Body-mass index and mortality among 1.46 million white adults.
Body-mass index and mortality among 1.46 million white adults.
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DOI：
10.1056/nejmoa1000367
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发表时间：
2010-12-02
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影响因子：
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通讯作者：
Thun MJ
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作者：
Berrington de Gonzalez A;Hartge P;Cerhan JR;Flint AJ;Hannan L;MacInnis RJ;Moore SC;Tobias GS;Anton-Culver H;Freeman LB;Beeson WL;Clipp SL;English DR;Folsom AR;Freedman DM;Giles G;Hakansson N;Henderson KD;Hoffman-Bolton J;Hoppin JA;Koenig KL;Lee IM;Linet MS;Park Y;Pocobelli G;Schatzkin A;Sesso HD;Weiderpass E;Willcox BJ;Wolk A;Zeleniuch-Jacquotte A;Willett WC;Thun MJ
高体重指数（BMI，以千克为单位的体重除以以米为单位的身高的平方）与心血管疾病和某些癌症的死亡率增加有关，但BMI与全因死亡率之间的精确关系仍不确定。我们使用考克斯回归来估计BMI和全因死亡率之间关联的风险比和95%置信区间，并在19项前瞻性研究的汇总数据中调整年龄、学习、体力活动、饮酒、教育和婚姻状况，这些研究包括146万白色成年人，年龄19至84岁（中位数58岁）。中位基线BMI为26.2。在10年的中位随访期间（范围，5至28年），确定了160，087例死亡。在从不吸烟的健康参与者中，BMI和全因死亡率之间存在J形关系。以BMI为22.5至24.9作为参考类别，女性的风险比为1.47（95%置信区间[CI]，1.33至1.62），BMI为15.0至18.4; 1.14（95% CI，1.07 - 1.22），BMI为18.5 - 19.9; 1.00（95% CI，0.96 - 1.04），BMI为20.0 - 22.4; 1.13（95% CI，1.09 - 1.17），BMI为25.0 - 29.9; 1.44（95% CI，1.38 - 1.50），BMI为30.0 - 34.9; 1.88（95% CI，1.77 - 2.00），BMI为35.0 - 39.9; 2.51（95% CI，2.30 - 2.73），BMI为40.0 - 49.9。总的来说，男性的风险比是相似的。BMI低于20.0的风险比随着长期随访而减弱。在白色成年人中，超重和肥胖（可能还有体重不足）与全因死亡率增加有关。全因死亡率通常最低，BMI为20.0至24.9。
A high body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) is associated with increased mortality from cardiovascular disease and certain cancers, but the precise relationship between BMI and all-cause mortality remains uncertain. We used Cox regression to estimate hazard ratios and 95% confidence intervals for an association between BMI and all-cause mortality, adjusting for age, study, physical activity, alcohol consumption, education, and marital status in pooled data from 19 prospective studies encompassing 1.46 million white adults, 19 to 84 years of age (median, 58). The median baseline BMI was 26.2. During a median follow-up period of 10 years (range, 5 to 28), 160,087 deaths were identified. Among healthy participants who never smoked, there was a J-shaped relationship between BMI and all-cause mortality. With a BMI of 22.5 to 24.9 as the reference category, hazard ratios among women were 1.47 (95 percent confidence interval [CI], 1.33 to 1.62) for a BMI of 15.0 to 18.4; 1.14 (95% CI, 1.07 to 1.22) for a BMI of 18.5 to 19.9; 1.00 (95% CI, 0.96 to 1.04) for a BMI of 20.0 to 22.4; 1.13 (95% CI, 1.09 to 1.17) for a BMI of 25.0 to 29.9; 1.44 (95% CI, 1.38 to 1.50) for a BMI of 30.0 to 34.9; 1.88 (95% CI, 1.77 to 2.00) for a BMI of 35.0 to 39.9; and 2.51 (95% CI, 2.30 to 2.73) for a BMI of 40.0 to 49.9. In general, the hazard ratios for the men were similar. Hazard ratios for a BMI below 20.0 were attenuated with longer-term follow-up. In white adults, overweight and obesity (and possibly underweight) are associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9.