Abstract
赵连成,周北凡,武阳丰,李莹,杨军.体重指数与死亡的前瞻性研究[J].Chinese journal of Epidemiology,2002,23(1):24-27
体重指数与死亡的前瞻性研究
A prospective study on body mass index and mortality
Received:August 29, 2001  
DOI:
KeyWord: 体重指数  死亡率  前瞻性研究  相对危险度
English Key Word: Body mass index(BMI)  Mortality  Prospective study  Relative risk
FundProject:国家“九五”科技攻关资助项目 ( 96 90 6 0 2 0 1)
Author NameAffiliation
ZHAO Liancheng Department of Epidemiology Fu Wai Hospital Peking Union Medical College Chinese Academy of Medical Sciences, Beijing 100037, China 
ZHOU Beifan Department of Epidemiology Fu Wai Hospital Peking Union Medical College Chinese Academy of Medical Sciences, Beijing 100037, China 
WU Yangfeng Department of Epidemiology Fu Wai Hospital Peking Union Medical College Chinese Academy of Medical Sciences, Beijing 100037, China 
LI Ying Department of Epidemiology Fu Wai Hospital Peking Union Medical College Chinese Academy of Medical Sciences, Beijing 100037, China 
YANG Jun Department of Epidemiology Fu Wai Hospital Peking Union Medical College Chinese Academy of Medical Sciences, Beijing 100037, China 
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Abstract:
      目的探讨不同体重指数(BMI)水平与总死亡及不同死因死亡的关系。方法1982~1985年在我国不同地区的10组人群中(年龄35~59岁)进行心血管病危险因素调查,并对研究对象中无脑卒中、无心肌梗死及无恶性肿瘤史的30560人(男性15723人,女性14837人)随访至1999~2000年,登记各种死亡的发生情况。结果在平均15.2年的随访中,共死亡3212例,其中冠心病和脑卒中共死亡676例,恶性肿瘤死亡1281例,其他原因死亡1255例。用Cox比例风险回归模型(调整年龄、性别)估计低BMI组(BMI<18.5)、正常BMI组(BMI为18.5~23.9)、超重组(BMI为24~27.9)和肥胖组(BMI≥28)总死亡的相对危险分别为1.21,1.00,0.91,1.12,呈“U”形关系,当同时剔除前5年死亡病例及吸烟者后,低BMI组死亡的相对危险降低,而肥胖组增加,正常BMI组的相对危险最小。随着BMI水平的上升,冠心病和脑卒中死亡的相对危险增加,恶性肿瘤死亡的相对危险降低,其他原因死亡的相对危险与BMI水平呈“U”形关系,当剔除早期死亡病例及吸烟者后,这些趋势依然存在。结论BMI在正常范围内,总死亡的相对危险较低,且冠心病和脑卒中死亡、恶性肿瘤死亡及其他原因死亡的综合风险也处于相对较低水平,
English Abstract:
      Objective To assess the relationship between body mass index (BMI, weight in kilograms divided by the square of height in meters) and both all-causes mortality and mortality from specific cause. Methods Cardiovascular disease (CVD) risk factors were studied in 1982-1985 on more than 30 thousands participants aged 35-59 from 10 Chinese populations. 30 560 participants ( 15 723 for men, 148 837 for women) without known myocardial infraction, stroke or cancer was followed from 1999 to 2000. All-causes of death were documented. Results Three thousand two hundred and twelve death cases occurred during follow-up of average 15.2 years, including 676 CVD (coronary heart disease and stroke) deaths, 1 281 cancer deaths and 1 255 deaths for other reasons. Cox proportional hazards model adjusting age and gender showed that the relative risks of all causes of death in groups of low BMI (BMI 18.5), normal BMI (BMI from 18.5 to 23.9), overweight (BMI from 24 to 27.9) and obesity (BMI≥28) which were defined according to the strata of BMI for Chinese were 1.21 (95%CI: 1.10- 1.33), 1.00, 0.91 (95%CI: 0.82- 1.01) and 1.12 (95%CI: 0.93- 1.37), respectively ("U" shaped relation). The relative risk of low BMI group (RR= 1.01, 95%CI: 0.84- 1.21) was not significant different and the relative risk of obesity significantly increased (RR= 1.36, 95%CI: 1.04- 1.80) while the lowest relative risk was in normal BMI group. The relative risks increased for CVD death, but decreased for cancer death with increased levels of BMI and a "U" shaped relationship was found between BMI groups and mortality for other reasons, which remained after excluding the early death and smokers. Conclusion BMI in normal level was not only related to low risk of all causes of death, but also with relative low risk of CVD, cancer and other deaths. Data were important to public health.
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