VARIABILITY OF BODY-WEIGHT AND HEALTH OUTCOMES IN THE FRAMINGHAM POPULATION
VARIABILITY OF BODY-WEIGHT AND HEALTH OUTCOMES IN THE FRAMINGHAM POPULATION
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DOI：
10.1056/nejm199106273242602
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发表时间：
1991-06-27
影响因子：
158.5
通讯作者：
BROWNELL, KD
中科院分区：
文献类型：
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作者：
LISSNER, L;ODELL, PM;BROWNELL, KD
背景体重波动是一种常见现象，部分原因是节食的盛行。在这项研究中，我们研究了参与心脏研究的受试者的体重变化与健康终点之间的关系，该研究包括入组后每两年进行一次随访检查。体重的变异程度表示为研究期间前8次每两年一次的检查时每名受试者的体重指数测量值的变异系数以及25岁时回忆的体重。使用32年的随访数据，我们分析了总死亡率、冠心病死亡率、冠心病和癌症发病率与个体内体重变化的关系，仅包括第10次两年一次检查后发生的终点。我们使用年龄调整的比例风险回归进行数据分析。体重差异较大的受试者总死亡率（男性P = 0.005，女性P = 0.01）、冠心病死亡率（男性P = 0.009，女性P = 0.009）和冠心病发病率（男性P = 0.0009，女性P = 0.006）增加。使用多变量分析，也控制了肥胖，体重随时间的变化趋势和心血管风险的五个指标，我们发现体重波动与死亡率和冠心病相关终点之间的正相关性不能归因于这些潜在的混杂因素。与体重相对稳定的受试者相比，体重变化较大的受试者发生这些终点的相对危险度为1.27 ~ 1.93。体重的波动可能会对健康产生负面影响，与肥胖和体重随时间的变化趋势无关。
Background. Fluctuation in body weight is a common phenomenon, due in part to the high prevalence of dieting. In this study we examined the associations between variability in body weight and health end points in subjects participating in the Framingham Heart Study, which involves follow-up examinations every two years after entry.Methods. The degree of variability of body weight was expressed as the coefficient of variation of each subject's measured body-mass-index values at the first eight biennial examinations during the study and on their recalled weight at 25 years of age. Using the 32-year follow-up data, we analyzed total mortality, mortality from coronary heart disease, and morbidity due to coronary heart disease and cancer in relation to intraindividual variation in body weight, including only end points that occurred after the 10th biennial examination. We used age-adjusted proportional-hazards regression for the data analysis.Results. Subjects with highly variable body weights had increased total mortality (P = 0.005 for men, P = 0.01 for women), mortality from coronary heart disease (P = 0.009 for men, P = 0.009 for women), and morbidity due to coronary heart disease (P = 0.0009 for men, P = 0.006 for women). Using a multivariate analysis that also controlled for obesity, trends in weight over time, and five indicators of cardiovascular risk, we found that the positive associations between fluctuations in body weight and end points related to mortality and coronary heart disease could not be attributed to these potential confounding factors. The relative risks of these end points in subjects whose weight varied substantially, as compared with those whose weight was relatively stable, ranged from 1.27 to 1.93.Conclusions. Fluctuations in body weight may have negative health consequences, independent of obesity and the trend of body weight over time.