Overweight, obesity, and risk of hospitalization for COVID-19: A community-based cohort study of adults in the United Kingdom
Overweight, obesity, and risk of hospitalization for COVID-19: A community-based cohort study of adults in the United Kingdom
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DOI：
10.1073/pnas.2011086117
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发表时间：
2020-09-01
影响因子：
11.1
通讯作者：
Batty, G. David
中科院分区：
文献类型：
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作者：
Hamer, Mark;Gale, Catharine R.;Batty, G. David
肥胖和超重在新冠肺炎发生中的作用尚不清楚。我们利用英国社区居住样本(n=343,329；56.4+/-8.1y；54.5%女性)的数据进行了一项大规模的普通人群研究，预期与国家新冠肺炎住院登记有关。体重指数(BMI，来自测量的身高和体重)被用作总体肥胖的指标，腰臀比被用作中心性肥胖的指标。主要结果是在2020年3月16日至2020年4月26日期间，新冠肺炎的病例严重到需要住院治疗。约0.2%的样本因新冠肺炎入院治疗。与正常体重(12.5‰)相比，超重(优势比1.39；95%可信区间1.13至1.71；粗发病率19.1‰)和肥胖I期(1.70；1.34至2.16；23.3‰)和II期(3.38；2.60至4.40；42.7‰)入院治疗新冠肺炎的可能性呈线性上升趋势。在对广泛的协变量进行调整后，这一梯度几乎没有受到影响；然而，控制生物标记物，特别是高密度脂蛋白胆固醇和糖化血红蛋白，会导致更大程度的衰减。腰臀比也出现了类似的关联模式。综上所述，总体肥胖和中心性肥胖是新冠肺炎入院的危险因素。即使体重略有增加，风险增加也是显而易见的。其机制可能涉及糖脂代谢受损。
The role of obesity and overweight in occurrence of COVID-19 is unknown. We conducted a large-scale general population study using data from a community-dwelling sample in England (n = 334,329; 56.4 +/- 8.1 y; 54.5% women) with prospective linkage to national registry on hospitalization for COVID-19. Body mass index (BMI, from measured height and weight) was used as an indicator of overall obesity, and waist-hip ratio for central obesity. Main outcome was cases of COVID-19 serious enough to warrant a hospital admission from 16 March 2020 to 26 April 2020. Around 0.2% (n = 640) of the sample were hospitalized for COVID-19. There was an upward linear trend in the likelihood of COVID-19 hospitalization with increasing BMI, that was evident in the overweight (odds ratio, 1.39; 95% CI 1.13 to 1.71; crude incidence 19.1 per 10,000) and obese stage I (1.70;1.34 to 2.16; 23.3 per 10,000) and stage II (3.38; 2.60 to 4.40; 42.7 per 10,000) compared to normal weight (12.5 per 10,000). This gradient was little affected after adjustment for a wide range of covariates; however, controlling for biomarkers, particularly high-density lipoprotein cholesterol and glycated hemoglobin, led to a greater degree of attenuation. A similar pattern of association emerged for waist-hip ratio. In summary, overall and central obesity are risk factors for COVID-19 hospital admission. Elevated risk was apparent even at modest weight gain. The mechanisms may involve impaired glucose and lipid metabolism.