Annual deaths attributable to obesity in the United States
Annual deaths attributable to obesity in the United States
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DOI：
10.1001/jama.282.16.1530
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发表时间：
1999-10-27
影响因子：
120.7
通讯作者：
VanItallie, TB
中科院分区：
文献类型：
--
作者：
Allison, DB;Fontaine, KR;VanItallie, TB
背景肥胖是美国的一个主要健康问题，但肥胖导致的死亡人数尚未得到严格估计。目的估计美国成年人每年因肥胖导致的死亡人数。设计数据来自5项前瞻性队列研究（阿拉米达社区健康研究，心脏病研究，特库姆塞社区壁炉研究，美国癌症协会癌症预防研究I，和国家健康和营养检查调查I流行病学随访研究）和1项已发表的研究（护士健康研究）与1991年国家统计数据相结合;研究对象1991年18岁或以上的成年人，按体重指数（kg/m2）分类为超重（25-30），结果肥胖或超重人群的死亡相对危险比（HR）在不同的队列中存在差异，但总体上是一致的。超过80%的估计肥胖归因死亡发生在体重指数超过30 kg/m2的个体中（2）。当对所有6项研究中所有合格受试者的HR进行估计时，美国因肥胖导致的死亡的平均估计值为280 184（范围：236 111-341 153），风险比也仅根据非吸烟者或从不吸烟者的数据计算。当这些HR应用于整个人群时，（假设HR适用于所有个体），肥胖可归因死亡的平均估计值为324940（范围、262 541-383 410）结论：根据所有受试者的HR，美国成年人中归因于肥胖的年死亡人数估计约为280 000人，根据仅受试者的HR，估计约为325 000人。不吸烟者和从不吸烟者。
Context Obesity is a major health problem in the United States, but the number of obesity-attributable deaths has not been rigorously estimated.Objective To estimate the number of deaths, annually, attributable to obesity among US adults.Design Data from 5 prospective cohort studies (the Alameda Community Health Study, the Framingham Heart Study, the Tecumseh Community Hearth Study, the American Cancer Society Cancer Prevention Study I, and the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study) and 1 published study (the Nurses' Health Study) in conjunction with 1991 national statistic; on body mass index distributions, population size, and overall deaths.Subjects Adults, 18 years or older in 1991, classified by body mass index (kg/m(2)) as overweight (25-30), obese (30-35), and severely obese (>35),Main Outcome Measure Relative hazard ratio (HR) of death for obese or overweight persons.Results The estimated number of annual deaths attributable to obesity varied with the cohort used to calculate the HRs, but findings were consistent overall. More than 80% of the estimated obesity-attributable deaths occurred among individuals with a body mass index of more than 30 kg/m(2). When HRs were estimated for all eligible subjects from ail 6 studies, the mean estimate of deaths attributable to obesity in the United States was 280 184 (range, 236 111-341 153),Hazard ratios also were calculated from data for nonsmokers or never-smokers only. When these HRs were applied to the entire population (assuming the HR applied to all individuals), the mean estimate for obesity-attributable death was 324 940 (range, 262 541-383 410).Conclusions The estimated number of annual deaths attributable to obesity among US adults is approximately 280 000 based on HRs from all subjects and 325 000 based on HRs from only nonsmokers and never-smokers.