Body-mass index and mortality in a prospective cohort of US adults
Body-mass index and mortality in a prospective cohort of US adults
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DOI：
10.1056/nejm199910073411501
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发表时间：
1999-10-07
影响因子：
158.5
通讯作者：
Heath, CW
中科院分区：
文献类型：
--
作者：
Calle, EE;Thun, MJ;Heath, CW
背景体重指数(以公斤为单位的体重除以以米为单位的身高的平方)与总死亡率有关。我们调查了年龄、种族、性别、吸烟状况和疾病史对体重指数和死亡率之间关系的影响。方法在一项对美国100多万成年人(457,785名男性和588,369名女性)进行的前瞻性研究中，在14年的跟踪调查中，有201,622人死亡。我们根据吸烟状况和病史分为四个亚组，研究体重指数与全死因死亡风险之间的关系。在从未吸烟的健康人中，我们进一步研究了这种关系是否因种族、死因或年龄而异。结果吸烟状况和疾病的存在显著改变了体重指数与死亡风险之间的关系。在从不吸烟的健康人中，体重指数和死亡率曲线的最低点是男性的体重指数在23.5到24.9之间，女性的体重指数在22.0到23.4之间。在体重指数最高的受试者中，白人男性和女性的相对死亡风险分别为2.58和2.00，而那些体重指数在23.5到24.9之间的受试者的相对死亡风险为2.00。体重指数最高的黑人男性和女性的死亡风险(1.35和1.21)要低得多，与1.00没有显著差异。高体重指数最能预测死于心血管疾病，尤其是男性(相对风险为2.90；95%可信区间为2.37至3.56)。结论所有年龄段的男性和女性在中度和重度超重的范围内，死于各种原因、心血管疾病、癌症或其他疾病的风险都在增加。与高体重指数相关的风险对白人来说比黑人更大。(N Engl J Med 1999；341：1097-105)(C)1999年，马萨诸塞州医学会。
Background Body-mass index (the weight in kilograms divided by the square of the height in meters) is known to be associated with overall mortality. We investigated the effects of age, race, sex, smoking status, and history of disease on the relation between body-mass index and mortality.Methods In a prospective study of more than 1 million adults in the United States (457,785 men and 588,369 women), 201,622 deaths occurred during 14 years of follow-up. We examined the relation between body-mass index and the risk of death from all causes in four subgroups categorized according to smoking status and history of disease. In healthy people who had never smoked, we further examined whether the relation varied according to race, cause of death, or age. The relative risk was used to assess the relation between mortality and body-mass index.Results The association between body-mass index and the risk of death was substantially modified by smoking status and the presence of disease. In healthy people who had never smoked, the nadir of the curve for body-mass index and mortality was found at a body-mass index of 23.5 to 24.9 in men and 22.0 to 23.4 in women. Among subjects with the highest body-mass indexes, white men and women had a relative risk of death of 2.58 and 2.00, respectively, as compared with those with a body-mass index of 23.5 to 24.9. Black men and women with the highest body-mass indexes had much lower risks of death (1.35 and 1.21), which did not differ significantly from 1.00. A high body-mass index was most predictive of death from cardiovascular disease, especially in men (relative risk, 2.90; 95 percent confidence interval, 2.37 to 3.56). Heavier men and women in all age groups had an increased risk of death.Conclusions The risk of death from all causes, cardiovascular disease, cancer, or other diseases increases throughout the range of moderate and severe overweight for both men and women in all age groups. The risk associated with a high body-mass index is greater for whites than for blacks. (N Engl J Med 1999;341:1097-105.) (C)1999, Massachusetts Medical Society.