Weight loss increases and fat loss decreases all-cause mortality rate: results from two independent cohort studies
Weight loss increases and fat loss decreases all-cause mortality rate: results from two independent cohort studies
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DOI：
10.1038/sj.ijo.0800875
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发表时间：
1999-06-01
影响因子：
4.9
通讯作者：
Heymsfield, SB
中科院分区：
文献类型：
--
作者：
Allison, DB;Zannolli, R;Heymsfield, SB
目的：在流行病学研究中，体重减轻通常与死亡率增加有关。实际上，在肥胖人群中，体重减轻减少了其他疾病和死亡的风险因素。我们假设这种矛盾可能存在，因为体重被用作隐性肥胖指数。没有研究考虑过减肥和减脂对死亡率的独立影响。我们研究了死亡率作为体重减轻和脂肪减少的函数。设计：两项前瞻性人群队列研究--特库姆塞社区健康研究--的“死亡时间”分析（1890例受试者; 321例在随访16年内死亡）和Frachial Heart研究（2731例受试者;随访8年内507例死亡），其中体重和脂肪（通过皮褶）损失是可评估的。在这两项研究中，无论统计方法如何，体重减轻与死亡率增加相关，脂肪减少与死亡率降低相关（P < 0.05）。每个标准差（s.d.）在两个样本中，估计体重减轻（特库姆塞为4.6 kg，弗拉姆塞为6.7 kg）会使风险率增加29%（95%置信区间CI），（分别为14%，47%）和39%（95% CI，分别为25%，54%）。因此，每个S.估计脂肪损失（特库姆塞为10.0 mm，弗拉德塞为4.8 mm）分别使特库姆塞和弗拉德塞的风险率降低15%（95% CI，4%，25%）和17%（95% CI，8%，25%）。结论：在非严重肥胖的个体中，体重减轻与死亡率增加相关，而脂肪减少与死亡率降低相关。
OBJECTIVE: In epidemiological studies, weight loss is usually associated with increased mortality rate. Contrarily, among obese people, weight loss reduces other risk factors for disease and death. We hypothesised that this paradox could exist because weight is used as an implicit adiposity index. No study has considered the independent effects of weight loss and fat loss on mortality rate. We studied mortality rate as a function of weight loss and fat loss.DESIGN: Analysis of 'time to death' in two prospective population-based cohort studies, the Tecumseh Community Health Study (1890 subjects; 321 deaths within 16 y of follow-up) and the Framingham Heart Study (2731 subjects; 507 deaths within 8 y of follow-up), in which weight and fat (via skinfolds) loss were assessable.RESULTS: In both studies, regardless of the statistical approach, weight loss was associated with an increased, and fat loss with a decreased, mortality rate (P < 0.05). Each standard deviation (s.d.) of weight loss (4.6 kg in Tecumseh, 6.7 kg in Framingham) was estimated to increase the hazard rate by 29% (95% confidence interval CI), (14%, 47%, respectively) and 39% (95% CI, 25%, 54% respectively), in the two samples. Contrarily, each s.d. of fat loss (10.0 mm in Tecumseh, 4.8 mm in Framingham) was estimated to reduce the hazard rate 15% (95% CI, 4%, 25%) and 17% (95% CI, 8%, 25%) in Tecumseh and Framingham, respectively. Generalisability of these results to severely (that is, body mass index BMI) greater than or equal to 34) obese individuals is unclear.CONCLUSIONS: Among individuals that are not severely obese, weight loss is associated with increased mortality rate and fat loss with decreased mortality rate.