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体重指数与全因死亡率之间的关联:系统性审查和元分析
Natasha Wiebe1, Anita Lloyd1, Ellen T Crumley2
1Department of Medicine, University of Alberta, Edmonton, Canada.
概括
禁食胰岛素和炎症标志物可能会混体质指数 (BMI) 和死亡率之间的联系. 重新检查肥胖问题
科学领域:
- 代谢健康和流行病学
- 肥胖研究的研究.
- 公共卫生 公共卫生
背景情况:
- 体重指数 (BMI) 和死亡率之间的关联是复杂的,并可能被代谢因素所混.
- 超胰岛素血症和慢性炎症与各种健康结果有关,但它们在调解BMI-死亡率关联中的作用需要进一步调查.
研究的目的:
- 为了确定BMI和死亡风险之间的平均关联.
- 调查如何调整禁食胰岛素和炎症标志物改变BMI与死亡率的关系.
- 批判性地重新审视肥胖在导致过度死亡率中的作用.
主要方法:
- 在2020年发表的研究中,对MEDLINE和EMBASE的系统文献搜索.
- 包括对成年参与者的研究,评估BMI和生命状态.
- 根据BMI对所有原因死亡率的元回归分析,在数据允许的情况下对禁食胰岛素和炎症标志物进行调整.
主要成果:
- 纳入了154项研究,参与者超过660万人.
- 只有3.2%的研究对炎症标志物进行了调整;没有人对禁食胰岛素进行了调整.
- 在心血管,COVID-19,重症患者和手术患者群体中观察到较高的BMI和较低的死亡率之间的显著反向关联,即使在某些情况下进行调整后.
- 对于一般人群,癌症或非传染性疾病群体,相关性并不显著.
- 在研究中发现了非常大的异质性 (I2 ≥97%).
结论:
- 肥胖作为过度死亡率的主要驱动因素的作用需要重新审视.
- 需要进一步的研究来阐明高胰岛素血症和慢性炎症的有害影响.
- 像禁食胰岛素和炎症这样的代谢因素可能会混观察到的BMI-死亡率关系.
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