practice score, obtained by adding the number of favorable habits, showed a strong inverse relationship with total mortality as well as deaths from cancer, cardiovascular diseases, and other causes. Odds ratio estimates for men with only favorable habits vs those with at most one such habit, were 0.31 for total mortality, 0.44 for cancer, and 0.36 for cardiovascular mortality. Separate analyses among current smokers and nonsmokers showed a particularly strong association between the five other habits and mortality from cardiovascular disease.     

Marital status and mortality in middle-aged Swedish men

In a large primary prevention trial among middle-aged men in Gothenburg, Sweden, register data were used to establish marital status, alcohol abuse, and economic problems for nearly all of the study population in 1970-1973. Married men had a higher participation rate in the examinations for the trial than non-married men, with non-married alcoholic men having the lowest participation rates. Among the participants, 26% of divorced men, but only 5% of married men were registered with the social authorities for alcohol problems. Serum cholesterol, body mass index, and diabetes were not associated with marital status, but smoking was more common among widowers and divorced men. Nonfatal myocardial infarction was not related to marital status among participants, after a mean follow-up of 11.8 years. Death from coronary heart disease was more common in non-married men in univariate analysis, but not when other risk factors were taken into consideration. In participants, married men had a mortality rate of 9%, compared with 20% for divorced men. After adjustment for other risk factors, including registration for alcohol problems, smoking, and occupational class, the association between marital status and total mortality was still highly significant. Among nonparticipants in the trial, 13% of married men were registered for alcohol problems, compared with 41% of divorced men. Nonparticipants had higher all-cause mortality, 18% for married men and 33% for divorced men.     

Adiposity measurements in association with metabolic syndrome in older men have different clinical implications

Obesity is a major public health problem, and measuring adiposity accurately and predicting its future comorbidities are important issues. Therefore, we hypothesized that 4 adiposity measurements, body mass index (BMI), waist circumference (WC), waist-to-height ratio, and body fat percentage, have different physiological meanings and distinct associations with adverse health consequences. This study aimed to investigate the relationship of these 4 measurements with metabolic syndrome (MetS) components and identify the most associated factor for MetS occurrence in older, non-medicated men. Cross-sectional data from 3004 men, all 65 years of age and older, were analyzed. The correlation and association between adiposity measurements and MetS components were evaluated by Pearson correlation and multiple linear regression. Based on multivariate logistic regression, BMI and WC were significantly associated with MetS and were selected to build a combined model of receiver operating characteristic curves to increase the diagnosis accuracy for MetS. The results show that BMI is independently associated with systolic and diastolic blood pressure; WC and body fat percentage are associated with fasting plasma glucose and log transformation of triglyceride; BMI and WC are negatively associated with high-density lipoprotein cholesterol (HDL-C); and WC is a better discriminate for MetS than BMI, although the combined model (WC + BMI) is not significantly better than WC alone. Based on these results, we conclude that the 4 adiposity measurements have different clinical implications. Thus, in older men, BMI is an important determinant for blood pressure and HDL-C. Waist circumference is associated with the risk of fasting plasma glucose, HDL-C, triglyceride, and MetS occurrence. The combined model did not increase the diagnosis accuracy.     

Weight and mortality in men: the Albany Study

In the Albany Study cohort of 1910 men, first examined between 1953 and 1955, 27-year mortality was least at relative weights between 100 and 109% of those considered desirable according to the 1959 Build and Blood Pressure Study. Mortality was greater at lower and higher weights. This association of weight and mortality was substantially stronger during the first 15 years after characterization than in the remaining 12 years. In contrast to the Albany Study, the 1979 insurance study and a study by the American Cancer Society reported minimum mortality for men at average weight by height, which is 15-20 pounds above the 1959 insurance standards. Other studies have reported minimum mortality at above-average weights. Perhaps the concept of an unvarying 'desirable' weight should be abandoned.     

Premature mortality among lone fathers and childless men

This study focuses on male family situation and premature mortality. For a total of 682,919 men, we analysed mortality from different causes (1991-2000) among lone fathers, with and without custody of their children, and among childless men, with and without partners. Long-term cohabiting fathers with a child in their household were used as comparison group. We employed data from Swedish censuses, national health-data registers, and a Swedish register containing information about known biological relations between children and parents. We investigated the extent to which different kinds of relations were influenced by varying socioeconomic circumstances between groups, and also processes of health selection. The results suggest that lone non-custodial fathers and lone childless men face the greatest increase in risks, especially from injury and addiction, and also from all-cause mortality and ischaemic heart disease. Being a lone custodial father also entails increased risk, although generally to a much lesser extent, and not for all outcomes. The elevated risks found in all the subgroups considered diminished substantially when proxy variables to control for health-selection effects and socioeconomic circumstances were added to the initial model. Risks fell most in response to introduction of the socioeconomic variables, but health selection also played a major role, mostly in the cases of lone non-custodial fathers and lone childless men. However, even following these adjustments, significant risk increases, although greatly attenuated, remained for all the subgroups.     

