Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
Obesity (Silver Spring). 2014 Mar;22(3):842-51. doi: 10.1002/oby.20471. Epub 2014 Feb 11.
To compare body-mass index (BMI)-related mortality risk in U.S. Blacks vs. Whites as the relationship appears to differ across race/ethnicity groups.
Cross-sectional surveys of nationally representative samples of 11,934 Blacks and 59,741 Whites aged 35-75 in the National Health Interview Survey from 1997 to 2002 with no history of cardiovascular disease (CVD) or cancer were pooled. Mortality follow-up was available through 2006. BMI was calculated from self-reported height and weight. We used adjusted Cox regression analysis to adjust for potential confounders.
Over 9 years of follow-up, there were 4303 deaths (1205 among never smokers). Age-adjusted mortality rates were higher in Blacks compared to Whites at BMI < 25 kg/m2 and showed no increase at higher levels of BMI. In men, adjusted hazard ratios for all-cause death rose in a similar fashion across upper BMI quintiles in Blacks and Whites; in women, however, BMI was positively associated with mortality risk in Whites, but inversely associated in Blacks (P interaction = 0.01). Racial disparities were amplified in subsidiary analyses that introduced a 12-month lag for mortality or focused on CVD mortality.
The relationship of elevated BMI to mortality appeared weaker in US Blacks than in Whites, especially among women.
比较美国黑人和白人的体重指数（BMI）相关死亡率风险，因为这种关系似乎因种族/族裔群体而异。
对 1997 年至 2002 年间年龄在 35-75 岁、无心血管疾病（CVD）或癌症病史的国家健康访谈调查中的 11934 名黑人及 59741 名白人进行了全国代表性样本的横断面调查。通过 2006 年的死亡率随访。BMI 是根据自我报告的身高和体重计算得出的。我们使用调整后的 Cox 回归分析来调整潜在的混杂因素。
在 9 年的随访期间，有 4303 人死亡（从不吸烟者中有 1205 人）。在 BMI<25kg/m2 时，黑人的年龄调整死亡率高于白人，而在更高水平的 BMI 时则没有增加。在男性中，所有原因死亡的调整后的危险比在黑人与白人的 BMI 较高五分位数中以相似的方式上升；然而，在女性中，BMI 与白人的死亡率风险呈正相关，而与黑人的死亡率风险呈负相关（P 交互=0.01）。在引入死亡 12 个月滞后或关注 CVD 死亡率的辅助分析中，种族差异被放大。
在美国黑人中，BMI 升高与死亡率的关系似乎比白人弱，尤其是在女性中。
