Muscle mass, BMI, and mortality among adults in the United States: A population-based cohort study.
Muscle mass, BMI, and mortality among adults in the United States: A population-based cohort study.
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DOI：
10.1371/journal.pone.0194697
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Hawkins M
中科院分区：
文献类型：
--
作者：
Abramowitz MK;Hall CB;Amodu A;Sharma D;Androga L;Hawkins M
与最低死亡风险相关的体重指数（BMI）水平尚不清楚。虽然肌肉质量的差异限制了BMI作为肥胖衡量标准的实用性，但没有研究直接研究肌肉质量对BMI-死亡率关系的影响。采用双能X射线吸收法对1999-2004年国家健康和营养调查的11,687名参与者进行了身体成分测定。低肌肉质量是使用阑尾骨骼肌质量指数（ASMI）的性别特异性阈值来定义的。创建比例风险模型，以模拟与全因死亡率的关联。在BMI ≥22的任何水平下，低肌肉质量的参与者比其他参与者具有更高的体脂百分比（%TBF），糖尿病的可能性增加，以及更高的校正死亡率。%TBF的增加表现为BMI的变化比在保留肌肉质量的参与者中观察到的变化小30-40%。排除低肌肉质量或调整ASMI的参与者减弱了与低BMI相关的风险，放大了与高BMI相关的风险，并降低了与最低死亡风险相关的BMI水平。较高的ASMI与较低的死亡率独立相关。在从不吸烟者和曾经吸烟者中的效果相似。腰围的额外调整消除了与较高BMI相关的风险。在排除意外体重减轻，慢性疾病，早期死亡，以及参与者进行肌肉强化锻炼或推荐的身体活动水平后，结果没有变化。肌肉质量介导BMI与肥胖和死亡率的关联，并与死亡风险呈负相关。考虑肌肉质量后，与最高生存率相关的BMI向下移至正常范围。这些结果为肥胖悖论提供了具体的解释。
The level of body-mass index (BMI) associated with the lowest risk of death remains unclear. Although differences in muscle mass limit the utility of BMI as a measure of adiposity, no study has directly examined the effect of muscle mass on the BMI-mortality relationship. Body composition was measured by dual-energy x-ray absorptiometry in 11,687 participants of the National Health and Nutrition Examination Survey 1999–2004. Low muscle mass was defined using sex-specific thresholds of the appendicular skeletal muscle mass index (ASMI). Proportional hazards models were created to model associations with all-cause mortality. At any level of BMI ≥22, participants with low muscle mass had higher body fat percentage (%TBF), an increased likelihood of diabetes, and higher adjusted mortality than other participants. Increases in %TBF manifested as 30–40% smaller changes in BMI than were observed in participants with preserved muscle mass. Excluding participants with low muscle mass or adjustment for ASMI attenuated the risk associated with low BMI, magnified the risk associated with high BMI, and shifted downward the level of BMI associated with the lowest risk of death. Higher ASMI was independently associated with lower mortality. Effects were similar in never-smokers and ever-smokers. Additional adjustment for waist circumference eliminated the risk associated with higher BMI. Results were unchanged after excluding unintentional weight loss, chronic illness, early mortality, and participants performing muscle-strengthening exercises or recommended levels of physical activity. Muscle mass mediates associations of BMI with adiposity and mortality and is inversely associated with the risk of death. After accounting for muscle mass, the BMI associated with the greatest survival shifts downward toward the normal range. These results provide a concrete explanation for the obesity paradox.
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影响因子：
158.5
作者：
Calle, EE;Thun, MJ;Heath, CW
通讯作者：
Heath, CW
运动和PGC1alpha在炎症和慢性疾病中的作用。
影响因子：
64.8
作者：
Handschin, Christoph;Spiegelman, Bruce M.
通讯作者：
Spiegelman, Bruce M.
DOI：
10.1136/bmj.i2716
发表时间：
2016-06-14
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Aune D;Keum N;Giovannucci E;Fadnes LT;Boffetta P;Greenwood DC;Tonstad S;Vatten LJ;Riboli E;Norat T
通讯作者：
Norat T
影响因子：
158.5
作者：
Bangalore, Sripal;Fayyad, Rana;Waters, David D.
通讯作者：
Waters, David D.
影响因子：
3.3
作者：
Gallagher, D;Visser, M;Heymsfield, SB
通讯作者：
Heymsfield, SB