Karnehed Nina, Rasmussen Finn, Kark Malin
Child and Adolescent Public Health Epidemiology Group, Department of Public Health Sciences, Karolinska Institute, Sweden.
Scand J Public Health. 2007;35(1):48-54. doi: 10.1080/14034940600858524.
The prevalence of obesity has increased threefold among Swedish men during recent decades. Knowledge from Sweden on how obese men manage in working life and become disability pensioners is sparse. The aim of this nationwide and population-based cohort study was to investigate to what extent body mass index (BMI) in young adulthood predicts later disability pension.
All Swedish men born 1952-59, who had their weight and height measured at age 18 years in the compulsory military conscription examinations, were followed up longitudinally from 1990 to 2001 with regard to receiving disability pension. Data on own socioeconomic position (1985), education and marital status (1990), parental socioeconomic position (1960), and education (1970) were obtained from censuses. For 366,929 men (81% of the eligible men) the hazard ratio for receiving disability pension was calculated with Cox regression controlling for own education, parental education, childhood and adult socioeconomic position, marital status, morbidity, and type of municipality.
Obesity in young adulthood increased the risk for disability pension later in life (1.35, 95% CI 1.19, 1.52) compared with men of normal weight. The relationship between BMI and disability pension was J-shaped with higher risks for underweight (1.14, 95% CI 1.09, 1.20) and obese men.
Obese men in Sweden are at higher risk of receiving disability pension. The relationship between BMI and disability pension is J-shaped. An important future task is to estimate the societal costs due to disability pension of obese people.
近几十年来,瑞典男性肥胖患病率增长了两倍。瑞典关于肥胖男性在工作生活中的表现以及成为残疾抚恤金领取者的相关知识较为匮乏。这项全国性基于人群的队列研究旨在调查青年时期的体重指数(BMI)在多大程度上能够预测日后的残疾抚恤金领取情况。
选取所有在1952年至1959年出生、在18岁义务兵役体检时测量过体重和身高的瑞典男性,从1990年至2001年对其领取残疾抚恤金情况进行纵向随访。通过人口普查获取关于自身社会经济地位(1985年)、教育程度和婚姻状况(1990年)、父母社会经济地位(1960年)以及教育程度(1970年)的数据。对366,929名男性(占符合条件男性的81%),采用Cox回归分析计算领取残疾抚恤金的风险比,并对自身教育程度、父母教育程度、童年及成年社会经济地位、婚姻状况、发病率和城市类型进行控制。
与体重正常的男性相比,青年时期肥胖会增加日后领取残疾抚恤金的风险(风险比为1.35,95%置信区间为1.19至1.52)。BMI与残疾抚恤金之间的关系呈J形,体重过轻(风险比为1.14,95%置信区间为1.09至1.20)和肥胖男性的风险更高。
瑞典肥胖男性领取残疾抚恤金的风险更高。BMI与残疾抚恤金之间的关系呈J形。未来一项重要任务是估算肥胖人群领取残疾抚恤金所带来的社会成本。