Between 1998 and 2004, CTSU, in collaboration with the Mexican Ministry of Health, established a study in Mexico City, in which over 150,000 middle-aged adults (including 100,000 women and 50,000 men) provided information about their lifestyle and disease history, had physical measurements recorded (including weight, waist and hip circumference, blood pressure) and had a blood sample taken.

All participants are now being tracked for mortality through linkage to Mexican national mortality databases; by December 2013, 16,000 were confirmed to have died. By relating participants' characteristics at recruitment to death over the following decades, this study is now investigating the main causes of premature death in Mexico.

A resurvey of 10,000 surviving participants is taking place in 2015 to 2017 to examine how lifestyles, physical measurements and blood biomarkers have changed over the past 15 years. This resurvey will allow for a better assessment of the relevance to premature death of characteristics that can vary over time (such as adiposity, diabetes, blood pressure, smoking and alcohol consumption).

The Mexico City Prospective Study is being done in collaboration with the National Autonomous University of Mexico in Mexico City and has received funding from the Mexican Ministry of Health (Secretaria de Salud), the Mexican National Council of Science and Technology (Consejo Nacional de Ciencia y Tecnologia), the British Heart Foundation, the UK Medical Research Council, and the UK Wellcome Trust (grant number 058299/Z/99).

Recent results: Diabetes and cause-specific mortality

At recruitment, nearly half of women and one-third of men aged 50-59 were obese (ie, had a BMI ≥30 kg/m2) and by age 60 more than 1-in-5 had a confirmed diagnosis of diabetes. Of those with previously-diagnosed diabetes, analysis of blood samples revealed that blood sugar was on average poorly controlled. Over the next 12 years, those with diabetes had four times the overall death rate at ages 35-74 compared with people without diabetes. (In comparison, in high-income countries people with diabetes have been found to have only about twice the death rate of other people.) The biggest excess risk of death among people with diabetes was from kidney disease, followed by heart and other vascular disease, infection and acute diabetic crises (also reflecting poor blood sugar control).

Overall, the excess mortality among people with diabetes accounted for at least one-third of all deaths between the ages 35-74 years, which is twice what previous studies had suggested.

The full paper is avaliable to view here.

Our team

  • Colin Baigent
    Colin Baigent

    Professor of Epidemiology and Director, MRC PHRU

  • Rory Collins
    Rory Collins

    Head of Nuffield Department of Population Health and BHF Professor of Medicine and Epidemiology

  • Jonathan Emberson
    Jonathan Emberson

    Associate Professor, Medical Statistics and Epidemiology

  • Louisa Gnatiuc
    Louisa Gnatiuc

    Senior Epidemiologist

  • Will Herrington
    Will Herrington

    Senior Clinical Research Fellow, Renal Studies Group, Clinical Trial Service Unit and Epidemiological Studies Unit

  • Michael Hill
    Michael Hill

    Laboratory Scientific Director

  • Sarah Lewington
    Sarah Lewington

    Associate Professor of Statistical Epidemiology, Director of Graduate Studies (Taught courses)

  • Richard Peto
    Richard Peto

    Professor of Medical Statistics and Epidemiology, Co-Director, CTSU

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