Janssen Ian, Bacon Eric
School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Obesity (Silver Spring). 2008 Nov;16(11):2504-9. doi: 10.1038/oby.2008.400. Epub 2008 Aug 28.
The primary purpose of this study was to determine whether current and midlife obesity status provide independent information on mortality risk in elderly persons. Analyses were based on 3,238 participants from the original Framingham Heart Study (FHS) cohort who lived to at least 70 years of age and who had BMI measures from when they were in their 50s. Within this group of 70-year olds, obesity based on current BMI was associated with a 21% increased risk of mortality (P = 0.019) whereas obesity in 70-year olds based on BMI measures obtained at around 50 years of age was associated with a 55% increased risk of mortality (P < 0.0001). Compared to 70-year olds who were nonobese at both 50 and 70 years of age, mortality risk was increased by 47% (P < 0.001) in those who were obese at both 50 and 70 years of age, increased by 56% (P < 0.001) in those who were obese at 50 years of age and nonobese at 70 years of age, and not significantly different (P > 0.9) in those who were nonobese at 50 years of age and obese at 70 years of age. In summary, in this cohort of elderly adults, midlife and current BMI had independent effects on mortality risk. Specifically, although mortality risk was increased in obese older adults who were already obese at midlife, this was not the case for newly obese older adults. Conversely, nonobese older adults who were obese at midlife had an increased mortality risk. These observations imply that it is imperative to consider an elderly adult's BMI in context of their BMI at midlife.
本研究的主要目的是确定当前和中年时期的肥胖状况是否能提供有关老年人死亡风险的独立信息。分析基于来自原始弗雷明汉心脏研究（FHS）队列的3238名参与者，这些参与者至少活到70岁，并且在50多岁时测量过体重指数（BMI）。在这群70岁的人群中，基于当前BMI的肥胖与死亡风险增加21%相关（P = 0.019），而基于50岁左右时获得的BMI测量值的70岁人群中的肥胖与死亡风险增加55%相关（P < 0.0001）。与50岁和70岁时均非肥胖的70岁人群相比，50岁和70岁时均肥胖的人群死亡风险增加47%（P < 0.001），50岁时肥胖而70岁时非肥胖的人群死亡风险增加56%（P < 0.001），50岁时非肥胖而70岁时肥胖的人群死亡风险无显著差异（P > 0.9）。总之，在这群老年成年人中，中年时期和当前的BMI对死亡风险有独立影响。具体而言，虽然中年时已肥胖的肥胖老年人死亡风险增加，但新肥胖的老年人并非如此。相反，中年时肥胖的非肥胖老年人死亡风险增加。这些观察结果表明，必须结合老年人中年时的BMI来考虑其当前的BMI。
