Williams Paul T, Hoffman Kathryn, La Isabelle
Donner Laboratory, Life Sciences Division, Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
Arterioscler Thromb Vasc Biol. 2007 Aug;27(8):1811-9. doi: 10.1161/ATVBAHA.107.141853. Epub 2007 May 17.
Although 36% of US men and 42% of US women are of normal weight, the health implications of greater weight in ostensibly normal-weight individuals are seldom acknowledged.
Self-reported physician-diagnosed incident diabetes, high cholesterol, and hypertension were compared with adult body mass index (BMI), and body circumferences in 29,139 male and 11,985 female nonsmoking runners followed prospectively for 7.7 and 7.4 years, respectively. Included among these were 20,731 men and 11,197 women who were of normal weight at baseline (BMI < 25 kg/m2). During follow-up, 2342 men (8.53%) and 499 women (4.26%) became hypertensive, 3330 men (12.2%) and 599 women (5.14%) were diagnosed with high cholesterol, and 197 men (0.68%) and 28 women (0.23%) became diabetic. Increasing BMI and waist circumference at baseline significantly increased the log odds for normal-weight men becoming hypertensive (P<0.0001), hypercholesterolemic (P<0.0001), and diabetic (P<0.02), and for normal-weight women becoming hypertensive (P=0.05). The log odds for being diagnosed with high cholesterol also increased with baseline BMI in normal-weight women (P<0.05). Relative to men with BMI < 20 kg/m2, the odds for being diagnosed with hypertension or high cholesterol increased by 45% (P=0.05) and 64% (P=0.002), respectively, for those with 20 < or = BMI < 22.5 kg/m2, and by 121% (P<0.0001) and 135% (P<0.0001), respectively, for those with 22.5 < or = BMI < 25 kg/m2. The odds for women with 22.5 < or = BMI < 25 kg/m2 developing hypertension or high cholesterol were 33% (P=0.02) and 29% (P=0.03) higher, respectively, than for women with 20 < or = BMI < 22.5 kg/m2, and 64% (P=0.0007) and 41% (P=0.008) higher, respectively, than women with BMI < 20 kg/m2. Relative to men and women with BMI < 22.5 kg/m2, the odds for developing diabetes during follow-up increased by 119% (P=0.009) and 116% (P=0.17), respectively, for those with 22.5 < or = BMI < 25 kg/m2.
Greater BMI and larger waist circumference increase the risks for hypertension, high cholesterol, and diabetes even among normal-weight nonsmoking runners, although overall risks remain relatively low vis-a-vis those for the overweight or obese.
尽管美国36%的男性和42%的女性体重正常，但表面上体重正常的个体体重增加对健康的影响却很少得到认可。
将自我报告的医生诊断的新发糖尿病、高胆固醇和高血压与成年人体重指数（BMI）以及29139名男性和11985名女性非吸烟跑步者的身体周长进行比较，这些人分别进行了7.7年和7.4年的前瞻性随访。其中包括20731名男性和11197名女性，他们在基线时体重正常（BMI<25kg/m²）。在随访期间，2342名男性（8.53%）和499名女性（4.26%）患高血压，3330名男性（12.2%）和599名女性（5.14%）被诊断为高胆固醇，197名男性（0.68%）和28名女性（0.23%）患糖尿病。基线时BMI和腰围的增加显著增加了体重正常男性患高血压（P<0.0001）、高胆固醇血症（P<0.0001）和糖尿病（P<0.02）的对数优势，以及体重正常女性患高血压的对数优势（P=0.05）。体重正常女性被诊断为高胆固醇的对数优势也随基线BMI增加（P<0.05）。与BMI<20kg/m²的男性相比，BMI在20≤BMI<22.5kg/m²的男性被诊断为高血压或高胆固醇的几率分别增加45%（P=0.05）和64%（P=0.002），而BMI在22.5≤BMI<25kg/m²的男性则分别增加121%（P<0.0001）和135%（P<0.0001）。BMI在22.5≤BMI<25kg/m²的女性患高血压或高胆固醇的几率分别比BMI在20≤BMI<22.5kg/m²的女性高33%（P=0.02）和29%（P=0.03），比BMI<20kg/m²的女性分别高64%（P=0.0007）和41%（P=0.008）。与BMI<22.5kg/m²的男性和女性相比，BMI在22.5≤BMI<25kg/m²的男性和女性在随访期间患糖尿病的几率分别增加119%（P=0.009）和116%（P=0.17）。
即使在体重正常的非吸烟跑步者中，较高的BMI和较大的腰围也会增加患高血压、高胆固醇和糖尿病的风险，尽管与超重或肥胖者相比，总体风险仍然相对较低。
