Obesity and risk of infections: results from men and women in the Swedish National March Cohort
Obesity and risk of infections: results from men and women in the Swedish National March Cohort
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DOI：
10.1093/ije/dyz129
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发表时间：
2019-12-01
影响因子：
7.7
通讯作者：
Lagerros, Ylva Trolle
中科院分区：
文献类型：
--
作者：
Ghilotti, Francesca;Bellocco, Rino;Lagerros, Ylva Trolle
背景：以往的研究表明身体质量指数（BMI）与感染之间存在关联，但关于特定类型的社区获得性感染的文献仍然有限。方法：我们纳入了39163名瑞典成年人，他们于1997年9月完成了一份调查问卷，并通过记录联系随访至2016年12月。BMI信息是自我报告的，感染是使用国际疾病分类（ICD）第十版（ICD-10）代码从瑞典国家患者登记册中确定的。我们拟合了多变量Cox比例风险模型，用于首次事件的时间分析，并在包括重复事件时使用了标准Cox模型的扩展。结果：在19年的随访中，32%的受试者至少有一次需要医疗保健接触的感染，导致总共27675次事件。我们发现肥胖女性任何感染的发生率都增加[危险比(HR) = 1.22；95%置信区间(CI) = 1.12；[1.33]和肥胖男性（HR = 1.25; 95% CI = 1.09; 1.43）。对于特定感染，男女皮肤感染（HR = 1.76, 95% CI = 1.47；肥胖女性为2.12,HR = 1.74; 95% CI = 1.33；肥胖男性为2.28）和胃肠道感染（HR = 1.44, 95% CI = 1.19; 1.75）、尿路感染（HR = 1.30, 95% CI = 1.08; 1.55）和脓毒症（HR = 2.09, 95% CI = 1.46; 2.99）的发生率均较高。在考虑重复事件时，发现了与上述类似的估计。结论：无论男女，肥胖都与感染风险增加有关。多次失败生存分析结果与经典Cox模型一致。
Background: Previous studies have shown an association between body mass index (BMI) and infections, but the literature on type-specific community acquired infections is still limited.Methods: We included 39 163 Swedish adults who completed a questionnaire in September 1997 and were followed through record-linkages until December 2016. Information on BMI was self-reported and infections were identified from the Swedish National Patient Register using International Classification of Diseases (ICD), Tenth Revision (ICD-10) codes. We fitted multivariable Cox proportional hazards models for time-to-first-event analysis, and we used extensions of the standard Cox model when repeated events were included.Results: During a 19-year follow-up 32% of the subjects had at least one infection requiring health care contact, leading to a total of 27 675 events. We found an increased incidence of any infection in obese women [hazard ratio (HR) = 1.22; 95% confidence interval (CI) = 1.12; 1.33] and obese men (HR = 1.25; 95% CI = 1.09; 1.43) compared with normal weight subjects. For specific infections, higher incidences were observed for skin infections in both genders (HR = 1.76; 95% CI = 1.47; 2.12 for obese females and HR = 1.74; 95% CI = 1.33; 2.28 for obese males) and gastrointestinal tract infections (HR = 1.44; 95% CI = 1.19; 1.75), urinary tract infections (HR = 1.30; 95% CI = 1.08; 1.55) and sepsis (HR = 2.09; 95% CI = 1.46; 2.99) in obese females. When accounting for repeated events, estimates similar to the aforementioned ones were found.Conclusions: Obesity was associated with an increased risk of infections in both genders. Results from multiple-failure survival analysis were consistent with those from classic Cox models.