Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
PLoS One. 2011 Apr 20;6(4):e18546. doi: 10.1371/journal.pone.0018546.
The association between obesity in adults and excess morbidity and mortality is well established, but the health impact throughout adult life of being obese in early adulthood needs elucidation. We investigated somatic morbidity, including fatal morbidity, throughout adulthood in men starting adult life as obese.
Among 362,200 Danish young men, examined for military service between 1943 and 1977, all obese (defined as BMI≥31.0 kg/m(2)), and, as controls, a random 1% sample of the others was identified. In the age range of 18-25 years, there were 1,862 obese, which encompass the men above the 99.5 percentile, and 3,476 controls. Information on morbidity was obtained via national registers. Cox regression models were used to estimate the relative morbidity assessed as first incidence of disease, occurrence of disease in the year preceding death and prevalent disease at time of death.
From age 18 through 80 years the obese had an increased risk of becoming diseased by or die from a broad range of diseases. Generally, the incidence of first event, occurrence in the year prior to death, and prevalence at time of death showed the same pattern. As an example, the relative hazard of type 2 diabetes was constant throughout life at 4.9 (95% confidence intervals [CI]: 4.1-5.9), 5.2 (95% CI: 3.6-7.5), and 6.8 (95% CI: 4.6-10.1), respectively.
Our findings strongly support the continued need to avoid beginning adult life as obese, as obese young men experience an increased morbidity, including fatal morbidity, from many diseases throughout life.
成年人肥胖与发病率和死亡率过高之间的关联已得到充分证实,但肥胖对成年早期成年人健康的影响仍需阐明。我们研究了肥胖男性在成年后的整个生命过程中的躯体发病率,包括致命发病率。
在 1943 年至 1977 年期间接受兵役检查的 362200 名丹麦年轻男性中,我们确定了所有肥胖者(BMI≥31.0kg/m²),并随机抽取了其余 1%的人作为对照组。在 18-25 岁的年龄段,有 1862 名肥胖者,包括 99.5%以上的男性,以及 3476 名对照组。通过国家登记册获得发病率信息。使用 Cox 回归模型来评估相对发病率,即首次发病、死亡前一年发生疾病以及死亡时的现患疾病。
从 18 岁到 80 岁,肥胖者患多种疾病的风险增加,包括发病或死于这些疾病。通常,首次发病、死亡前一年发生疾病和死亡时现患疾病的发生率呈现出相同的模式。例如,2 型糖尿病的相对危险度在整个生命过程中始终保持不变,分别为 4.9(95%置信区间:4.1-5.9)、5.2(95%置信区间:3.6-7.5)和 6.8(95%置信区间:4.6-10.1)。
我们的研究结果强烈支持继续避免成年早期肥胖,因为肥胖的年轻男性在整个生命过程中会面临更多疾病的发病率增加,包括致命发病率。