[Mortality attributable to high body mass index in Chinese people aged 15 or over, in 1990 and 2013]

Objective: To analyze and compare deaths(mortality)attributable to high body mass index(BMI)in Chinese population aged ≥15 years between 1990 and 2013. Methods: We used the results of the 2013 Global Burden of Disease Study for China, based on population attributable fractions(PAF)to analyze deaths attributable to high BMI in all provinces(not including Taiwan, China)in 1990 and 2013. The average world population from 2000 to 2025 was used as a reference to calculate age-standardized mortality rates, and to compare the change of attributable deaths in 1990 and 2013. Results: In 2013, the number of deaths attributable to high BMI was 640 294, compared with 301 231 in 1990, an increase of 114.27%. Compared with 1990, in 2013, the number of deaths and age-standardized mortality rate attributable to high BMI showed a higher growth rate in men(142.81% and 30.74%, respectively)than women(84.69% and 2.88% , respectively). The growth rate of attributable deaths increased with age. Compared with 1990, in 2013, the growth rates of attributable deaths among 15-49, 50-69 and ≥70 years age groups were 63.37%, 89.11% and 183.64%, respectively. In both 1990 and 2013, the top three diseases in terms of deaths attributable to high BMI were stroke(128 657 and 247 042, respectively), ischemic heart disease(57 173 and 156 614, respectively), and hypertensive heart disease(34 960 and 58 435, respectively). Compared with 1990, in 2013, the standardized mortality rates of chronic kidney disease(129.44%), pancreatic cancer(101.76%), colorectal cancer(85.45%)and breast cancer(63.86%)showed more substantial increases. In 1990, the top three provinces with most deaths attributable to high BMI were Henan(31 376), Shandong(27 969)and Hebei(24 164), while in 2013 they were Shandong(61 897), Hebei(58 383)and Henan(57 501). Compared with 1990, in 2013, the age-standardized mortality rate attributable to high BMI increased in 26 of 33 provinces, with a faster increase in Qinghai(56.96%), Guizhou(45.30%)and Yunnan(39.39%). The rate declined in the other seven provinces, declining faster in Tianjin(20.68%), Macao(14.08%)and Jilin(6.86%). Conclusion: Deaths and age-standardized mortality rates attributable to high BMI increased rapidly between 1990 and 2013, with higher increases in men than in women. Age-standardized mortality rates of chronic kidney disease, pancreatic cancer, colorectal cancer and breast cancer attributable to high BMI showed much higher growth rates than other attributed diseases. The highest BMI-attributed age-standardized mortality rates were found in northeast and northern provinces, and the fastest growth rates of BMI-attributed age-standardized mortality rates were observed in southwest and northwest provinces.