Department of Epidemiology, Clinical Research and Community Health, Faculty of Medicine, Fez University, BP 1893, Km 2.2 Route Sidi Hrazem, Fez, Morocco.
J Aging Health. 2010 Feb;22(1):68-83. doi: 10.1177/0898264309349422. Epub 2009 Nov 17.
To investigate the relationship between mortality and BMI in older people, taking into account other established mortality risk factors.
A total of 3,646 French community dwellers aged 65 years and older from PAQUID cohort study were included. Cox proportional-hazards analysis was used to assess association between BMI and mortality.
Death occurred in 54.1% of the cohort more than 13 years: 68.99% of the underweight (BMI <19), 52.13% of the obese (BMI >30), 51.66% of the overweight (BMI 25-30), and 51.79% of the reference participants (BMI 22-25) died.The relative risk of death as a function of BMI, adjusted for gender and age, formed a U-shaped pattern, with larger risks associated with lower BMI (<22.0) and for BMI of 25.0 to 30.0 and BMI >/=30. (BMI 22.0-24.9 was the reference.) After adjustment for demographic factors, smoking history, and comorbidity, increased mortality risk persisted in underweight older people, BMI <18.5 and BMI 18.5-22 (respectively, HR = 1.45, 95% CI 1.17-1.78; HR = 1.27, 95% CI 1.12-1.43) compared with reference. Overweight (BMI 25-29.9) and obesity (>/=30) were not associated with increased mortality compared with the reference category (respectively, HR = 0.98, 95% IC 0.88-1.10; HR = 1.06, 95% IC 0.89-1.27). Similar relationships persisted for disabled participant. For nondisabled participant disability did not alter the associations for BMI of 25.0 and higher but for BMI less than 22.0, the risks become insignificantly different from those for the reference group.
BMI below 22 kg/ m(2) is a risk factor for 13-year mortality in older people, but our findings suggest that overweight and obesity may not be associated to mortality after adjustment for established mortality risk factors.
探讨考虑到其他已确立的死亡风险因素后，老年人的死亡率与 BMI 的关系。
本研究纳入了来自 PAQUID 队列研究的 3646 名年龄在 65 岁及以上的法国社区居民。采用 Cox 比例风险分析评估 BMI 与死亡率之间的关系。
在超过 13 年的随访中，队列中有 54.1%的人死亡：体重不足（BMI<19）的人中有 68.99%，肥胖（BMI>30）的人中有 52.13%，超重（BMI 25-30）的人中有 51.66%，参考组（BMI 22-25）的人中有 51.79%死亡。调整性别和年龄后，BMI 与死亡风险的相对风险呈 U 型模式，较低的 BMI（<22.0）和 BMI 为 25.0 至 30.0 和 BMI>/=30.0 与更大的风险相关（BMI 22.0-24.9 为参考）。在调整人口统计学因素、吸烟史和合并症后，体重不足的老年人（BMI<18.5 和 BMI 18.5-22）死亡率仍然较高，与参考组相比（分别为 HR=1.45，95%CI 1.17-1.78；HR=1.27，95%CI 1.12-1.43）。与参考组相比，超重（BMI 25-29.9）和肥胖（>/=30）与死亡率增加无关（分别为 HR=0.98，95%CI 0.88-1.10；HR=1.06，95%CI 0.89-1.27）。对于残疾参与者，类似的关系仍然存在。对于非残疾参与者，残疾并没有改变 BMI 为 25.0 及更高的关联，但对于 BMI 小于 22.0，风险变得与参考组没有显著差异。
BMI 低于 22kg/m2 是老年人 13 年死亡率的一个危险因素，但我们的研究结果表明，在调整了已确立的死亡风险因素后，超重和肥胖可能与死亡率无关。
