General and abdominal obesity and risk of death among black women.
General and abdominal obesity and risk of death among black women.
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DOI：
10.1056/nejmoa1104119
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发表时间：
2011-09-08
期刊：
影响因子：
--
通讯作者：
Palmer JR
中科院分区：
文献类型：
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作者：
Boggs DA;Rosenberg L;Cozier YC;Wise LA;Coogan PF;Ruiz-Narvaez EA;Palmer JR
最近的汇总分析显示，在欧洲血统的人群中，随着体重指数（BMI，体重（公斤）除以身高（米）的平方）达到25.0或更高水平，死亡风险增加，东亚人的相关性较弱，而南亚人的BMI增加与死亡风险增加无关。关于黑人的有限数据表明，死亡风险仅在非常高的BMI水平（≥35.0）时增加。我们前瞻性地评估了BMI和腰围与51，695名黑人女性死亡风险的关系，这些女性在研究入组时年龄在21至69岁之间，没有癌症或心血管疾病史。我们的分析是基于1995年至2008年黑人妇女健康研究的随访数据。多变量比例风险模型用于估计风险比和95%置信区间。在随访期间确定的1773例死亡中，有770例发生在33,916名从未吸烟的妇女中。在非吸烟者中，BMI在20.0至24.9之间的死亡风险最低。对于高于这个范围的BMI，死亡风险随着BMI的增加而增加。以BMI为22.5 - 24.9作为参考类别，多变量校正的风险比为1.12（95%置信区间[CI]，0.87 - 1.44），BMI为25.0 - 27.4，1.31（95% CI，1.01 - 1.72）BMI为27.5 - 29.9，1.27（95% CI，0.99 - 1.64）BMI为30.0 - 34.9，1.51 BMI为35.0至39.9的患者为2.19（95%CI，1.13至2.02），BMI为40.0至49.9的患者为2.19（95%CI，1.62至2.95）（趋势P<0.001）。在BMI小于30.0的女性中，腰围较大与任何原因导致的死亡风险增加有关。黑人女性任何原因的死亡风险随着BMI增加而增加25.0或更高，这与白人中观察到的模式相似。腰围似乎只与非肥胖女性的死亡风险增加有关。（由国家癌症研究所资助。
Recent pooled analyses show an increased risk of death with increasing levels of the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 25.0 or higher in populations of European ancestry, a weaker association among East Asians, and no association of an increased BMI with an increased risk of death among South Asians. The limited data available on blacks indicate that the risk of death is increased only at very high levels of BMI (≥35.0). We prospectively assessed the relation of both BMI and waist circumference to the risk of death among 51,695 black women with no history of cancer or cardiovascular disease who were 21 to 69 years of age at study enrollment. Our analysis was based on follow-up data from 1995 through 2008 in the Black Women’s Health Study. Multivariable proportional-hazards models were used to estimate hazard ratios and 95% confidence intervals. Of 1773 deaths identified during follow-up, 770 occurred among 33,916 women who had never smoked. Among nonsmokers, the risk of death was lowest for a BMI of 20.0 to 24.9. For a BMI above this range, the risk of death increased as the BMI increased. With a BMI of 22.5 to 24.9 as the reference category, multivariable-adjusted hazard ratios were 1.12 (95% confidence interval [CI], 0.87 to 1.44) for a BMI of 25.0 to 27.4, 1.31 (95% CI, 1.01 to 1.72) for a BMI of 27.5 to 29.9, 1.27 (95% CI, 0.99 to 1.64) for a BMI of 30.0 to 34.9, 1.51 (95% CI, 1.13 to 2.02) for a BMI of 35.0 to 39.9, and 2.19 (95% CI, 1.62 to 2.95) for a BMI of 40.0 to 49.9 (P<0.001 for trend). A large waist circumference was associated with an increased risk of death from any cause among women with a BMI of less than 30.0. The risk of death from any cause among black women increased with an increasing BMI of 25.0 or higher, which is similar to the pattern observed among whites. Waist circumference appeared to be associated with an increased risk of death only among nonobese women. (Funded by the National Cancer Institute.)