The association between weight fluctuation and mortality: Results from a population-based cohort study
The association between weight fluctuation and mortality: Results from a population-based cohort study
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DOI：
10.1007/s10900-004-1955-1
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发表时间：
2005-06-01
影响因子：
5.9
通讯作者：
Everett, CJ
中科院分区：
文献类型：
--
作者：
Diaz, VA;Mainous, AG;Everett, CJ
以前评估体重波动和死亡率之间的关联的研究是有限的，结果相互矛盾。这项研究将通过对NHANES I和NHANES I流行病学随访研究(n=8479；加权样本=68,200,905)进行生存分析，进一步评估全国代表性队列中体重波动与死亡率之间的关系。从1971年到1992年对这一队列进行了跟踪，并根据五个时间点上的体重变化将其分为稳定非肥胖组、稳定肥胖组、体重增加组、体重减轻组和体重波动组。评估全因死亡率(ACM)和心血管死亡率(CM)。体重波动的受试者的ACM(HR：1.83，95%CI：1.25-2.69)和CM危险比(HR：1.86，95%CI：1.10-3.15)比稳定的非肥胖组更高，即使在控制了既往疾病、初始BMI并排除健康状况不佳或丧失工作能力的人后也是如此。减肥组(ACM HR：3.36，95%CI：2.47~4.55)和CM HR(CM HR 4.22，95%CI：2.60~6.84)的死亡率也有升高。稳定肥胖组没有增加ACM，但在排除健康状况不佳或丧失工作能力的人之前确实增加了CM。(HR：2.17，95%CI：1.10-4.28)。在美国人口中，体重波动与全因和心血管疾病死亡的风险更高相关，即使在对既往疾病、初始BMI和排除健康状况不佳或丧失工作能力的人进行调整后也是如此。因此，卫生保健提供者应该促进对保持体重减轻的承诺，以避免体重波动，并在评估患者的风险状态时考虑患者的体重历史。
Previous Studies evaluating the association between weight fluctuation and mortality are limited and have conflicting results. This study will further evaluate the association between weight fluctuation and mortality in a nationally representative cohort by performing survival analysis of NHANES I and NHANES I Epidemiologic Follow-up Study (n = 8479; weighted sample = 68,200,905). This cohort was followed from 1971 to 1992 and categorized using weight change over five time points into stable non-obese, stable obese, weight gain, weight loss and weight fluctuation groups. All-cause mortality (ACM) and cardiovascular mortality (CM) were evaluated. Respondents with weight fluctuation had higher ACM (HR: 1.83, 95% CI: 1.25-2.69) and CM hazards ratios (HR: 1.86, 95% CI: 1.10-3.15) than the stable non-obese group, even after controlling for pre-existing disease, initial BMI and excluding those in poor health or incapacitated. Increased mortality was also seen in the weight loss group (ACM HR: 3.36, 95% CI: 2.47-4.55), (CM HR 4.22, 95% CI: 2.60-6.84). The stable obese group did not have increased ACM, but did have increased CM prior to the exclusion of those in poor health or incapacitated. (HR: 2.17, 95% CI: 1.10-4.28). Weight fluctuation is associated with a higher risk of all-cause and cardiovascular disease mortality in the US population, even after adjustment for pre-existing disease, initial BMI and the exclusion of those in poor health or incapacitated. Thus, health care providers should promote a commitment to maintaining weight loss to avoid weight fluctuation and consider patients' weight histories when assessing their risk status.