Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study.
Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study.
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DOI：
10.1136/bmj.k2575
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发表时间：
2018-07-03
期刊：
影响因子：
--
通讯作者：
Giovannucci EL
中科院分区：
文献类型：
--
作者：
Lee DH;Keum N;Hu FB;Orav EJ;Rimm EB;Willett WC;Giovannucci EL
研究预测的瘦体重、脂肪量和体重指数（BMI）与男性全因死亡率和死因特异性死亡率的关系。前瞻性队列研究。美国卫生专业人员对38006名男性（40-75岁）进行了卫生专业人员随访研究，随访了死亡情况（1987-2012年）。全因和特定原因死亡率。使用先前从国家健康和营养检查调查开发的经验证的人体测量预测方程，估计所有参与者的瘦体重和脂肪量。在平均21.4年的随访期间，确定了12356例死亡。在BMI和全因死亡率之间始终观察到J形关联。多变量校正的考克斯模型，包括预测的脂肪质量和瘦体重显示预测的脂肪质量和全因死亡率之间的强正单调相关。与预测脂肪量最低的五分之一的人相比，预测脂肪量最高的五分之一的人因各种原因死亡的风险比为1.35（95%置信区间为1.26至1.46）。相比之下，预测的瘦体重和全因死亡率之间存在U形关联。与预测瘦体重最低的五分之一的人相比，第二到第四个五分之一的人因各种原因死亡的风险降低了8-10%。在限制性三次样条模型中，全因死亡的风险在预测脂肪量达到21 kg之前相对平稳，之后迅速增加，风险比为1.22（1.18至1.26）/标准差。对于预测的瘦体重，在56 kg之前的较低范围内观察到风险大幅降低，每个标准差的风险比为0.87（0.82至0.92），此后增加（非线性P <0.001）。对于死因特异性死亡率，预测脂肪量最高的五分之一的男性患心血管疾病的风险比为1.67（1.47至1.89），患癌症的风险比为1.24（1.09至1.43），患呼吸系统疾病的风险比为1.26（0.97至1.64）。另一方面，预测的瘦体重与心血管疾病和癌症的死亡率之间存在U形关联。然而，预测的瘦体重和呼吸系统疾病的死亡率之间存在很强的负相关（趋势P <0.001）。BMI和死亡率之间的关系由两个身体成分（瘦体重和脂肪量）和死亡率之间的关系决定。这一发现表明，“肥胖悖论”的争议可能在很大程度上是由低瘦体重，而不是低脂肪质量，在较低的BMI范围。
To investigate the association of predicted lean body mass, fat mass, and body mass index (BMI) with all cause and cause specific mortality in men. Prospective cohort study. Health professionals in the United States 38 006 men (aged 40-75 years) from the Health Professionals Follow-up Study, followed up for death (1987-2012). All cause and cause specific mortality. Using validated anthropometric prediction equations previously developed from the National Health and Nutrition Examination Survey, lean body mass and fat mass were estimated for all participants. During a mean of 21.4 years of follow-up, 12 356 deaths were identified. A J shaped association was consistently observed between BMI and all cause mortality. Multivariable adjusted Cox models including predicted fat mass and lean body mass showed a strong positive monotonic association between predicted fat mass and all cause mortality. Compared with those in the lowest fifth of predicted fat mass, men in the highest fifth had a hazard ratio of 1.35 (95% confidence interval 1.26 to 1.46) for mortality from all causes. In contrast, a U shaped association was found between predicted lean body mass and all cause mortality. Compared with those in the lowest fifth of predicted lean body mass, men in the second to fourth fifths had 8-10% lower risk of mortality from all causes. In the restricted cubic spline models, the risk of all cause mortality was relatively flat until 21 kg of predicted fat mass and increased rapidly afterwards, with a hazard ratio of 1.22 (1.18 to 1.26) per standard deviation. For predicted lean body mass, a large reduction of the risk was seen within the lower range until 56 kg, with a hazard ratio of 0.87 (0.82 to 0.92) per standard deviation, which increased thereafter (P for non-linearity <0.001). For cause specific mortality, men in the highest fifth of predicted fat mass had hazard ratios of 1.67 (1.47 to 1.89) for cardiovascular disease, 1.24 (1.09 to 1.43) for cancer, and 1.26 (0.97 to 1.64) for respiratory disease. On the other hand, a U shaped association was found between predicted lean body mass and mortality from cardiovascular disease and cancer. However, a strong inverse association existed between predicted lean body mass and mortality from respiratory disease (P for trend <0.001). The shape of the association between BMI and mortality was determined by the relation between two body components (lean body mass and fat mass) and mortality. This finding suggests that the “obesity paradox” controversy may be largely explained by low lean body mass, rather than low fat mass, in the lower range of BMI.
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影响因子：
2
作者：
DURRLEMAN, S;SIMON, R
通讯作者：
SIMON, R
影响因子：
5
作者：
Gallagher, D;Visser, M;Heymsfield, SB
通讯作者：
Heymsfield, SB
影响因子：
2
作者：
Govindarajulu, Usha S.;Spiegelman, Donna;Eisen, Ellen A.
通讯作者：
Eisen, Ellen A.
DOI：
10.1093/gerona/glp099
发表时间：
2010-01-01
影响因子：
5.1
作者：
Auyeung, Tung Wai;Lee, Jenny S. W.;Woo, Jean
通讯作者：
Woo, Jean
DOI：
10.1038/oby.2004.131
发表时间：
2004-07-01
期刊：
OBESITY RESEARCH
影响因子：
--
作者：
Bigaard, J;Frederiksen, K;Sorensen, TIA
通讯作者：
Sorensen, TIA