黑种女性的全身肥胖和腹部肥胖与死亡风险。
General and abdominal obesity and risk of death among black women.
机构信息
Slone Epidemiology Center at Boston University, Boston, MA 02215, USA.
出版信息
N Engl J Med. 2011 Sep 8;365(10):901-8. doi: 10.1056/NEJMoa1104119.
BACKGROUND
Recent pooled analyses show an increased risk of death with increasing levels of the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 25.0 or higher in populations of European ancestry, a weaker association among East Asians, and no association of an increased BMI with an increased risk of death among South Asians. The limited data available on blacks indicate that the risk of death is increased only at very high levels of BMI (≥35.0).
METHODS
We prospectively assessed the relation of both BMI and waist circumference to the risk of death among 51,695 black women with no history of cancer or cardiovascular disease who were 21 to 69 years of age at study enrollment. Our analysis was based on follow-up data from 1995 through 2008 in the Black Women's Health Study. Multivariable proportional-hazards models were used to estimate hazard ratios and 95% confidence intervals.
RESULTS
Of 1773 deaths identified during follow-up, 770 occurred among 33,916 women who had never smoked. Among nonsmokers, the risk of death was lowest for a BMI of 20.0 to 24.9. For a BMI above this range, the risk of death increased as the BMI increased. With a BMI of 22.5 to 24.9 as the reference category, multivariable-adjusted hazard ratios were 1.12 (95% confidence interval [CI], 0.87 to 1.44) for a BMI of 25.0 to 27.4, 1.31 (95% CI, 1.01 to 1.72) for a BMI of 27.5 to 29.9, 1.27 (95% CI, 0.99 to 1.64) for a BMI of 30.0 to 34.9, 1.51 (95% CI, 1.13 to 2.02) for a BMI of 35.0 to 39.9, and 2.19 (95% CI, 1.62 to 2.95) for a BMI of 40.0 to 49.9 (P<0.001 for trend). A large waist circumference was associated with an increased risk of death from any cause among women with a BMI of less than 30.0.
CONCLUSIONS
The risk of death from any cause among black women increased with an increasing BMI of 25.0 or higher, which is similar to the pattern observed among whites. Waist circumference appeared to be associated with an increased risk of death only among nonobese women. (Funded by the National Cancer Institute.).
背景
最近的汇总分析显示，在欧洲血统人群中，BMI（体重以千克为单位除以身高以米为单位的平方）达到或超过 25.0 时，死亡风险会随着 BMI 的增加而增加，而在东亚人群中这种关联较弱，而 BMI 与南亚人群的死亡风险增加之间没有关联。关于黑人的有限数据表明，只有在 BMI 非常高（≥35.0）时，死亡风险才会增加。
方法
我们前瞻性评估了 BMI 和腰围与 51695 名无癌症或心血管疾病史的黑人女性死亡风险之间的关系，这些女性在研究入组时年龄为 21 至 69 岁。我们的分析基于黑人女性健康研究（Black Women's Health Study）在 1995 年至 2008 年期间的随访数据。多变量比例风险模型用于估计风险比和 95%置信区间。
结果
在随访期间确定的 1773 例死亡中，有 770 例发生在从未吸烟的 33916 名女性中。在不吸烟者中，BMI 为 20.0 至 24.9 的死亡风险最低。对于超出该范围的 BMI，随着 BMI 的增加，死亡风险也会增加。以 BMI 22.5 至 24.9 为参考类别，多变量调整后的风险比为 BMI 25.0 至 27.4 为 1.12（95%置信区间[CI]，0.87 至 1.44），BMI 27.5 至 29.9 为 1.31（95% CI，1.01 至 1.72），BMI 30.0 至 34.9 为 1.27（95% CI，0.99 至 1.64），BMI 35.0 至 39.9 为 1.51（95% CI，1.13 至 2.02），BMI 40.0 至 49.9 为 2.19（95% CI，1.62 至 2.95）（趋势 P<0.001）。对于 BMI 低于 30.0 的女性，较大的腰围与任何原因导致的死亡风险增加有关。
结论
黑人女性的任何原因导致的死亡风险随着 BMI 达到或超过 25.0 而增加，这与白人观察到的模式相似。腰围似乎仅与非肥胖女性的死亡风险增加有关。（由美国国家癌症研究所资助）。
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