American Journal of Epidemiology Advance Access originally published online on July 14, 2006
American Journal of Epidemiology 2006 164(4):398; doi:10.1093/aje/kwj226
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Letter to the Editor |
RE: "ASSOCIATION OF BODY MASS INDEX WITH SUICIDE MORTALITY: A PROSPECTIVE COHORT STUDY OF MORE THAN ONE MILLION MEN"
Department of Community Medicine, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
(e-mail: roos.bernsen{at}uaeu.ac.ae)
We read with great interest the paper by Magnusson et al. (1
) on the inverse relation between body mass index (weight (kg)/height (m)2) and the risk of suicide, a finding that may provide important insights into the mechanisms underlying suicide. The authors tried to exclude, as far as their data allowed, the possibility of confounding by psychiatric disorder, and they deliberated extensively on possible mechanisms underlying this intriguing observation. Remarkably, they did not explore the possibility of smoking as an underlying confounding factor. In fact, in the same group of Swedish conscripts, Hemmingsson and Kriebel (2) found that smokers had a threefold risk of suicide compared with nonsmokers, probably due to confounding by low mental well-being and heavy alcohol consumption. Since Magnusson et al. did not adjust for these latter factors (with the exception of a diagnosis of a psychiatric disorder), a plausible explanation for the inverse relation between body mass index and suicide risk would be confounding by smoking, which is well known to be associated with lower body mass index (3). We would encourage the authors to redo their analyses with smoking included as a confounder in their model.
ACKNOWLEDGMENTS
Conflict of interest: none declared.
References
- Magnusson PK, Rasmussen F, Lawlor DA, et al. Association of body mass index with suicide mortality: a prospective cohort study of more than one million men. Am J Epidemiol 2006;163:1–8.
[Abstract/Free Full Text] - Hemmingsson T, Kriebel D. Smoking at age 18–20 and suicide during 26 years of follow-up—how can the association be explained? Int J Epidemiol 2003;32:1000–4.
[Abstract/Free Full Text] - Rodu B, Stegmayr B, Nasic S, et al. The influence of smoking and smokeless tobacco use on weight amongst men. J Intern Med 2004;255:102–7.[CrossRef][Web of Science][Medline]
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. K. E. Magnusson, F. Rasmussen, D. A. Lawlor, P. Tynelius, and D. Gunnell THE AUTHORS REPLY Am. J. Epidemiol., August 15, 2006; 164(4): 399 - 400. [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||