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[BMJ发表论文]:成年期间体重改变对全因及病因特异性死亡率的影响
2019年11月29日 时讯速递, 进展交流 暂无评论

Research

Weight change across adulthood in relation to all cause and cause specific mortality: prospective cohort study

Chen Chen,  Yi Ye, Yanbo Zhang, et al

BMJ 2019;367:l5584 doi: https://doi.org/10.1136/bmj.l5584

Objective 目的

To investigate the association between weight changes across adulthood and mortality.

研究成年期间体重改变与死亡率的相关性

Design 实验设计

Prospective cohort study.

前瞻队列研究

Setting 场景

US National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2014.

1988-94年与1999-2014年美国健康与营养调查 (NHANES)

Participants 研究人群

36 051 people aged 40 years or over with measured body weight and height at baseline and recalled weight at young adulthood (25 years old) and middle adulthood (10 years before baseline).

36051名年龄40岁以上的居民,测定基线体重与身高,回忆青年(25岁)及中年(基线测定前10年)时体重

Main outcome measures 主要预后指标

All cause and cause specific mortality from baseline until 31 December 2015.

从基线至2015年12月31日全因及病因特异性死亡率

Results 结果

During a mean follow-up of 12.3 years, 10 500 deaths occurred. Compared with participants who remained at normal weight, those moving from the non-obese to obese category between young and middle adulthood had a 22% (hazard ratio 1.22, 95% confidence interval 1.11 to 1.33) and 49% (1.49, 1.21 to 1.83) higher risk of all cause mortality and heart disease mortality, respectively. Changing from obese to non-obese body mass index over this period was not significantly associated with mortality risk. An obese to non-obese weight change pattern from middle to late adulthood was associated with increased risk of all cause mortality (1.30, 1.16 to 1.45) and heart disease mortality (1.48, 1.14 to 1.92), whereas moving from the non-obese to obese category over this period was not significantly associated with mortality risk. Maintaining obesity across adulthood was consistently associated with increased risk of all cause mortality; the hazard ratio was 1.72 (1.52 to 1.95) from young to middle adulthood, 1.61 (1.41 to 1.84) from young to late adulthood, and 1.20 (1.09 to 1.32) from middle to late adulthood. Maximum overweight had a very modest or null association with mortality across adulthood. No significant associations were found between various weight change patterns and cancer mortality.

在平均 12.3 年随访期间,共发生10 500例死亡。与保持正常体重者相比,从青年至中年期间体重由非肥胖变为肥胖者全因死亡率和心脏疾病死亡率分别增加 22% (风险比 1.22, 95% 可信区间 1.11 to 1.33) 和 49% (1.49, 1.21 to 1.83) 。在此期间从肥胖变为非肥胖BMI者死亡风险无显著改变。从成年中期至晚期由肥胖变为非肥胖者全因死亡率 (1.30, 1.16 to 1.45) 和心脏病死亡率 (1.48, 1.14 to 1.92) 升高,而此期间从非肥胖变为肥胖与死亡风险无关。成年期间保持肥胖状态始终伴随全因死亡风险增加;从青年至成年中期风险比为 1.72 (1.52 to 1.95),从青年至成年晚期风险比为 1.61 (1.41 to 1.84),从成年中期至晚期风险比为 1.20 (1.09 to 1.32)。成年期间最大超重与死亡率之间仅有轻度相关或不相关。各种体重变化方式与肿瘤死亡率之间无相关性。

Conclusions 结论

Stable obesity across adulthood, weight gain from young to middle adulthood, and weight loss from middle to late adulthood were associated with increased risks of mortality. The findings imply that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, is important for preventing premature deaths in later life.

成年期间维持肥胖状态,从青年至中年期间体重增加,以及从成年中期至晚期体重下降均伴随死亡风险增加。这些发现提示,成年期间维持正常体重,尤其是在成年早期避免体重增加,对于预防过早死亡非常重要。

评论[仅代表个人观点]

  • 肥胖与体重增加带来的风险不言而喻
  • 好像千金难买老来瘦也不太对:p

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