Body mass index, physical inactivity and low level of physical fitness as determinants of all-cause and cardiovascular disease mortality - 16y follow-up of middle-aged and elderly men and women
Body mass index, physical inactivity and low level of physical fitness as determinants of all-cause and cardiovascular disease mortality - 16y follow-up of middle-aged and elderly men and women
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DOI：
10.1038/sj.ijo.0801426
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发表时间：
2000-11-01
影响因子：
4.9
通讯作者：
Malmberg, J
中科院分区：
文献类型：
--
作者：
Haapanen-Niemi, N;Miilunpalo, S;Malmberg, J
目的：调查体重指数 (BMI)、休闲时间体力活动 (LTPA) 以及感知身体健康和功能能力与死亡风险之间的独立关联和可能的相互作用。设计：前瞻性 16 年随访研究。主题：具有区域代表性的 35-63 岁芬兰男性 (n = 1090) 和女性 (n = 1122) 队列。测量：所有原因、心血管疾病（CVD）和冠心病（CHD）死亡率来自截至1996年9月末的全国人口普查数据，而BMI、LTPA、体质和功能的初始水平则通过自填问卷确定。 结果：在调整年龄、婚姻和就业状况、感知的健康状况、吸烟和饮酒后，Cox比例风险模型显示BMI与男性或女性的死亡风险无关。与最活跃的受试者相比，每周没有剧烈活动的男性和女性的 CVD 死亡相对风险分别为 1.61（95% CI，0.98-2.64）和 4.68（95% CI，1.41-15.57），而男性的 CHD 死亡相对风险为 1.66（95% CI，0.92-2.99）。与认为自己健康状况优于同龄人的男性相比，评估“较差”的男性全因死亡率的相对风险为 3.29（95% CI，1.80-6.02），CVD 死亡率的相对风险为 4.37（95% CI，1.80-10.6）。与没有功能障碍的男性相比，步行 2 公里的距离至少有一定困难的男性全因死亡的相对风险为 1.62（95% CI，1.05-2.50）。此外，与没有功能障碍的受试者相比，爬几段楼梯有困难的男性和女性全因死亡率的相对风险分别为 1.47（95% CI，0.97-2.23）和 2.39（95% CI，1.25-4.60）。 CVD 死亡的相对风险分别为 1.85（95% Ci，1.04-3.30）和 3.38（1.22-9.41）。结论：虽然 BMI 并未被证明是 CVD、CHD 或所有原因综合死亡的独立危险因素，但感知的身体健康和功能能力却是。 LTPA 的增加似乎对肥胖和非肥胖男性和女性的死亡风险有类似的有益影响，而且对于健康和不健康的受试者，这种影响似乎也相似。
OBJECTIVE: To investigate the independent associations and the possible interaction of body mass index (BMI), leisure time physical activity (LTPA) and perceived physical fitness and functional capability with the risk of mortality.DESIGN: Prospective 16 y follow-up study.SUBJECTS: A regionally representative cohort of 35-63-y-old Finnish men (n = 1090) and women (n = 1122).MEASUREMENTS: All-cause, cardiovascular disease (CVD) and coronary heart disease (CHD) mortality were derived from the national census data until the end of September 1996 while the initial levels of BMI, LTPA, physical fitness and function were determined from self-administered questionnaires.RESULTS: After adjustment for age, marital and employment status, perceived hearth status, smoking and alcohol consumption, the Cox proportional hazards model showed that BMI was not associated with the risk of death among the men or the women. Compared with the most active subjects the men and women with no weekly vigorous activity had relative risks of 1.61 (95% confidence interval, CI, 0.98-2.64) and 4.68 (95% CI, 1.41-15.57), respectively, for CVD mortality, and for the men there was a relative risk of 1.66 (95% CI, 0.92-2.99) for CHD mortality. When compared with the men who perceived their fitness as better than their age-mates, the men with the 'worse' assessment had a relative risk of 3.29 (95% CI, 1.80-6.02) for all-cause mortality and 4.37 (95% CI, 1.80-10.6) for CVD mortality. Men with at least some difficulty in walking a distance of 2 km had a relative risk of 1.62 (95% CI, 1.05-2.50) for all-cause mortality when compared with those who had no functional difficulties. In addition, in the comparison with subjects with no functional difficulties, the men and women who had some difficulty climbing several flights of stairs had relative risks of 1.47 (95% CI, 0.97-2.23) and 2.39 (95% CI, 1.25-4.60) for all-cause mortality, respectively. For CVD mortality the relative risks were 1.85 (95% Ci, 1.04-3.30) and 3.38 (1.22-9.41), respectively.CONCLUSIONS: Although BMI did not prove to be an independent risk factor for mortality from CVD, CHD or from all causes combined, perceived physical fitness and functional capability did. An increase in LTPA seems to have a similar beneficial effect on the mortality risk of obese and nonobese men and women, and the effect also seems to be similar for fit and unfit subjects.