Must A, Jacques P F, Dallal G E, Bajema C J, Dietz W H
Epidemiology Program, USDA Human Nutrition Research Center, Tufts University, Boston, MA 02111.
N Engl J Med. 1992 Nov 5;327(19):1350-5. doi: 10.1056/NEJM199211053271904.
Overweight in adults is associated with increased morbidity and mortality. In contrast, the long-term effect of overweight in adolescence on morbidity and mortality is not known.
We studied the relation between overweight and morbidity and mortality in 508 lean or overweight adolescents 13 to 18 years old who participated in the Harvard Growth Study of 1922 to 1935. Overweight adolescents were defined as those with a body-mass index that on two occasions was greater than the 75th percentile in subjects of the same age and sex in a large national survey. Lean adolescents were defined as those with a body-mass index between the 25th and 50th percentiles. Subjects who were still alive were interviewed in 1988 to obtain information about their medical history, weight, functional capacity, and other risk factors. For those who had died, information on the cause of death was obtained from death certificates.
Overweight in adolescent subjects was associated with an increased risk of mortality from all causes and disease-specific mortality among men, but not among women. The relative risks among men were 1.8 (95 percent confidence interval, 1.2 to 2.7; P = 0.004) for mortality from all causes and 2.3 (95 percent confidence interval, 1.4 to 4.1; P = 0.002) for mortality from coronary heart disease. The risk of morbidity from coronary heart disease and atherosclerosis was increased among men and women who had been overweight in adolescence. The risk of colorectal cancer and gout was increased among men and the risk of arthritis was increased among women who had been overweight in adolescence. Overweight in adolescence was a more powerful predictor of these risks than overweight in adulthood.
Overweight in adolescence predicted a broad range of adverse health effects that were independent of adult weight after 55 years of follow-up.
成年人超重与发病率和死亡率增加相关。相比之下，青少年超重对发病率和死亡率的长期影响尚不清楚。
我们研究了508名13至18岁的瘦或超重青少年的超重与发病率和死亡率之间的关系，这些青少年参与了1922年至1935年的哈佛生长研究。超重青少年被定义为那些在两次测量中身体质量指数大于一项大型全国性调查中同年龄、同性别的受试者第75百分位数的人。瘦青少年被定义为身体质量指数在第25至50百分位数之间的人。1988年对仍在世的受试者进行了访谈，以获取他们的病史、体重、功能能力和其他风险因素的信息。对于已死亡的人，从死亡证明中获取死亡原因的信息。
青少年受试者超重与男性各种原因导致的死亡风险增加以及特定疾病死亡率增加相关，但女性并非如此。男性中，各种原因导致的死亡相对风险为1.8（95%置信区间为1.2至2.7；P = 0.004），冠心病死亡相对风险为2.3（95%置信区间为1.4至4.1；P = 0.002）。青少年时期超重的男性和女性患冠心病和动脉粥样硬化的发病风险增加。青少年时期超重的男性患结直肠癌和痛风的风险增加，女性患关节炎的风险增加。青少年超重比成年后超重更能有力地预测这些风险。
经过55年的随访，青少年超重预示着一系列广泛的不良健康影响，且这些影响独立于成年后的体重。
