Obesity-Related Variables and Motor Vehicle Injury

描述(申请人提供)：摘要：肥胖是近三分之一的美国成年人存在的主要公共健康问题，据报道，肥胖会增加机动车碰撞(MVC)的死亡风险。风险增加的各种机制已被提出，包括：1)动量效应；2)与肥胖相关的并发症，如心血管疾病、糖尿病和睡眠呼吸暂停；3)肥胖者的治疗后问题；以及4)载体设计。我们最近进行的研究发现，在MVC死亡率和身体质量指数(BMI)之间的关系中存在性别差异：在BMI连续的两端，男性(但不是女性)的死亡风险都有所增加。我们假设，这种不同的联系可能部分是由于体重和体型、重心的差异，以及BMI作为男性和女性肥胖诊断标准的不同准确性造成的。为了评估这一假设，该项目将使用国家MVC数据库和几何磁共振成像(MRI)辅助的计算机碰撞模拟中的身体变化建模。具体目标1是利用MVC数据在BMI和体重模型中测试动量、肥胖相关并发症和治疗后对男性和女性MVC结果的影响。我们假设，肥胖对MVC结果影响的性别差异主要是由于动量效应的差异以及与肥胖相关的男性和女性之间的共病。具体目标2是利用计算机碰撞模型预测身体形状和重心对男性和女性MVC损伤的影响。我们假设，在撞车过程中，体重和脂肪分布的性别差异，即身体形状，以及速度的变化，将对男性和女性的受伤程度和模式产生很大影响。这个项目的发现将促进我们对美国这两个主要死亡原因的理解。此外，它还将为重新审查联邦机动车安全标准(FMVSS)提供基础，以保护尽可能多的人口。目前的FMVSS是基于标准的假人尺寸(第50个百分位数的男性混合III撞车假人，1.78米，77公斤，BMI=24.3公斤/平方米)。考虑到肥胖司机的高比例和体重分布的不同影响，在确定交通安全和公共卫生标准时，同样重要的是考虑更大的身体尺寸、更大的BMI和更多的体型差异。

DESCRIPTION (provided by applicant): Abstract: Obesity, a major public health problem present in nearly one third of American adults, has been reported to increase risk of death in motor vehicle crashes (MVCs). Various mechanisms for the increased risk have been proposed, including: 1) momentum effects; 2) obesity-related comorbidities such as cardiovascular disease (CVD), diabetes, and sleep apnea; 3) post-treatment problems in the obese; and 4) vehicle design. Recent research we have conducted identified gender differences in the relationships between MVC fatality and body mass index (BMI): men (but not women) had an increased risk of death at both ends of the BMI continuum. We hypothesize that this differential association may be caused in part by differences in body weight and shape, center of gravity, and different accuracy of BMI as an obesity diagnosis standard for men and women. To evaluate this hypothesis, this project will use national MVC databases and geometric magnetic resonance imaging (MRI) assisted modeling of body variations in computer crash simulations. Specific Aim 1 is to test the effects of momentum, obesity-related comorbidities, and post-treatment on MVC outcomes for men and women in BMI and weight models using MVC data. We hypothesize that the gender differences of the influence of obesity on MVC outcomes will be mainly caused by differences in momentum effects and the co-morbidities related to obesity between men and women. Specific Aim 2 is to predict the effects of body shape and center of gravity on MVC injuries in men and women using computer crash modeling. We hypothesize that the gender differences in body weight and fat distribution, i.e., body shape, interacted with changes in velocity during the crash will have a great impact on injury severity and pattern between men and women. The findings of this project will advance our understanding of these two leading causes of death in the US. Moreover, it will provide groundwork for revisiting Federal Motor Vehicle Safety Standards (FMVSS) to protect as great a population as possible. Current FMVSS are based on standard dummy sizes (the 50th percentile male Hybrid III Crash Dummy, 1.78 m, 77 kg, BMI = 24.3 kg/m2). Given the high proportion of obese drivers and the variable effects of weight distribution, it is important to consider as well larger body size, greater BMI, and more shape variations in determining standards for traffic safety and public health.