Zhu Shankuan, Heo Moonseong, Plankey Michael, Faith Myles S, Allison David B
New York Obesity Research Center, St. Luke's/Roosevelt Hospital, Institute of Human Nutrition, Columbia University College of Physicians & Surgeons, New York, NY, USA.
Ann Epidemiol. 2003 Apr;13(4):286-93. doi: 10.1016/s1047-2797(02)00417-9.
This study tests whether fat mass (FM) and fat free mass (FFM) have opposite associations with mortality in a nationally representative sample of females.
Data on 13,369 female participants from National Health and Nutrition Examination Surveys (NHANES) I and II (aged 25 to 75 years) were analyzed. Mean follow-up time was 16.1 years. Ninety-seven percent of the participants with 3020 deaths were successfully followed. Subscapular and triceps skinfolds thickness were used as a FM indicator (FMI). Upper arm circumference was used as a FFM indicator (FFMI). Cox regression tested the relationships of BMI, FM and FFM with all-cause mortality adjusting for various socio-demographic variables.
BMI had a U-shaped relationship with mortality with a nadir of approximately 27 kg/m(2). When FFMI was added to the model, the relationship between BMI and mortality became more monotonic increasing. FMI showed a significant negative relationship with mortality.
Contrary to expectations, both FFMI and FMI had negative relationships with mortality. These results differ from patterns previously observed in males and may reflect sex differences in fat distribution. Research using superior measures of body fat amount and distribution may resolve these discrepancies.
本研究旨在检验在全国具有代表性的女性样本中，脂肪量（FM）和去脂体重（FFM）与死亡率是否存在相反的关联。
对来自第一次和第二次全国健康与营养检查调查（NHANES）的13369名女性参与者（年龄在25至75岁之间）的数据进行了分析。平均随访时间为16.1年。在3020例死亡的参与者中，97%得到了成功随访。肩胛下和肱三头肌皮褶厚度用作脂肪量指标（FMI）。上臂围用作去脂体重指标（FFMI）。Cox回归分析了在调整各种社会人口统计学变量的情况下，BMI、FM和FFM与全因死亡率之间的关系。
BMI与死亡率呈U形关系，最低点约为27kg/m²。当将FFMI纳入模型时，BMI与死亡率之间的关系变得更呈单调增加。FMI与死亡率呈显著负相关。
与预期相反，FFMI和FMI与死亡率均呈负相关。这些结果与之前在男性中观察到的模式不同，可能反映了脂肪分布的性别差异。使用更精确的身体脂肪量和分布测量方法的研究可能会解决这些差异。