温州城区≥18岁居民代谢综合征流行特征分析

  目的  了解中老年男性部分雄激素缺乏症（PADAM）与血糖及血脂的关系,为PADAM的预防控制提供参考依据。  方法  于2011年1月 — 2015年10月在浙江省温州医科大学附属第一医院体检中心整群抽取7 153名≥20岁男性体检者,本研究抽取其中4 291名≥40岁男性体检者作为研究对象,按照测定的血清睾酮（T）水平并结合临床症状分为PADAM病例组和对照组,比较2组人群T水平以及血糖和血脂相关指标差异,分析PADAM与血糖及血脂相关指标的关系。  结果  4 291名≥40岁男性体检者中,病例组PADAM患者754例（17.57 %）,对照组非PADAM者3 537人（82.43 %）;病例组PADAM患者的血糖（GLU）、甘油三酯（TG）、非高密度脂蛋白胆固醇（non-HDL-C）、血浆致动脉硬化指数（AIP,× 100对数值）、动脉硬化指数（ASI）平均水平分别为5.70 mmol/L、2.02 mmol/L、3.87 mmol/L、2.29、3.57,均高于对照组非PADAM者的5.50 mmol/L、1.60 mmol/L、3.78 mmol/L、2.14、3.27 （均P < 0.05）,而T、高密度脂蛋白胆固醇（HDL-C）平均水平分别为9.67 nmol/L、2.84 mmol/L,均低于对照组非PADAM者的15.35 nmol/L、 2.96 mmol/L （均P < 0.01）;相关分析结果显示,T水平与GLU、TG、non-HDL-C、AIP（× 100对数值）和ASI均呈负相关（均P < 0.001）,与HDL-C呈正相关（r = 0.17,P = 0.002）;多因素logistic回归分析结果显示,年龄、GLU和AIP（× 100对数值）是PADAM患病的危险因素。  结论  PADAM与血糖及血脂具有相关性,T水平低下会导致GLU、TG、non-HDL-C、AIP（× 100对数值）和ASI水平升高而HDL-C水平降低。     

Self-assessment of health status and mortality in middle-aged British men

In a prospective study of 7725 middle-aged British men, 357 of whom died in an average follow-up period of four years, self-assessment of health status was strongly associated with mortality. Men who reported poor health had an eight-fold increase in total mortality compared with those reporting excellent health. Those perceiving fair or poor health were older, more likely to be manual workers and cigarette smokers, more likely to be thin and to be heavy drinkers or to have given up drinking in the past five years. They were also more likely to recall multiple diagnoses and to be on regular medication. Half of those with poor perceived health had chest pain on exertion (angina), one-third had experienced severe chest pain (possible myocardial infarction) half were breathless on exertion and 80% had been off work for more than a month in recent years. At all age levels between 45 and 64 years, and in both manual and non-manual workers, mortality was twice as high in men reporting fair or poor health than in men reporting excellent or good health. In both men with and without recall of at least one major diagnosis, fair or poor perceived health was associated with a two fold increase in age-adjusted mortality rate. In both groups this increased mortality was to a large extent accounted for by the increase in the prevalence of adverse characteristics such as regular medication, chest pain, breathlessness and current smoking. Self-assessment of health status appears to be a good measure of current physical health and risk of death. It could be useful in both clinical and epidemiological situations.     

Alcohol consumption and mortality in aging or aged Finnish men

The association between alcohol consumption and 10-year mortality by death cause was studied in 1112 men aged 55-74 years and living either in eastern or south-western Finland. After adjustment for age, blood pressure, smoking, serum cholesterol, and other variables, the relative odds ratio of 10-year total mortality associated with consuming 1-273 g of absolute alcohol per month was 0.9 (95% confidence interval of 0.6-1.2) and with consuming more than 273 g per month due to violence was small, 15, but relative odds of violent death associated with consuming 1-273 and 274 or more grams of alcohol per month were 3.4 and 16.2, respectively (95% confidence intervals of 0.4-31.9 and 1.9-141.2).     

