Mortality of severely obese subjects.
Mortality of severely obese subjects.
复制标题
严重肥胖受试者的死亡率。
DOI：
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发表时间：
1992
影响因子：
7.1
通讯作者：
L. Sjöström
中科院分区：
文献类型：
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作者：
L. Sjöström
所有大型前瞻性研究（n大于20，000）和几项较小的研究都发现，重度肥胖[体重指数（BMI）大于或等于35 kg/m2]与总死亡率增加约2倍以及糖尿病、脑和心血管疾病以及某些形式的癌症导致的死亡率增加数倍相关。无法证实这一点的研究是小规模和/或短期的，未能控制吸烟或早期死亡率，以不适当的方式控制中等风险因素，或由于错误分类偏倚而降低了内部效度。与BMI相比，在大多数研究中，腹部肥胖是死亡率的更强预测因子。与一般人群相比，严重肥胖受试者中尸检无法解释的猝死发生率可能高达40倍。从18岁起体重的小幅增加与风险降低有关，而体重增加超过10公斤与死亡率增加有关。严重肥胖的总死亡率从55岁开始下降，80岁以上则检测不到。缺乏适当对照组的研究表明，持续的体重减轻可能会降低死亡率，但迄今为止还没有对照干预研究的结果。
All large prospective studies (n greater than 20,000) and several smaller studies have found that severe obesity [body mass index (BMI) greater than or equal to 35 kg/m2] is associated with approximately a twofold increase in total mortality and in a severalfold increase in mortality due to diabetes, cerebro-, and cardiovascular disease, and certain forms of cancer. Studies that have not been able to confirm this have been small and/or short term, have failed to control for smoking or early mortality, have controlled for intermediate risk factors in an inappropriate way, or have a reduced internal validity due to misclassification biases. As compared with BMI, abdominal obesity is a stronger predictor of mortality in most studies available. The incidence of sudden death unexplained by autopsy may be up to 40 times higher in severely obese subjects as compared with the general population. A small weight increase since the age of 18 is associated with a decreased risk whereas weight increases greater than 10 kg are associated with an increased mortality. The total mortality ratio for severe obesity decreases from 55 y of age and is not detectable above 80 y of age. Studies lacking adequate control groups indicate that a sustained weight loss may induce a reduced mortality but results from controlled intervention studies are so far not available.