Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
Obesity (Silver Spring). 2013 Sep;21(9):1746-9. doi: 10.1002/oby.20602.
There is indisputable evidence from epidemiologic and clinical studies that being overweight and obese elevates the risk of developing debilitating and costly chronic diseases, including hypertension, hypercholesterolemia, type 2 diabetes, cardiovascular diseases (CVD), and cancer (1). Nonetheless, the relationship between body mass index (BMI) and mortality remains the subject of much debate. A recent meta-analysis concluded that compared to those of normal weight (BMI<25.0), overweight individuals (BMI 25.0–29.9) had a significantly lower mortality risk (2). Even Class 1 obesity (BMI 30–34.9) was associated with marginally reduced mortality. In this Perspective, we discuss why this finding is likely to be an artifact of methodological limitations and what the clinical and public health implications may be.
有确凿的证据表明，来自流行病学和临床研究，超重和肥胖会增加患使人衰弱和昂贵的慢性疾病的风险，包括高血压、高胆固醇血症、2 型糖尿病、心血管疾病 (CVD) 和癌症 (1)。尽管如此，身体质量指数 (BMI) 与死亡率之间的关系仍然是许多争论的主题。最近的一项荟萃分析得出的结论是，与体重正常的人 (BMI<25.0) 相比，超重的人 (BMI 25.0-29.9) 的死亡率明显降低 (2)。即使是 1 级肥胖 (BMI 30-34.9) 也与死亡率略有降低有关。在这篇观点文章中，我们讨论了为什么这一发现可能是方法学局限性的一个产物，以及可能的临床和公共卫生意义。
