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Type: Journal article
Title: Adiposity, its related biologic risk factors, and suicide: a cohort study of 542,088 Taiwanese adults
Author: Chang, S.
Wen, C.
Tsai, M.
Lawlor, D.
Yang, Y.
Gunnell, D.
Citation: American Journal of Epidemiology, 2012; 175(8):804-815
Publisher: Oxford University Press
Issue Date: 2012
ISSN: 0002-9262
Statement of
Shu-Sen Chang, Chi Pang Wen, Min Kuang Tsai, Debbie A. Lawlor, Yi Chen Yang, and David Gunnell
Abstract: Recent studies in Western nations have shown inverse associations between body mass index (BMI, measured as weight (kg)/height (m)2) and suicide. However, it is uncertain whether the association is similar in non-Western settings, and the biologic pathways underlying the association are unclear. The authors investigated these issues in a cohort of 542,088 Taiwanese people 20 years of age or older who participated in a health check-up program (1994–2008); there were 573 suicides over a mean 8.1 years of follow up. There was a J-shaped association between BMI and suicide risk (P for the quadratic term = 0.033) but limited evidence of a linear association (adjusted hazard ratio per 1-standard-deviation increase = 0.95 (95% confidence interval: 0.85, 1.06)); compared with individuals whose BMI was 18.5–22.9, adjusted hazard ratios for those with a BMI <18.5 or ≥35 were 1.56 (95% confidence interval: 1.07, 2.28) and 3.62 (95% confidence interval: 1.59, 8.22), respectively. A high waist-to-hip ratio was associated with an increased risk of suicide. There was some evidence for a reverse J-shaped association of systolic blood pressure and high density lipoprotein cholesterol with suicide and an association of higher triglyceride level with increased suicide risk; these associations did not appear to mediate the associations of BMI and waist-to-hip ratio with suicide.
Keywords: body mass index; cholesterol; cohort studies; suicide; systolic blood pressure; Taiwan; triglycerides; waist-to-hip ratio
Rights: © The Author 2012. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail:
DOI: 10.1093/aje/kwr386
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