Imai Kumiko, Gregg Edward W, Chen Yiling J, Zhang Ping, de Rekeneire Nathalie, Williamson David F
1Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Obesity (Silver Spring). 2008 Feb;16(2):402-8. doi: 10.1038/oby.2007.70.
To examine the association of BMI with functional status and self-rated health among US adults and how the association differs by age and sex.
All analyses are based on the National Health Interview Survey (NHIS), 1997-2005, a yearly, representative study of the US household population. We pooled all survey years and fitted logistic regression for the two sexes and three age strata (ages 18-44, 45-64, and > or =65).
Our study found that although underweight and severe obesity are consistently associated with increased disability and poorer health status, overweight and moderate obesity show associations that vary considerably by age and sex. For men, the adjusted odds ratios (ORs) for disability and poor/fair self-rated health tended to be lowest among overweight persons, especially for ages > or =45. Among men with moderate obesity, the risk of disability was elevated for ages 18-44 but lower for ages > or =65. For women, the adjusted ORs for disability and poor/fair self-rated health tended to be lowest among normal-weight persons, particularly for ages < or =45. Compared to normal-weight counterparts, overweight women aged > or =65 had a lower risk of disability but a somewhat elevated risk of poor/fair self-rated health.
The results suggest that the association of BMI with functional status and self-rated health varies significantly across ages and sexes. The variations in the association of BMI with functional status and self-rated health suggest that a single "ideal body weight category" may not be appropriate for all persons or all health outcomes.
研究美国成年人中体重指数（BMI）与功能状态及自评健康状况之间的关联，以及这种关联在年龄和性别上的差异。
所有分析均基于1997 - 2005年的美国国家健康访谈调查（NHIS），这是一项对美国家庭人口的年度代表性研究。我们汇总了所有调查年份的数据，并对两个性别和三个年龄层（18 - 44岁、45 - 64岁以及≥65岁）进行了逻辑回归分析。
我们的研究发现，虽然体重过轻和重度肥胖一直与残疾增加和健康状况较差相关，但超重和中度肥胖所显示的关联在年龄和性别上有很大差异。对于男性，超重者中残疾和自评健康状况为差/一般的调整后比值比（OR）往往最低，尤其是在年龄≥45岁的人群中。在中度肥胖的男性中，18 - 44岁人群的残疾风险升高，而≥65岁人群的残疾风险较低。对于女性，正常体重者中残疾和自评健康状况为差/一般的调整后OR往往最低，特别是在年龄≤45岁的人群中。与正常体重的女性相比，年龄≥65岁的超重女性残疾风险较低，但自评健康状况为差/一般的风险略有升高。
结果表明，BMI与功能状态及自评健康状况之间的关联在年龄和性别上存在显著差异。BMI与功能状态及自评健康状况关联的差异表明，单一的“理想体重类别”可能不适用于所有人或所有健康结果。
