Association of Obesity With Mortality Over 24 Years of Weight History Findings From the Framingham Heart Study
Association of Obesity With Mortality Over 24 Years of Weight History Findings From the Framingham Heart Study
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DOI：
10.1001/jamanetworkopen.2018.4587
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发表时间：
2018-11-01
影响因子：
13.8
通讯作者：
Liu, Ching-Ti
中科院分区：
文献类型：
--
作者：
Xu, Hanfei;Cupples, L. Adrienne;Liu, Ching-Ti
许多关于肥胖与死亡率之间关系的研究依赖于单一时间点的体重状况，因此很难充分解决与反向因果关系相关的偏差。目的探讨最大体重指数（BMI）与无反向因果关系的全因死亡率之间的关系。设计、环境和参与者弗雷明汉心脏研究的原始和后代队列的前瞻性队列研究。随访期从原始队列基线检查13开始，从后代队列基线检查6开始，至2014年12月31日结束。这些分析是在2017年进行的。参与者是6197人，在平均17年的随访期间有3478人死亡。主要结局和测量方法：随访开始前24年体重史上的最大BMI，以观察全因死亡率和病因特异性死亡率。全因死亡率和特定原因死亡率（因心血管疾病、癌症或其他原因导致的死亡）。结果在6197名参与者中（基线时平均[SD]年龄为62.79[8.98]岁，女性55.5%），3478人（56.1%）在随访期间死亡。最大体重指数与死亡率之间存在单调关联，在肥胖I（体重指数为30至30）中观察到风险增加
IMPORTANCE Many studies of the association between obesity and mortality rely on weight status at a single point in time, making it difficult to adequately address bias associated with reverse causality.OBJECTIVE To investigate the association between maximum body mass index (BMI) and all-cause mortality without the consequences of reverse causality.DESIGN, SETTING, AND PARTICIPANTS Prospective cohort studies for the original and offspring cohorts of the Framingham Heart Study. The follow-up period started from baseline examination 13 for the original cohort and from baseline examination 6 for the offspring cohort and ended December 31, 2014. The analyses were conducted in 2017. Participants were 6197 individuals with 3478 deaths during a mean of 17 years of follow-up.MAIN OUTCOMES AND MEASURES Maximum BMI over 24 years of weight history before the beginning of follow-up for all-cause mortality and cause-specific mortality. All-cause mortality and cause-specific mortality (deaths due to cardiovascular disease, cancer, or other causes).RESULTS Among 6197 participants (mean [SD] age at baseline, 62.79 [8.98] years; 55.5% female), 3478 (56.1%) died during the follow-up. A monotonic association was observed between maximum BMI and mortality, with increasing risks observed across obese I (BMI of 30 to