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【NEJM】美国研究发现BMI与死亡率的关系呈“J”型
来自美国国家癌症研究所等单位的Amy Berrington de Gonzalez等进行了一项研究，对19个前瞻性研究中的146万位年龄在19岁～84岁(中位年龄：58岁)的美国白人进行了分析，汇集了这些研究对象的年龄、学习情况、躯体功能、饮酒情况、教育和婚姻状态等指标，采用Cox回归模型来分析BMI与全因死亡率之间的风险比(hazard ratio，HR)和95%置信区间。
所有观察者的基线平均BMI为26.2，在中位数为10年(5～28年)的随访过程中，出现160,087例死亡。研究发现，在不吸烟人群中，BMI与全因死亡率的关系呈“J”型。
与BMI在22.5 ～24.9 之间的健康人群相比，BMI在15.0～18.4之间的女性全因死亡率HR为1.47，BMI在18.5～19.9之间的HR为1.14，20.0～22.4之间的HR为1.00，25.0～29.9之间的HR为1.13，30.0～34.9之间的HR为1.44，35.0～39.9之间的HR为1.88，40.0～49.9之间的HR达到了2.51。总体来说，男性与女性各分段BMI的全因死亡率HR相似，BMI低于20.0者需要加强长期随访。
结论：在成年白人中，BMI保持在20.0～24.9之间的全因死亡率最低，体重过轻、超重和肥胖都会增加死亡风险，因此，保持适当的体重非常重要!
译者：贾医生 http://www.91sqs.com/2/viewspace-64538.html
Authorsde Gonzalez, AB; Hartge, P; Cerhan, JR; Flint, AJ; Hannan, L; MacInnis, RJ; Moore, SC; Tobias, GS; Anton-Culver, H; Freeman, LB; Beeson, WL; Clipp, SL; English, DR; Folsom, AR; Freedman, DM; Giles, G; Hakansson, N; Henderson, KD; Hoffman-Bolton, J; Hoppin, JA; Koenig, KL; Lee, IM; Linet, MS; Park, Y; Pocobelli, G; Schatzkin, A; Sesso, HD; Weiderpass, E; Willcox, BJ; Wolk, A; Zeleniuch-Jacquotte, A; Willett, WC; Thun, MJ;
NEW ENGLAND JOURNAL OF MEDICINE 2010 Volume: 363 Issue: 23 Pages: 2211-2219
Abstract Background: A high body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) is associated with increased mortality from cardiovascular disease and certain cancers, but the precise relationship between BMI and all-cause mortality remains uncertain. Methods: We used Cox regression to estimate hazard ratios and 95% confidence intervals for an association between BMI and all-cause mortality, adjusting for age, study, physical activity, alcohol consumption, education, and marital status in pooled data from 19 prospective studies encompassing 1.46 million white adults, 19 to 84 years of age (median, 58). Results: The median baseline BMI was 26.2. During a median follow-up period of 10 years (range, 5 to 28), 160,087 deaths were identified. Among healthy participants who never smoked, there was a J-shaped relationship between BMI and all-cause mortality. With a BMI of 22.5 to 24.9 as the reference category, hazard ratios among women were 1.47 (95 percent confidence interval [CI], 1.33 to 1.62) for a BMI of 15.0 to 18.4; 1.14 (95% CI, 1.07 to 1.22) for a BMI of 18.5 to 19.9; 1.00 (95% CI, 0.96 to 1.04) for a BMI of 20.0 to 22.4; 1.13 (95% CI, 1.09 to 1.17) for a BMI of 25.0 to 29.9; 1.44 (95% CI, 1.38 to 1.50) for a BMI of 30.0 to 34.9; 1.88 (95% CI, 1.77 to 2.00) for a BMI of 35.0 to 39.9; and 2.51 (95% CI, 2.30 to 2.73) for a BMI of 40.0 to 49.9. In general, the hazard ratios for the men were similar. Hazard ratios for a BMI below 20.0 were attenuated with longer-term follow-up. Conclusions: In white adults, overweight and obesity (and possibly underweight) are associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9. N Engl J Med 2010;363:2211-9. 全文下载：
http://ki.se/content/1/c6/04/99/84/body_Mass10120209.pdf 呵呵，又找到一个很好的谈资了~
PS:各位园友新年快乐！ 飘过~~~~~~~~~~~~~~~~~~~~~ 呵呵，这个有意思 非常有意思，研究研究~~~~ 身体质量指数(body mass index，BMI)是应用得比较广泛的判断身体肥胖程度的指标，计算方法为BMI=体重/身高2 (Kg/cm2)
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