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丹麦一项为期 33 年的随访研究:年轻男性肥胖与 2 型糖尿病、心血管发病率和 55 岁前死亡的个体及联合风险

Obesity in young men, and individual and combined risks of type 2 diabetes, cardiovascular morbidity and death before 55 years of age: a Danish 33-year follow-up study.

机构信息

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.

出版信息

BMJ Open. 2013 Apr 29;3(4). doi: 10.1136/bmjopen-2013-002698. Print 2013.

Abstract

OBJECTIVES

To examine the association between body mass index (BMI) in young adulthood and cardiovascular risks, including venous thromboembolism, before 55 years of age.

DESIGN

Cohort study using population-based medical databases.

SETTING

Outcomes registered from all hospitals in Denmark from 1977 onwards.

PARTICIPANTS

6502 men born in 1955 and eligible for conscription in Northern Denmark.

MAIN OUTCOME MEASURES

Follow-up began at participants' 22nd birthday and continued until death, emigration or 55 years of age, whichever came first. Using regression analyses, we calculated the risks and HRs, adjusting for cognitive test score and years of education.

RESULTS

48% of all obese young men (BMI ≥30 kg/m(2)) were either diagnosed with type 2 diabetes, hypertension, myocardial infarction, stroke or venous thromboembolism or died before reaching 55 years of age. Comparing obese men with normal weight men (BMI 18.5 to <25.0 kg/m(2)), the risk difference for any outcome was 28% (95% CI 19% to 38%) and the HR was 3.0 (95% CI 2.3 to 4.0). Compared with normal weight, obesity was associated with an event rate that was increased more than eightfold for type 2 diabetes, fourfold for venous thromboembolism and twofold for hypertension, myocardial infarction and death.

CONCLUSIONS

In this cohort of young men, obesity was strongly associated with adverse cardiometabolic events before 55 years of age, including venous thromboembolism. Compared with those of normal weight, young obese men had an absolute risk increase for type 2 diabetes, cardiovascular morbidity or premature death of almost 30%.

摘要

目的

研究青年时期的体重指数(BMI)与心血管风险(包括 55 岁前的静脉血栓栓塞症)之间的关系。

设计

基于人群的医学数据库的队列研究。

地点

丹麦所有医院的结局登记。

参与者

1955 年出生且有资格在丹麦北部应征入伍的 6502 名男性。

主要观察指标

随访始于参与者 22 岁生日,直至死亡、移民或 55 岁,以先发生者为准。通过回归分析,我们计算了风险和 HR,同时调整了认知测试评分和受教育年限。

结果

所有肥胖青年男性(BMI≥30kg/m2)中,48%的人在达到 55 岁之前,要么被诊断为 2 型糖尿病、高血压、心肌梗死、中风或静脉血栓栓塞症,要么死亡。与正常体重男性(BMI 18.5 至<25.0kg/m2)相比,任何结局的风险差异为 28%(95%CI 19%至 38%),HR 为 3.0(95%CI 2.3 至 4.0)。与正常体重相比,肥胖与 2 型糖尿病、静脉血栓栓塞症、高血压、心肌梗死和死亡的发生率增加了 8 倍以上、4 倍以上和 2 倍以上相关。

结论

在该队列的年轻男性中,肥胖与 55 岁前的不良心血管代谢事件密切相关,包括静脉血栓栓塞症。与正常体重的男性相比,年轻肥胖男性的 2 型糖尿病、心血管疾病发病率或过早死亡的绝对风险增加了近 30%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e5e/3641453/be20ff17b86f/bmjopen2013002698f01.jpg

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