Eligibility for obesity treatment and risk of mortality in men

OBJECTIVE: To evaluate the risk of all-cause and cardiovascular disease (CVD) mortality associated with each outcome of the NIH obesity treatment algorithm and to examine the effects of cardiorespiratory fitness on the risk of mortality associated with these outcomes. RESEARCH METHODS AND PROCEDURES: The NIH obesity treatment algorithm was applied to 18,666 men (20 to 64 years of age) from the Aerobics Center Longitudinal Study in Dallas, TX, examined between 1979 and 1995. Risk of all-cause and CVD mortality was assessed using Cox proportional hazards regression. RESULTS: A total of 7029 men (37.7%) met the criteria for needing weight loss treatment [overweight (BMI = 25 to 29.9 kg/m2 or WC > 102 cm) with > or =2 CVD risk factors or obese (BMI > or = 30 kg/m2)]. Mortality surveillance through 1996 identified 435 deaths (151 from CVD) during 191,364 man-years of follow-up. Compared with the normal weight reference group, the hazard ratios (95% confidence interval) for death from all causes were 0.63 (0.45 to 0.88), 1.23 (0.98 to 1.54), 1.05 (0.60 to 1.85), and 1.71 (1.64 to 2.31) for men who were overweight with <2 CVD risk factors, overweight with > or = 2 CVD risk factors, obese with <2 CVD risk factors, and obese with > or =2 CVD risk factors, respectively. Corresponding hazard ratios for CVD mortality were 0.72 (0.38 to 1.37), 1.67 (1.12 to 2.50), 1.69 (0.67 to 4.30), and 3.31 (2.07 to 5.30). Including physical fitness as a covariate significantly attenuated all risk estimates. DISCUSSION: The NIH obesity treatment algorithm is useful in identifying men at increased risk of premature mortality; however, including an assessment of fitness would help improve risk stratification among all groups of patients.     

Hip circumference and cardiovascular morbidity and mortality in men and women

OBJECTIVE: It has recently been demonstrated that, in middle-aged women, a wide hip circumference is a protective factor for a number of health endpoints in later years. The effect seems to be independent of both overweight and waist circumference. This paper aims to replicate this finding in another population-based sample consisting of women and men. RESEARCH METHODS AND PROCEDURES: This was a prospective observational study consisting of a random subset of adult Danes. A total of 2987 subjects born in 1922, 1932, 1942, or 1952 and 35, 45, 55, or 65 years of age (at examination in 1987 to 1988) participated in the Danish MONICA (MONItoring trends and determinants of CArdiovascular disease) project, with measurements of height, weight, and hip and waist circumference taken. Through personal identification numbers, incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) until the end of 1998 and all causes of death until 2001 were retrieved from the National Registers of Hospital Discharge. There was an average of 10 years of follow-up for incidence of CVD and CHD and 13 years of follow-up for total mortality. RESULTS: Large hip circumference, relative to body size and waist circumference, predicted less incidence of CVD, CHD, and total death in women. This was not the case in men; BMI and waist circumference were the strongest independent predictors. DISCUSSION: A large hip circumference seems to have independent and positive effects on CVD and CHD morbidity and mortality in women, but no protective effect on cardiovascular health in men. However, a borderline significant protective effect on total mortality was observed.     

Future trends in mortality of French men from mesothelioma

OBJECTIVES—Previous projections of mortality from mesothelioma among French men have used the age-generation method, based on the Poisson regression model. In this study an alternative method to model mortality from mesothelioma was used to predict its future trend: this method was based on the risk function that links this mortality to past exposure to asbestos, combined with population exposure data.
METHOD—Data on past French asbestos imports were used to model the overall past exposure to asbestos in men and assess two extreme scenarios (optimistic and pessimistic) for its future trends. The number of male deaths occurring between the ages of 50 and 79, from 1997-2050, was then calculated with the risk function for mesothelioma.
RESULTS—The results showed that mortality from mesothelioma among French men aged 50-79 will continue to increase, reaching a peak averaging between 1140 (optimistic scenario) and 1300 deaths (pessimistic scenario) annually around the years 2030 and 2040, respectively. No preventive measures applied now will affect this trend before then. These results are similar to those of two other predictions of mortality from mesothelioma among French men: a peak around 2030 of 800-1600 deaths annually among men aged 25-89 years, and a peak around 2020 of 1550 deaths annually among men aged 40-84.
CONCLUSIONS—Our results indicate that between 1997 and 2050, the most optimistic and pessimistic trends of future exposure will lead to the deaths from mesothelioma of between 44 480 and 57 020 men, with a corresponding loss of from 877 200 to 1 171 500 person-years of life.


