The relationship between body weight and mortality: a quantitative analysis of combined information from existing studies.
The relationship between body weight and mortality: a quantitative analysis of combined information from existing studies.
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发表时间：
1996
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通讯作者：
Troiano Rp;E. Frongillo;J. Sobal;D. Levitsky
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文献类型：
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作者：
Troiano Rp;E. Frongillo;J. Sobal;D. Levitsky
目的从已发表的科学文献中估计体重指数(BMI，kg/m2)与全因死亡率的关系。使用分层混合模型设计Meta分析。分析包括对信息源的随机影响和对可能改变BMI-死亡率关系的因素的固定影响，如吸烟、疾病控制和原籍国，这些因素允许结合来自不同研究的信息。主要结果指标预测了由BMI绘制的白人性别年龄队列在给定持续时间内的死亡概率。结果一项广泛的搜索确定了19项符合纳入标准的前瞻性队列研究。对50岁的男性进行了30年的跟踪调查，结果显示体重指数与死亡率之间呈U型关系。在进入研究时没有疾病证据的非吸烟者组中，死亡风险随着低BMI和高BMI(28)而增加。来自女性研究的有限信息表明，经过10年的随访，对于(1)不吸烟者和(2)吸烟者和非吸烟者的混合人群来说，BMI和死亡率之间几乎没有关系。结论这项对现有研究的定量分析显示，白人男性在中等低BMI时的死亡率与观察到的极端超重时的死亡率相当，这似乎不是由吸烟或现有疾病引起的。需要注意体重不足的健康风险，并需要根据这些风险考虑最佳长寿的体重建议。
OBJECTIVE To estimate the relationship between body mass index (BMI, kg/m2) and all-cause mortality with information from the published scientific literature. DESIGN Meta-analysis using a hierarchical, mixed model. The analysis included random effects for information sources and fixed effects for factors that may modify the BMI-mortality relationship such as smoking, control for disease, and country of origin, which allowed combining information from diverse studies. MAIN OUTCOME MEASURES Predicted probability of death over a given duration of follow-up plotted by BMI for sex-age cohorts of white race. RESULTS An extensive search identified nineteen prospective cohort studies that met inclusion criteria. A U-shaped relationship between BMI and mortality was demonstrated for 50-year-old men followed for 30 years. Mortality risk increased with low and high BMI ( 28) in groups of non-smokers without evidence of disease upon study entry. Limited information from studies of women indicated that, with 10 year follow-up, there was little relationship between BMI and mortality for (1) non-smokers and for (2) mixtures of smokers and non-smokers. CONCLUSION This quantitative analysis of existing studies revealed increased mortality at moderately low BMI for white men comparable to that observed at extreme overweight, which does not appear to be due to smoking or existing disease. Attention to the health risks of underweight is needed, and body weight recommendations for optimum longevity need to be considered in light of these risks.