Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians
Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians
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DOI：
10.1017/s1368980008002802
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发表时间：
2009-04-01
影响因子：
3.2
通讯作者：
Eriksen, Michael P.
中科院分区：
文献类型：
--
作者：
Wen, Chi Pang;Cheng, Ting Yuan David;Eriksen, Michael P.
目的：评估根据WHO标准评估的超重亚洲人的死亡风险是否高于超重高加索人，并确定超重的替代临界点BMI = 23-0-24-9 kg/m2和BMI >= 2 5。0 kg/m2）的肥胖）是适当的。设计：队列前瞻性随访至2001年底。采用考克斯回归分析，校正年龄、吸烟和性别，评估超重和肥胖组相对于参考组（BMI = 18-5-24-9或18-5-22-9 kg/m2）的全因和心血管疾病死亡风险。超额死亡的估计方法由美国疾病控制和预防中心提出。设置：国家健康访谈调查（NHIS 2001）。研究对象：1989- 1992年台湾地区36386名40岁以上的公务员和学校教师。结果：在WHO定义的超重组中，亚洲人的全因死亡风险显著高于白人。在较低的BMI（约5个单位）下，亚洲人显示出与高加索人相当的风险。BMI每增加一个单位，在25.0 kg/m2或以上，与所有原因的相对死亡风险增加9%相关。采用25-0 kg/m2的肥胖临界点将导致27.1%的患病率，而传统的WHO临界点30.0 kg/m2则导致4.1%的肥胖患病率。根据另一个截止值，肥胖导致的额外死亡占所有死亡的8.6%，占CVD死亡的21.1%。结论：在这个亚洲人群中，显著的死亡风险始于2 2.0 kg/m2。该研究支持使用BMI ≥ 25.0kg/m2而不是BMI ≥ 30.0kg/m2作为肥胖的新分界点，BMI = 23.0-24.9kg/m2作为超重的新分界点。迄今为止，亚洲人中肥胖导致的死亡人数一直被低估。
Objectives: To assess whether overweight Asians, assessed on the basis of WHO criteria, are at greater mortality risk than overweight Caucasians, and to determine whether alternative cut-off points BMI = 23-0-24-9 kg/m(2) for overweight and BMI >= 2 5 . 0 kg/m(2) for obesity) Suggested by the WHO Western Pacific Regional Office are appropriate.Design: The cohort was followed prospectively until the end of 2001. All-cause and CVD mortality risks of the overweight and Obese group, relative to the reference group (BMI = 18-5-24-9 or 18-5-22-9 kg/m(2)), were assessed using Cox regression analysis, adjusting for age, smoking and gender. Excess deaths were estimated with a method proposed by the US Centers for Disease Control and Prevention.Setting: National Health Interview Survey (NHIS 2001.) and a middle-aged perspective cohort in Taiwan.Subjects: Subjects comprised 36386 civil servants and school teachers, aged 40 years and older, who underwent a medical examination during 1989-1992.Results: In the WHO-defined overweight group, Asians showed a significant increase in all-cause mortality risk compared with Caucasians. Asians showed risks equivalent to Caucasians' at lower BMI (around 5 units). Every unit of BMI increase, at 25.0 kg/m(2) or above, was associated with a 9% increase in relative mortality risk from all causes. Applying a cut-off point of 25-0 kg/m2 for obesity would result a prevalence of 27.1%, while the traditional WHO cut-off point of 30.0 kg/m(2) yielded obesity prevalence of 4.1%. Excess deaths due to obesity accounted for 8.6% of all deaths and 21.1% of CVD deaths, based on the alternative cut-offs.Conclusions: In this Asian population, significant mortality risks started at 2 2.0 kg/m(2). The Study supports the use of BMI >= 25.0kg/m(2) rather than at BMI >= 30.0kg/m(2) BMI >= 25.0 kg/m(2) as a new cut-off point for obesity and BMI = 23.0-24.9kg/m(2) for overweight. The magnitude Of obesity-attributable deaths has been hitherto Under-appreciated among Asians.