ASSOCIATION OF WEIGHT-LOSS AND WEIGHT FLUCTUATION WITH MORTALITY AMONG JAPANESE-AMERICAN MEN
ASSOCIATION OF WEIGHT-LOSS AND WEIGHT FLUCTUATION WITH MORTALITY AMONG JAPANESE-AMERICAN MEN
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DOI：
10.1056/nejm199509143331102
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发表时间：
1995-09-14
影响因子：
158.5
通讯作者：
PETROVITCH, H
中科院分区：
文献类型：
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作者：
IRIBARREN, C;SHARP, DS;PETROVITCH, H
背景体重减轻和体重波动与心血管疾病和所有原因导致的死亡风险增加有关。这些协会的临床和公共卫生影响尚不清楚。我们对参加檀香山心脏项目的6537名中年日裔美国男性进行了为期6年的前瞻性研究（平均随访时间为14.5年），研究了体重变化和体重波动与死亡率的长期关系。在六年的时间里，体重减轻4.5公斤或更多的男性或体重波动较大的男性（或两者兼而有之）的健康状况平均比体重更稳定的同龄人更差。在排除前5年随访期间死亡的受试者并调整混杂因素后，体重减轻超过4.5 kg与除癌症死亡外的所有原因死亡风险相关。体重波动最大的受试者因心血管原因死亡的风险明显更高（相对危险度，1.41; 95%置信区间，1.03至1.93），非心血管和非癌症原因死亡（相对危险度，1.53; 95%置信区间，1.12至2.10）和全因死亡（相对危险度，1.25; 95%置信区间，1.05至1.48）。然而，在从不吸烟的健康男性中，没有发现体重减轻和体重变化与心血管原因和非心血管和非癌症原因死亡的相关性。体重减轻或波动与死亡率之间的相关性部分由混杂因素和既往疾病的存在解释。然而，体重减轻和体重波动与从不吸烟的健康男性的死亡无关。因此，对体重减轻和变化的健康危害的关注可能不适用于其他健康的人。
Background. Weight loss and fluctuations in weight have been associated with increased risks of death from cardiovascular disease and from all causes. The clinical and public health implications of these associations are unclear.Methods. We examined the long-term relation of weight change and fluctuation in weight with mortality over a 6-year period in 6537 middle-aged Japanese American men enrolled in the Honolulu Heart Program, a prospective study (mean follow-up, 14.5 years).Results. Men who had a weight loss of 4.5 kg or more or who had large fluctuations in weight (or both) over a six-year period were, on average, in poorer health than their peers whose weight was more stable. After the exclusion of subjects who died during the first five years of follow-up and after adjustment for confounding factors, a weight loss of more than 4.5 kg was associated with the risk of death from all causes, with the exception of death from cancer. The subjects whose weight fluctuated the most had a significantly higher risk of death from cardiovascular causes (relative risk, 1.41; 95 percent confidence interval, 1.03 to 1.93), death from noncardiovascular and noncancerous causes (relative risk, 1.53; 95 percent confidence interval, 1.12 to 2.10), and death from all causes (relative risk, 1.25; 95 percent confidence interval, 1.05 to 1.48). However, the associations of weight loss and variation in weight with death from cardiovascular causes and from noncardiovascular and noncancerous causes were not found among healthy men who had never smoked.Conclusions. The associations between weight loss or fluctuation and mortality were partially explained by confounding factors and by the presence of preexisting disease. However, weight loss and weight fluctuation were unrelated to death among healthy men who had never smoked. Thus, concern about the health hazards of weight loss and variation may not be applicable to otherwise healthy people.