極端に肥満の女性の死亡率,心臓および血管のアウトカム

Kathleen McTigue¹, Joseph C Larson, Alice Valoski

¹Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa 15213, USA. mctiguem@.edu

JAMA

|July 6, 2006

まとめ

極端な肥満は,女性の心血管疾患と死亡リスクを大幅に増加させ,体重カテゴリーを超えてリスクがエスカレートします. これらのリスクは,糖尿病や高血圧などの疾患によってしばしば媒介されます.

科学分野:

心血管の健康についてです.
肥満に関する研究
エピデミオロジーエピデミオロジー

背景:

体重指数 (BMI) が30以上と定義される肥満は,肥満1 (30-34.9),肥満2 (35-39.9),極度の肥満 (≥40) とに分類されます.
極端な肥満は米国で急速に増加しているが,それに関連する健康リスクについては,さらなる特徴づけが必要である.

研究の目的:

女性の様々な臨床体重カテゴリーにおける心血管疾患と死亡リスクの違いを調査する.
極端な肥満に関連する健康リスクに特に焦点を当てること.

主な方法:

女性の健康イニシアチブの観察研究から90,185人の女性におけるインシデント死亡率と心血管疾患のアウトカムの分析.
追跡期間は平均7.0年であり,データは1993年10月1日から2004年8月31日まで収集された.
結果には,死亡率,冠動脈疾患,糖尿病,高血圧の発生率が含まれていました.

主要な成果:

1万人年あたりの全因死亡率は,体重カテゴリーによって増加し,通常のBMIから極度の肥満まで増加した.
調整された分析では,体重による死亡率と冠動脈疾患のリスクは,人種/民族によって異なっていないことが示された.
糖尿病,高血圧,高脂血症は,肥満に関連する死亡率と冠動脈疾患のリスクの大部分を媒介することが判明しました.

結論:

肥満をBMI30以上で定義するだけでは,個人および人口の健康リスクの誤った解釈につながる可能性があります.
極端な肥満の増加は,進行中の肥満流行の健康効果と関連するコストを悪化させる可能性が高い.

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