Keywords: mesothelioma; risk function; mortality trends; prediction; France     

Japanese alcoholic beverage and all cause mortality in Japanese adult men

This article examines whether an association is found between quantity of alcohol consumed and all cause mortality, and a relation is detected between types of alcoholic beverage and all cause mortality in Japanese male adults. A cohort study was performed in three towns located in two former coal mine areas and a rural area in Fukuoka. A mail survey was carried out between 1988 and 1990, and was extended in a follow-up period to 1995 (two towns) and 1999 (one town). 6,652 Japanese men aged from 40 to 69 years responded to a questionnaire that included alcohol consumption and smoking habit. The data were analysed with Cox's proportional hazards model. As regards an association between all cause mortality and quantity of alcohol consumed, statistically significant relations were recognized in occasional drinkers and drinkers with less than 25g ethanol per day (hazard ratio= 0.71, 95% CI: 0.50-0.99; hazard ratio= 0.51, 95% CI: 0.29-0.88, respectively). With respect to drinkers with 25-50g/day and > or =50g/day, no significant relation was observed in the risk for all cause mortality. Comparing all cause mortality for daily drinkers and nondrinkers with respect to the beverage types, a risk was lower for daily drinkers than for nondrinkers with every type of beverage studied. In particular, there was a statistically significant adverse association for all cause mortality among subjects who reported drinking Japanese sake compared with nondrinkers (hazard ratio= 0.45, 95% CI: 0.30-0.68). Alcohol consumption (particularly Japanese sake) is likely to be associated with a reduced hazardous ratio of all cause mortality.     

Urban air pollution and mortality in a cohort of Norwegian men

We investigated the association between total and cause-specific mortality and individual measures of long-term air pollution exposure in a cohort of Norwegian men followed from 1972-1973 through 1998. Data from a follow-up study on cardiovascular risk factors among 16,209 men 40-49 years of age living in Oslo, Norway, in 1972-1973 were linked with data from the Norwegian Death Register and with estimates of average yearly air pollution levels at the participants' home addresses from 1974 to 1998. Cox proportional-hazards regression was used to estimate associations between exposure and total and cause-specific mortality. During the follow-up time 4,227 men died from a disease corresponding to an ICD-9 (International Classification of Diseases, Revision 9) code < 800. Controlling for a number of potential confounders, the adjusted risk ratio for dying was 1.08 [95% confidence interval (CI), 1.06-1.11] for a 10- microg/m3 increase in average exposure to nitrogen oxides (NOx) at the home address from 1974 through 1978. Corresponding adjusted risk ratios for dying from a respiratory disease other than lung cancer were 1.16 (95% CI, 1.06-1.26); from lung cancer, 1.11 (95% CI, 1.03-1.19); from ischemic heart diseases, 1.08 (95% CI, 1.03-1.12); and from cerebrovascular diseases, 1.04 (95% CI, 0.94-1.15). The findings indicate that urban air pollution may increase the risk of dying. The effect seemed to be strongest for deaths from respiratory diseases other than lung cancer.     

Dietary supplement use and mortality in a cohort of Swedish men

The use of dietary supplements has increased substantially in most industrialized countries. The aim of this study was to prospectively examine the association between use of dietary supplements and all-cause mortality, cancer mortality and CVD mortality in men. We used the population-based prospective cohort of 38 994 men from central Sweden, 45-79 years of age, with no cancer or CVD at baseline and who completed a self-administered FFQ including questions on dietary supplement use and life-style factors in 1997. During average 7.7 years of follow-up, 3403 deaths were ascertained; among them, 771 due to cancer and 930 due to CVD (during 5.9 years of follow-up). In multivariate adjusted models including all men there was no association observed between use of any dietary supplement or of multivitamins, vitamin C, vitamin E or fish oil specifically and all-cause mortality, cancer or CVD mortality. Among current smokers, regular use of any supplement was associated with statistically significant increased risk of cancer mortality: relative risk (RR) 1.46 (95 % CI 1.06, 1.99). Among men reporting an inadequate diet at baseline (assessed by Recommended Food Score), there was a statistically significant inverse association between use of any dietary supplement and CVD mortality (RR 0.72; 95 % CI 0.57, 0.91), no associations were observed among men with adequate diets. In conclusion, we cannot exclude that the use of dietary supplements is harmful for smokers. On the other hand, among men with an insufficient diet, the use of supplements might be beneficial in reducing CVD mortality.