Obesity-Related Variables and Motor Vehicle Injury

摘要：肥胖是近三分之一的美国成年人存在的主要公共卫生问题，据报道，肥胖会增加机动车碰撞（MVCs）中的死亡风险。风险增加的各种机制已被提出，包括：1)动量效应；2)肥胖相关的合并症，如心血管疾病（CVD）、糖尿病和睡眠呼吸暂停；3)肥胖患者的治疗后问题；4)车辆设计。我们最近进行的研究确定了MVC死亡率和身体质量指数（BMI）之间关系的性别差异：男性（而不是女性）在BMI连续体的两端死亡风险都增加。我们假设，这种不同的关联可能部分是由体重和体型、重心的差异以及作为肥胖诊断标准的BMI的不同准确性引起的。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）辅助的人体变化计算机碰撞模拟建模。具体目标1是使用MVC数据在BMI和体重模型中测试动量、肥胖相关合并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结局影响的性别差异主要是由动量效应和男性与女性肥胖相关的合并症的差异引起的。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女MVC损伤的影响。我们假设，体重和脂肪分布的性别差异，即身体形状，与碰撞过程中速度的变化相互作用，将对男女之间的损伤严重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，它将为重新修订联邦机动车辆安全标准（FMVSS）提供基础，以保护尽可能多的人口。目前的FMVSS是基于标准假人的尺寸（第50百分位男性混合III碰撞假人，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可变影响，在确定交通安全和公共卫生标准时，考虑更大的身体尺寸、更高的BMI和更多的形状变化是很重要的。

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.