Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, New York Obesity Research Center, New York, New York, USA.
Obesity (Silver Spring). 2013 Feb;21(2):405-12. doi: 10.1002/oby.20023.
Although obesity is a serious public health problem, there are few reliable measures of its health hazards in the United States. The objective of this study was to estimate how much earlier mortality is likely to occur for Americans who are obese (body mass index [BMI], ≥ 30).
Data from the National Health and Nutrition Examination Survey (NHANES) I (1971-1975), NHANES II (1976-1980), and NHANES III (1988-1994) for 37,632 participants who experienced 8,791 deaths during 15 years of follow-up were prospectively analyzed. The relative risk of death from all causes and its advancement period, adjusted for covariates, were calculated. Stratification was used to investigate the effects of pre-existing illness, smoking, and older age on the advancement period.
Compared to the participants of reference weight (BMI, 23 to <25 kg/m2), mortality was likely to occur 9.44 years (95% confidence interval [CI]: 0.72, 18.16) earlier for those who were obese (BMI, ≥ 30). For overweight (25 to <30 kg/m2), grade 1 obesity (BMI, 30 to <35) and grades 2-3 obesity (BMI, ≥ 35.0), the mortality was likely to occur earlier by 4.40 (-3.90, 12.70), 6.69 (-2.06, 15.43), and 14.16 (3.35, 24.97) years, respectively. These estimates apply to healthy nonsmoker young- and middle-aged (21-55 years) adults, who constituted an estimated 32.8% of Americans with age of >21 years between 1988 and 1994. Without stratifying simultaneously for preexisting illness, smoking, and age, values of the advancement period for obesity were markedly smaller than those observed for healthy nonsmoker young and middle-aged adults.
For healthy nonsmokers young- and middle-aged adults who constitute about one-third of American adults, being obese is likely to hasten mortality by 9.44 years.
尽管肥胖是一个严重的公共卫生问题，但在美国，评估肥胖对健康危害的可靠指标却寥寥无几。本研究的目的是估计美国肥胖人群（体重指数[BMI]≥30）的预期死亡时间。
前瞻性分析了 37632 名参与者的数据，这些参与者来自于美国国家健康与营养调查（NHANES）I 期（1971-1975 年）、NHANES II 期（1976-1980 年）和 NHANES III 期（1988-1994 年），这些参与者在 15 年的随访期间经历了 8791 例死亡。通过调整协变量，计算出全因死亡率的相对风险及其提前期。分层分析了预先存在的疾病、吸烟和年龄对提前期的影响。
与参考体重（BMI，23-<25kg/m2）的参与者相比，肥胖者（BMI≥30）的死亡风险可能提前 9.44 年（95%置信区间[CI]：0.72，18.16）。对于超重（25-<30kg/m2）、一级肥胖（BMI，30-<35）和二级至三级肥胖（BMI，≥35.0），死亡风险可能分别提前 4.40 年（-3.90，12.70）、6.69 年（-2.06，15.43）和 14.16 年（3.35，24.97）。这些估计适用于健康的非吸烟者年轻和中年（21-55 岁）成年人，他们构成了 1988 年至 1994 年年龄大于 21 岁的美国人的估计 32.8%。如果不同时对预先存在的疾病、吸烟和年龄进行分层，肥胖的提前期值明显小于健康的非吸烟者年轻和中年成年人的观察值。
对于构成大约三分之一美国成年人的健康非吸烟者年轻和中年成年人来说，肥胖可能使死亡率提前 9.44 年。
