Bjørge Tone, Engeland Anders, Tverdal Aage, Smith George Davey
Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
Am J Epidemiol. 2008 Jul 1;168(1):30-7. doi: 10.1093/aje/kwn096. Epub 2008 May 13.
The prevalence of obesity in childhood and adolescence has increased worldwide. Long-term effects of adolescent obesity on cause-specific mortality are not well specified. The authors studied 227,000 adolescents (aged 14-19 years) measured (height and weight) in Norwegian health surveys in 1963-1975. During follow-up (8 million person-years), 9,650 deaths were observed. Cox proportional hazards regression was used to compare cause-specific mortality among individuals whose baseline body mass index (BMI) was below the 25th percentile, between the 75th and 84th percentiles, and above the 85th percentile in a US reference population with that of individuals whose BMI was between the 25th and 75th percentiles. Risk of death from endocrine, nutritional, and metabolic diseases and from circulatory system diseases was increased in the two highest BMI categories for both sexes. Relative risks of ischemic heart disease death were 2.9 (95% confidence interval (CI): 2.3, 3.6) for males and 3.7 (95% CI: 2.3, 5.7) for females in the highest BMI category compared with the reference. There was also an increased risk of death from colon cancer (males: 2.1, 95% CI: 1.1, 4.1; females: 2.0, 95% CI: 1.2, 3.5), respiratory system diseases (males: 2.7, 95% CI: 1.4, 5.2; females: 2.5, 95% CI: 1.4, 4.8), and sudden death (males: 2.2, 95% CI: 1.2, 4.3; females: 2.7, 95% CI: 1.1, 6.6). Adolescent obesity was related to increased mortality in middle age from several important causes.
儿童期和青少年期肥胖症在全球范围内呈上升趋势。青少年肥胖症对特定病因死亡率的长期影响尚未明确。作者研究了1963年至1975年挪威健康调查中测量过（身高和体重）的22.7万名青少年（年龄在14至19岁之间）。在随访期间（800万人年），观察到9650例死亡。使用Cox比例风险回归，将美国参考人群中基线体重指数（BMI）低于第25百分位数、在第75和第84百分位数之间以及高于第85百分位数的个体的特定病因死亡率与BMI在第25和第75百分位数之间的个体进行比较。在两个最高BMI类别中，男女因内分泌、营养和代谢疾病以及循环系统疾病导致的死亡风险均有所增加。与参考组相比，最高BMI类别中男性缺血性心脏病死亡的相对风险为2.9（95%置信区间（CI）：2.3，3.6），女性为3.7（95%CI：2.3，5.7）。结肠癌（男性：2.1，95%CI：1.1，4.1；女性：2.0，95%CI：1.2，3.5）、呼吸系统疾病（男性：2.7，95%CI：1.4，5.2；女性：2.5，95%CI：1.4，4.8）和猝死（男性：2.2，95%CI：1.2，4.3；女性：2.7，95%CI：1.1，6.6）的死亡风险也有所增加。青少年肥胖与中年期因多种重要病因导致的死亡率增加有关。
