The associations between relative and absolute body mass index with mortality rate based on predictions from stigma theory.
The associations between relative and absolute body mass index with mortality rate based on predictions from stigma theory.
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DOI：
10.1016/j.ssmph.2022.101200
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发表时间：
2022-09
影响因子：
4.7
通讯作者：
Allison, David B.
中科院分区：
文献类型：
--
作者：
Pavela, Gregory;Yi, Nengjun;Mestre, Luis;Lartey, Stella;Xun, Pengcheng;Allison, David B.
肥胖的社会后果可能影响健康和死亡率（MR），因为肥胖是一种高度污名化的疾病。因此，高绝对体重指数（BMI）与高BMI的污名化可能各自独立地增加MR的发生率。我们测试了相对BMI（定义为由年龄、性别和种族/民族共同定义的社会参考群体中的序数等级）是否与MR独立于绝对BMI相关。数据来自三个具有全国代表性的数据集：健康与退休研究（n = 31,115）、全国健康访谈调查（NHIS, n = 529,362）和全国健康与营养检查调查（n = 31,115）。相对BMI kg/m2十分位数在24个亚组中计算，这些亚组由年龄（6个水平）、性别（2个水平）和种族/民族（4个水平）共同定义。在每个数据集中使用Cox生存广义加性模型评估序号BMI和MR之间的关系，并对年龄、种族、性别、吸烟、受教育程度和绝对BMI进行调整。绝对BMI与MR存在显著的非单调关联，因此BMI水平高于约25 kg/m2时，BMI与死亡率呈正相关。与预期相反，NHIS的结果表明，相对BMI的前十分位个体的MR最高，而在NHANES和HRS中，相对BMI与MR无关。我们假设，在控制绝对BMI后，肥胖的污名化可能导致MR增加。与预期相反，较高的相对BMI与MR增加无关，与绝对BMI无关。在社会定义的参照组中，较高的绝对BMI与较高的死亡率相关，与相对BMI无关。相对于社会定义参照组较高的BMI与独立于绝对BMI的死亡率无关。在对绝对和相对BMI进行调整后，高中教育程度以下、曾经或现在吸烟的人与较高的死亡率显著相关。
The social consequences of obesity may influence health and mortality rate (MR), given obesity's status as a highly stigmatized condition. Hence, a high absolute body mass index (BMI) in conjunction with the stigmatization of a high BMI may each independently increase the rate of MR. We tested whether relative BMI, defined as ordinal rank within a social reference group jointly defined by age, sex, and race/ethnicity, is associated with MR independent of absolute BMI. Data were from three nationally representative datasets: the Health and Retirement Study (n = 31,115), the National Health Interview Survey (NHIS, n = 529,362), and the National Health and Nutrition Examination Survey (n = 31,115). Relative BMI kg/m2 deciles were calculated within twenty-four subgroups jointly defined by age (6 levels), sex (2 levels), and race/ethnicity (4 levels). The association between ordinal rank BMI and MR was assessed using Cox survival generalized additive models in each dataset with adjustments for age, race, sex, smoking, educational attainment, and absolute BMI. Absolute BMI had a significant non-monotonic association with MR, such that BMI was positively associated with mortality at BMI levels above approximately 25 kg/m2. Contrary to expectations, results from NHIS indicated that individuals in the first decile of relative BMI had the highest MR whereas relative BMI was not associated with MR in the NHANES and HRS. We hypothesized that the stigmatization of obesity might lead to an increased MR after controlling for absolute BMI. Contrary to expectations, a higher relative BMI was not associated with an increased MR independent of absolute BMI. A higher absolute BMI is associated with a higher mortality rate independent of relative BMI within a socially defined reference group. A higher BMI relative to a socially defined reference group was not associated with mortality rate independent of absolute BMI. After adjusting for absolute and relative BMI, having less than a high school education and being a former or current smoker are significantly associated with a higher mortality rate.
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影响因子：
5.4
作者：
Feng，Xiaoqi;Wilson，Andrew
通讯作者：
Wilson，Andrew
影响因子：
2.9
作者：
Gutin I
通讯作者：
Gutin I
影响因子：
120.7
作者：
MANSON, JE;STAMPFER, MJ;WILLETT, WC
通讯作者：
WILLETT, WC
DOI：
10.1097/med.0b013e32833d4687
发表时间：
2010-10-01
影响因子：
3.2
作者：
Hammond, Ross A.
通讯作者：
Hammond, Ross A.
影响因子：
6.3
作者：
Cao, Sissi;Moineddin, Rahim;Ray, Joel G.
通讯作者：
Ray, Joel G.