Abstract
王俊,高玉堂,王学励,刘恩菊,张玉兰,袁剑敏.上海市中老年男性体重指数与死亡的前瞻性研究[J].Chinese journal of Epidemiology,2005,26(6):394-399
上海市中老年男性体重指数与死亡的前瞻性研究
A prospective cohort study on bodymass index and mortality amongmiddle-aged and elderlymen in urban Shanghai
Received:August 24, 2004  
DOI:
KeyWord: 体重指数  死亡率  年龄  前瞻性研究
English Key Word: Body mass index  Mortality  Age  Prospective study
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Author NameAffiliationE-mail
WANG Jun The Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China  
GAO Yu-tang The Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China ytgao@online.sh.cn 
WANG Xue-li The Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China  
LIU En-ju The Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China  
ZHANG Yu-lan The Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China  
YUAN Jian-min The Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China  
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Abstract:
      目的探讨上海市区中老年男性体重指数(BMI)与死亡的关系及年龄对这种关系的影响。方法1986年1月至1989年9月调查上海市区45~64岁男性居民18244人,每年上门随访一次;用Cox比例风险模型计算相对危险度(RR)。结果至2002年度随访结束,全队列共随访235762人年,人均随访12.9年,在此期间共死亡3365人。在不吸烟者中,相对于正常BMI组(BMI18.5~23.9),低BMI组(BMI>18.5)、超重组(BMI24~27.9)和肥胖组(BMI≥28)总死亡RR值分别为1.20、1.12和1.61;在不吸烟者中去除随访开始头5年随访资料后,三组相应的RR值分别为1.01、1.12和1.75。结肠癌和心脑血管疾病死亡危险性随BMI增加而上升;除肿瘤和心脑血管疾病之外的死亡,其中主要为一些感染性疾病死亡的危险性在低BMI组显著升高,去除随访开始头5年随访资料对此结果无明显影响。在基线调查时≥55岁的对象中,肥胖组总死亡危险性上升更明显;而在<55岁的对象中,BMI与总死亡无显著相关。结论上海市区的中老年男性中肥胖会增加总死亡危险性,在年龄较大者中这种趋势更明显;结肠癌及心脑血管疾病死亡危险性随BMI增加而上升;感染性疾病的死亡危险性则在低BMI组显著升高。
English Abstract:
      Objective To examine the association betw een body mass index (BMI) and mortality as well as the effect of age on it among middle aged and elderly men in urban area of Shang hai. Methods A total of 18 244 male subjects ag ed 45 64 years r esided in urban area of Shanghai were enrolled in the study during January 1, 1986 through September 30, 1989, and were actively follow ed under annual visits. Cox propor tional hazards model was used to estimate the r elative r isks(RR). Results By the end of the follow up process in 2002, a total number of 235 762 person years was accumulated in the cohort, with an average of 12. 9 years per subject. A total number of 3365 deaths including 1381 from cancer and 1165 from car dio and cerebro vascular diseases (CVD), was identified during the follow up period. Compared with those under normal BMI(BMI 18. 5 23. 9), the RRs of death for all causes of death among groups at low BM I(BMI< 18. 5), overweight(BMI 24 27. 9) and obesity (BMI 28) were 1. 20, 1. 12 and 1. 61,respectively, among non smokers after adjustment for age, alcohol consumption and level of education.After ex cluding the numbers observ ed dur ing the first 5 y ears of follow up, the corr esponding RRs became 1.01, 1.12, and 1.75, respectively. The risk of deaths from colon cancer or CVD increased along with the increase o f BMI, w hile the risk of non cancer and non CVD deaths, mostly deat hs from infectious diseases, increased sig nificantly in the group of low BMI. Among those aged 55 years at baseline surv ey, the risk for all causes of death increased more significantly with those hav ing obesity. However, among those who were younger than 55 years of age, no significant corr elatio n between BMI and overall mortality was noticed. Conclusion A positive relationship betw een obesity and total mortality w as obser ved in the middle aged and elderly men in urban Shanghai. The association w as mo re obvious among the elderly while the risk of deaths from colon cancer or CVD rose along with the increase of BMI. The risk of death from infectious disease increased significantly in the group with low BMI.
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