The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey
The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey
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DOI：
10.1007/s10654-008-9269-8
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发表时间：
2008-09-01
影响因子：
13.6
通讯作者：
Willekens, Frans
中科院分区：
文献类型：
--
作者：
Reuser, Mieke;Bonneux, Luc;Willekens, Frans
超重和肥胖对中老年死亡率影响的证据是相互矛盾的。与正常体重相比，超重和肥胖个体患心血管疾病和糖尿病的相对风险增加，这是有据可查的，但自20世纪80年代以来，心血管死亡的绝对风险已大幅下降。我们在美国健康与退休调查（HRS）的一项前瞻性纵向研究中估计了中老年人肥胖的死亡负担。我们计算了单变量和多变量年龄特异性死亡概率和比例风险比与自我报告的体重指数（BMI），吸烟和教育。生命表将年龄特异性调整后的事件率转换为生存时间，取决于风险因素分布（吸烟，教育水平和自我报告的BMI）。通过bootstrapping计算95%置信区间。55岁时的预期寿命最高的是超重（BMI 25-29.9），受过高等教育的非吸烟者：30.7（29.5-31.9）岁（男性）和33.2（32.1-34.3）岁（女性），略高于BMI 23-24.9的男性和女性。吸烟使人口预期寿命减少3.5（2.7-4.4）年（男性）和1.8（1.0-2.5）年（女性）。低于最佳教育标准的教育成本，男子和妇女分别为2.8年（2.1-3.6年）和2.6年（1.6-3.6年）。在当代美国人口中，肥胖和低正常体重分别使男性和女性的人口预期寿命减少0.8（0.2-1.3）和0.8（0.0-1.5）年。与吸烟和低教育水平相比，肥胖的死亡率负担有限。
The evidence of effect of overweight and obesity on mortality at middle and old age is conflicting. The increased relative risk of cardiovascular disease and diabetes for overweight and obese individuals compared to normal weight is well documented, but the absolute risk of cardiovascular death has decreased spectacularly since the 1980s. We estimate the burden of mortality of obesity among middle and old aged adults in the Health and Retirement Survey (HRS), a US prospective longitudinal study. We calculate univariate and multivariate age-specific probabilities and proportional hazard ratios of death in relation to self-reported body mass index (BMI), smoking and education. The life table translates age specific adjusted event rates in survival times, dependent on risk factor distributions (smoking, levels of education and self reported BMI). 95% confidence intervals are calculated by bootstrapping. The highest life expectancy at age 55 was found in overweight (BMI 25-29.9), highly educated non smokers: 30.7 (29.5-31.9) years (men) and 33.2 (32.1-34.3) (women), slightly higher than a BMI 23-24.9 in both sexes. Smoking decreased the population life expectancy with 3.5 (2.7-4.4) years (men) and 1.8 (1.0-2.5) years (women). Less than optimal education cost men and women respectively 2.8 (2.1-3.6) and 2.6 (1.6-3.6) years. Obesity and low normal weight decreased population life expectancy respectively by 0.8 (0.2-1.3) and 0.8 (0.0-1.5) years for men and women in a contemporary, US population. The burden of mortality of obesity is limited, compared to smoking and low education.