Neovius M, Kark M, Rasmussen F
Department of Public Health Sciences, Karolinska Institutet, Karolinska University Hospital, Norrbacka, Stockholm, Sweden.
Int J Obes (Lond). 2008 Aug;32(8):1319-26. doi: 10.1038/ijo.2008.70. Epub 2008 May 27.
Obesity and underweight in young adulthood are associated with greater risk of future disability pension. Neither underlying causes of disability pension nor whether overweight confers excess risk is established in this age group. The aim of this study was to investigate risk of future disability pension according to body mass index (BMI) in young adulthood.
BMI was measured at military conscription (1969-1994; n=1 191 027; mean age 18.3+/-0.5 years). Date and cause of disability pension, death and emigration dates were collected from national registers (1971-2006). Muscular strength, age, municipality, socioeconomic position, testing center and year were adjusted for in Cox regressions.
During 28.4 million person-years, 60 024 subjects were granted disability pension. The hazard ratios (HRs) for underweight (1.14, CI 95% 1.11-1.17), overweight (1.36, 1.32-1.40), moderate (BMI 30-34.9; 1.87, 1.76 to 1.99) and morbid obesity (BMI>or=35; 3.04, 2.72-3.40) were elevated compared to normal weight. Not adjusting for muscular strength led to overestimation of the risk in underweight (1.27, 1.24-1.31), but underestimation in overweight (1.29, 1.25-1.33), moderately (1.72, 1.62-1.82) and morbidly obese subjects (2.77, 2.48-3.09). For circulatory and musculoskeletal causes, respectively, HRs were elevated only for overweight (2.06; 1.82-2.34; 1.47; 1.39-1.55) and obesity (3.51; 2.79-4.40; 2.15; 1.94-2.38). The same applied for tumors and nervous system, but not psychiatric causes, for which underweight (1.20; 1.16-1.24) displayed similar HR as overweight (1.21; 1.16-1.27), whereas the risk in obese subjects was higher (1.60; 1.46-1.75).
The risks in overweight and obese, but not underweight, subjects were significantly elevated for each cause investigated. Although causality cannot be inferred, productivity losses associated with adverse BMI in young adulthood appear to be large.
青年期肥胖和体重过轻与未来领取残疾抚恤金的风险增加有关。该年龄组中，导致领取残疾抚恤金的潜在原因以及超重是否会带来额外风险均未明确。本研究的目的是根据青年期的体重指数（BMI）调查未来领取残疾抚恤金的风险。
在征兵时测量BMI（1969 - 1994年；n = 1191027；平均年龄18.3±0.5岁）。从国家登记处收集残疾抚恤金的日期和原因、死亡和移民日期（1971 - 2006年）。在Cox回归中对肌肉力量、年龄、市政当局、社会经济地位、检测中心和年份进行了调整。
在2840万人年期间，60024名受试者获得了残疾抚恤金。与正常体重相比，体重过轻（风险比[HRs]为1.14，95%置信区间[CI] 1.11 - 1.17）、超重（1.36，1.32 - 1.40）、中度肥胖（BMI 30 - 34.9；1.87，1.76至1.99）和病态肥胖（BMI≥35；3.04，2.72 - 3.40）的HRs升高。未对肌肉力量进行调整导致体重过轻的风险被高估（1.27，1.24 - 1.31），但超重（1.29，1.25 - 1.33）、中度肥胖（1.72，1.62 - 1.82）和病态肥胖受试者的风险被低估（2.77，2.48 - 3.09）。分别就循环系统和肌肉骨骼系统病因而言，仅超重（2.06；1.82 - 2.34；1.47；1.39 - 1.55）和肥胖（3.51；2.79 - 4.40；2.15；1.94 - 2.38）的HRs升高。肿瘤和神经系统病因也是如此，但精神病因则不然，体重过轻（1.20；1.16 - 1.24）的HR与超重（1.21；1.16 - 1.27）相似，而肥胖受试者的风险更高（1.60；1.46 - 1.75）。
对于所调查的每种病因，超重和肥胖受试者的风险显著升高，但体重过轻的受试者并非如此。尽管无法推断因果关系，但青年期不良BMI相关的生产力损失似乎很大。
