Bender Ralf, Zeeb Hajo, Schwarz Martin, Jöckel Karl-Heinz, Berger Michael
Institute for Quality and Efficiency in Health Care, Dillenburger Str. 27, Cologne D-51105, Germany.
J Clin Epidemiol. 2006 Oct;59(10):1064-71. doi: 10.1016/j.jclinepi.2006.01.006. Epub 2006 May 30.
To assess the relation between body mass index (BMI) and the risk of death from various causes in a prospective cohort study.
In 6,192 obese patients (BMI > or =25 kg/m(2)) with mean BMI 36.6 kg/m(2) (SD 6.1) and mean age 40.4 years (SD 12.9) who had been referred to the obesity clinic of the Heinrich-Heine-University Düsseldorf, Germany, between 1961 and 1994, there were 1,058 deaths from all causes during a median follow-up time of 14.8 years. We calculated standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) for death from predefined groups of diseases by using Germany as reference population.
In both sexes, risk of death from cardiovascular diseases (men: SMR = 2.2, CI 1.9-2.5; women: SMR = 1.6, CI 1.5-1.8), from diabetes (men: SMR = 5.4, CI 3.2-8.7; women: SMR = 3.5, CI 2.6-4.8), and in men from digestive diseases (SMR = 1.6, CI 1.01-2.3) was significantly increased. In contrast to other studies, an association between obesity and all-cancer mortality could not be found. Only in morbidly obese women (BMI > or =40 kg/m(2)), all-cancer mortality was significantly increased (SMR = 1.5, CI 1.1-1.9).
Obesity is associated with increased risk of death from cardiovascular diseases and diabetes in both sexes, and from diseases of the digestive system in men.
在一项前瞻性队列研究中评估体重指数（BMI）与各种原因导致的死亡风险之间的关系。
1961年至1994年间，德国杜塞尔多夫海因里希-海涅大学肥胖门诊收治了6192例肥胖患者（BMI≥25kg/m²），平均BMI为36.6kg/m²（标准差6.1），平均年龄40.4岁（标准差12.9）。在中位随访时间14.8年期间，共有1058例患者死于各种原因。我们以德国作为参照人群，计算了预定义疾病组死亡的标准化死亡比（SMR）及其95%置信区间（CI）。
在男性和女性中，心血管疾病死亡风险（男性：SMR = 2.2，CI 1.9 - 2.5；女性：SMR = 1.6，CI 1.5 - 1.8）、糖尿病死亡风险（男性：SMR = 5.4，CI 3.2 - 8.7；女性：SMR = 3.5，CI 2.6 - 4.8）以及男性消化系统疾病死亡风险（SMR = 1.6，CI 1.01 - 2.3）均显著升高。与其他研究不同，未发现肥胖与所有癌症死亡率之间存在关联。仅在病态肥胖女性（BMI≥40kg/m²）中，所有癌症死亡率显著升高（SMR = 1.5，CI 1.1 - 1.9）。
肥胖与男性和女性心血管疾病及糖尿病死亡风险增加有关，且与男性消化系统疾病死亡风险增加有关。
