Tayback M, Kumanyika S, Chee E
Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
Arch Intern Med. 1990 May;150(5):1065-72.
To determine whether body weight is a risk factor for mortality among older persons, we analyzed body mass index (weight [kilogram]/height [square meter]) data for 4710 white, National Health and Nutrition Examination Survey respondents who were aged 55 to 74 years during 1971 through 1975, in relation to their survival over an average of 8.7 years of follow-up. In a multivariate analysis that controlled for elevated blood pressure, smoking, and poverty, we found no additional risk associated with weight among women and a statistically significant, but moderate, additional risk (relative risk, 1.1 to 1.2) among men in the upper decile (body mass index, greater than or equal to 30 kg/m2). In contrast, low weight (body mass index, less than 22 kg/m2) was associated with increased mortality (relative risk, 1.3 to 1.6) except for women aged 55 to 64 years. We conclude that the accepted definition of overweight (body mass index, greater than or equal to 27.8 kg/m2 [men] or greater than or equal to 27.3 kg/m2 [women]) lacks specificity and may be inappropriate for older persons who do not have weight-related medical conditions. The low-weight mortality association, consistently demonstrated, deserves serious scrutiny.
为了确定体重是否为老年人死亡的一个风险因素，我们分析了4710名白人的体重指数（体重[千克]/身高[平方米]）数据，这些人是1971年至1975年期间年龄在55至74岁的美国国家健康和营养检查调查的受访者，并将其与他们平均8.7年随访期内的生存情况相关联。在一项对高血压、吸烟和贫困进行控制的多变量分析中，我们发现，对于女性，体重并未带来额外风险；而对于男性，体重处于最高十分位数（体重指数大于或等于30kg/m²）时，虽然存在统计学上显著但程度适中的额外风险（相对风险为1.1至1.2）。相比之下，除了55至64岁的女性外，低体重（体重指数小于22kg/m²）与死亡率增加相关（相对风险为1.3至1.6）。我们得出结论，公认的超重定义（体重指数，男性大于或等于27.8kg/m²，女性大于或等于27.3kg/m²）缺乏特异性，可能不适用于没有与体重相关疾病的老年人。持续显示出的低体重与死亡率的关联值得认真审视。
