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過剰体重や肥満に関連する病気の負担
A Must1, J Spadano, E H Coakley
1Department of Family Medicine and Community Health, Tufts University School of Medicine, Boston, MA 02111, USA. amust@hnrc.tufts.edu
JAMA
|November 5, 1999
まとめ
体重過多と肥満は,特に若い成人では,2型糖尿病や胆囊疾患を含む複数の健康状態のリスクを大幅に高めます. 肥満に対処することは,これらの重篤な併発性疾患の予防に不可欠です.
科学分野:
- 公衆衛生と流行病学について
- 肥満に関する研究
- 慢性疾患管理について
背景:
- 米国における過体重と肥満の増加率は,慢性疾患の負担に大きく寄与しています.
- 体重状態と特定の健康状態の間の関係を理解することは,公衆衛生イニシアチブにとって非常に重要です.
研究 の 目的:
- 体重状態の関係 (重量や肥満の度合いなど) と,米国の成人の集団における特定の健康状態の流行の関係を調べる.
- 過剰体重と肥満の重度が慢性疾患の発生とどのように相関するかを分析する.
主な方法:
- 1988年から1994年にかけて実施された第3回全国保健栄養調査 (NHANES III) の全国的に代表的な横断調査から得られたデータを使用した.
- 25歳以上成人16,884人のデータを分析し,ボディマス指数 (BMI) によって体重過多および肥満のグループ (BMI ≥25 kg/m2) に分類した.
- 2型糖尿病,胆囊疾患,冠動脈疾患,高血圧,高コレステロール,高血圧,骨関節炎の罹患率を評価した.
主要な成果:
- 米国の成人の半数以上 (63%の男性,55%の女性) は,過体重または肥満 (BMI ≥25 kg/m2) と分類されました.
- ほとんどの健康状態の有病率 (PR) の有意で段階的な増加は,男性における冠動脈疾患と両性における高コレステロールを除いて,BMIの重度が増加するにつれて観察されました.
- 55歳未満の重度の肥満者 (BMI ≥40 kg/m2) は,2型糖尿病と胆囊疾患の最高PRを示した. 流行率は,若い成人では一般的に高く,体重が高いすべての人種/民族サブグループで増加しました.
- 2つ以上の健康状態を持つ人の割合は,すべての人口集団で体重状態のカテゴリーの増加とともに増加しました.
結論:
- 米国成人の半数以上が体重過多または肥満で,公衆衛生上の大きな懸念を強調しています.
- 肥満に関連した併発性疾患の高い罹患率は,肥満に関連する疾患の管理に限るのではなく,肥満の予防と治療に焦点を当てた包括的な戦略の緊急の必要性を強調しています.
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