身体质量指数和全因死亡率:对四大洲239项前性研究的个人参与者数据进行元分析
Lancet (London, England)
|July 18, 2016
概括
在全球范围内,超重和肥胖显著增加死亡风险. 这项前性研究的元分析证实,多余的体重指数 (BMI) 与不同人群的死亡率有关.
科学领域:
- 流行病学
- 公共卫生
- 生物统计学
背景情况:
- 全球超重和肥胖率的上升是一个重大的公共卫生挑战.
- 了解体重指数 (BMI) 与死亡率之间的关联对于人口健康策略至关重要.
- 之前的研究可能因吸烟,先前存在的疾病和早期随访期等因素而混.
研究的目的:
- 对前性研究中的个人参与者数据进行元分析,以评估BMI与全因死亡率之间的关系.
- 通过分析从未吸烟者的数据来限制混和反向因果关系,排除患有先前疾病的个人,并排除前五年的随访.
- 检查这些协会在不同大陆和人口群体之间的一致性.
主要方法:
- 对239项涉及亚洲,澳大利亚/新西兰,欧洲和北美超过1060万参与者的前性研究进行个人参与者数据元分析.
- 主要分析的重点是395万从未吸烟的人,在招募时没有慢性疾病,他们至少存活了五年,记录了385,879例死亡.
- 对所有死因的危险比率 (HRs) 进行了计算,根据研究,年龄和性别进行了调整,相对于BMI为22. 525. 0 kg/ m2.
主要成果:
- 所有原因的死亡率在20.0~25.0 kg/ m2之间是最低的,在较低的BMI (15.0~18.5 kg/ m2) 和整个超重范围 (BMI 25.0 kg/ m2及以上) 中显著增加.
- 1级肥胖 (30. 0~35. 0公斤/ 公尺2) HR=1. 45, 2级 (35. 0~40. 0公斤/ 公尺) HR=1. 94, 3级 (40. 0~60. 0公斤/ 公尺) HR=2. 76.
- 对于BMI> 25. 0 kg/ m2的患者,死亡率与BMI相比呈日志线性增长,年轻人和男性每增加5 kg/ m2的风险较老年人和女性高.
结论:
- 在四大洲, 超重和肥胖都与死亡率上升有关.
- 这些发现支持旨在解决所有过度肥胖问题的公共卫生策略.
- 与BMI过高相关的风险在年轻人群和男性中尤为明显.
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