Body-mass index and mortality in a prospective cohort of U.S. adults.
Body-mass index and mortality in a prospective cohort of U.S. adults.
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DOI：
10.1097/00008483-200003000-00010
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发表时间：
1999-10
期刊：
影响因子：
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通讯作者：
E. Calle;M. Thun;Jennifer M. Petrelli;C. Rodríguez;C. Heath
中科院分区：
文献类型：
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作者：
E. Calle;M. Thun;Jennifer M. Petrelli;C. Rodríguez;C. Heath
背景：体重指数（体重（千克）除以身高（米）的平方）与总死亡率相关。我们调查了年龄、种族、性别、吸烟状况和疾病史对体重指数和死亡率之间关系的影响。在一项对美国100多万成年人（457，785名男性和588，369名女性）进行的前瞻性研究中，在14年的随访期间发生了201，622例死亡。我们在根据吸烟状况和疾病史分类的四个亚组中研究了体重指数和各种原因死亡风险之间的关系。在从不吸烟的健康人群中，我们进一步研究了这种关系是否因种族、死因或年龄而异。相对危险度用于评估死亡率与体重指数之间的关系。结果体重指数和死亡风险之间的关联被吸烟状况和疾病的存在实质性地改变。在从不吸烟的健康人群中，体重指数和死亡率曲线的最低点在男性体重指数为23.5至24.9，女性为22.0至23.4。在体重指数最高的受试者中，与体重指数在23.5到24.9之间的受试者相比，白色男性和女性的相对死亡风险分别为2.58和2.00。体重指数最高的黑人男性和女性的死亡风险要低得多（1.35和1.21），与1.00没有显著差异。高体重指数是心血管疾病死亡的最佳预测指标，尤其是男性（相对危险度为2.90; 95%可信区间为2.37 ~ 3.56）。在所有年龄组中，体重较重的男性和女性死亡风险增加。结论：所有年龄组的男性和女性，在中度和重度超重的范围内，死于各种原因、心血管疾病、癌症或其他疾病的风险都会增加。白人与高体重指数相关的风险比黑人大。
BACKGROUND Body-mass index (the weight in kilograms divided by the square of the height in meters) is known to be associated with overall mortality. We investigated the effects of age, race, sex, smoking status, and history of disease on the relation between body-mass index and mortality. METHODS In a prospective study of more than 1 million adults in the United States (457,785 men and 588,369 women), 201,622 deaths occurred during 14 years of follow-up. We examined the relation between body-mass index and the risk of death from all causes in four subgroups categorized according to smoking status and history of disease. In healthy people who had never smoked, we further examined whether the relation varied according to race, cause of death, or age. The relative risk was used to assess the relation between mortality and body-mass index. RESULTS The association between body-mass index and the risk of death was substantially modified by smoking status and the presence of disease. In healthy people who had never smoked, the nadir of the curve for body-mass index and mortality was found at a body-mass index of 23.5 to 24.9 in men and 22.0 to 23.4 in women. Among subjects with the highest body-mass indexes, white men and women had a relative risk of death of 2.58 and 2.00, respectively, as compared with those with a body-mass index of 23.5 to 24.9. Black men and women with the highest body-mass indexes had much lower risks of death (1.35 and 1.21), which did not differ significantly from 1.00. A high body-mass index was most predictive of death from cardiovascular disease, especially in men (relative risk, 2.90; 95 percent confidence interval, 2.37 to 3.56). Heavier men and women in all age groups had an increased risk of death. CONCLUSIONS The risk of death from all causes, cardiovascular disease, cancer, or other diseases increases throughout the range of moderate and severe overweight for both men and women in all age groups. The risk associated with a high body-mass index is greater for whites than for blacks.