Body mass index and mortality in men: evaluating the shape of the association
Body mass index and mortality in men: evaluating the shape of the association
复制标题
DOI：
10.1038/sj.ijo.0803564
复制
发表时间：
2007-08-01
影响因子：
4.9
通讯作者：
Gaziano, J. M.
中科院分区：
文献类型：
--
作者：
Gelber, R. P.;Kurth, T.;Gaziano, J. M.
目的：关于体重指数（BMI）与死亡率之间关系的争议仍然存在。之前的大多数研究都没有全面解释偏差的主要来源。我们根据先前存在的疾病和吸烟状况，在一个大型前瞻性队列中检查了 BMI 和全因死亡率之间的关联。方法：参与者是 1982 年提供自我报告信息的医生健康研究登记队列中的 99 253 名男性医生（40-84 岁）。我们使用 Cox 比例风险回归来检查基线 BMI 和死亡率之间的关联。结果：共有 5438 名男性死亡（中位数）随访，5.7 年）。尽管在所有男性中都发现 BMI 与全因死亡率之间存在 U 形关联，但在考虑潜在偏差来源时，我们发现了线性关系。在排除 2 年内死亡男性的最佳模型中，并根据年龄、吸烟、饮酒、体力活动、既往疾病以及 BMI 与既往疾病之间以及 BMI 与吸烟之间的相互作用进行调整，与 BMI 22.5-24.9 的男性相比，BMI < 20.0 kg/m(2) 的患者的死亡相对风险 (RR) 为 0.88（95% 置信区间 (CI)，0.56-1.40）。公斤/米(2)。相比之下，BMI 30.0-34.9 kg/m(2) 的男性的 RR 为 1.45（95% CI，1.10-1.91），BMI >= 35.0 kg/m(2) 的男性 RR 为 1.62（95% CI，1.12-2.35；线性趋势 P < 0.001）。根据世界卫生组织的分类，与“正常”范围内的男性（BMI < 25.0kg/m(2)）相比，“超重”范围内的男性（BMI 25.0-29.9 kg/m(2)）的 RR 为 1.20（95% CI，1.05-1.38）。结论：在这个大型前瞻性队列中，在考虑了多项因素后，我们发现较高的 BMI 与死亡风险增加之间存在一致的线性相关性。潜在的偏见来源，即使是在体重指数“超重”范围内的人中。公共卫生信息应强调大量证据支持与体重增加相关的不良健康影响。
Objective: Controversy regarding the relationship between body mass index (BMI) and mortality continues to exist. Most of the previous studies have not comprehensively accounted for major sources of bias. We examined the association between BMI and all-cause mortality according to pre-existing disease and smoking status in a large prospective cohort.Methods: Participants were 99 253 male physicians in the Physicians' Health Study enrollment cohort (40-84 years) who provided self-reported information in 1982. We used Cox proportional hazards regression to examine the association between baseline BMI and mortality.Results: A total of 5438 men died (median follow-up, 5.7 years). Although a U-shaped association between BMI and all-cause mortality was seen among all men, we found a linear relationship when accounting for potential sources of bias. In the optimal model excluding men who died within 2 years, and adjusting for age, smoking, alcohol consumption, physical activity, prior disease and interactions between BMI and prior disease, and between BMI and smoking, those with BMI < 20.0 kg/m(2) had a relative risk (RR) of death of 0.88 (95% confidence interval (CI), 0.56-1.40), as compared to men with BMI 22.5-24.9 kg/m(2). By contrast, men with BMI 30.0-34.9 kg/m(2) had an RR of 1.45 (95% CI, 1.10-1.91) and those with BMI >= 35.0 kg/m(2) had an RR of 1.62 (95% CI, 1.12-2.35; P for linear trend, < 0.001). According to WHO categories, men in the 'overweight' range (BMI 25.0-29.9 kg/m(2)) had an RR of 1.20 (95% CI, 1.05-1.38) as compared to men in the 'normal' range (BMI < 25.0kg/m(2)).Conclusions: In this large, prospective cohort, we found a consistent linear association between higher BMI and increased risk of mortality after accounting for several potential sources of bias, even among those within the 'overweight' range of BMI. Public health messages should emphasize the preponderance of evidence supporting the adverse health effects associated with higher body weight.