Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, Beijing, China Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, Beijing, China
School of Public Health and Department of Community Medicine, The University of Hong Kong, Hong Kong, China.
Diabetes Care. 2014 Sep;37(9):2540-7. doi: 10.2337/dc14-0243. Epub 2014 Jun 19.
It is unclear whether changes in BMI during rapid economic development influence subsequent mortality.
We analyzed whether BMI in 1976 and 1994 and changes in BMI during 1976-1994 predict cardiovascular disease (CVD) and all-cause mortality in a 35-year follow-up cohort of 1,696 Chinese (1,124 men and 572 women, aged 35-65 years) in Xi'an, China. Participants were categorized as underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), and overweight (≥25.0 kg/m(2)).
During 51,611 person-years of follow-up, we identified 655 deaths from all causes and 234 from CVD. From 1976 to 1994, the prevalence of overweight rose from 9.2 to 27.8%. With each unit increment in 1976 BMI, multivariate hazard ratios (HRs) (95% CI) were 0.78 (0.72-0.84) for CVD and 0.91 (0.87-0.95) for all-cause mortality. In contrast, corresponding HRs were 1.14 (1.08-1.19) and 1.05 (1.01-1.08) in 1994 BMI. The HRs for each unit increment in BMI change from 1976 to 1994 were 1.35 (1.25-1.41) for CVD and 1.09 (1.05-1.13) for all-cause mortality. Compared with participants with stable normal weight in 1976 and 1994, HRs of all-cause mortality for those who had normal weight in 1976 but became overweight in 1994 and for those who were persistently overweight during 1976-1994 were 1.42 (1.12-1.80) and 1.80 (1.04-3.14), respectively.
Gaining weight with increased BMI at middle age in Chinese during economic development was associated with elevated risks of all-cause and CVD mortality. Higher BMI measured before economic development was associated with lower mortality risk, whereas BMI measured afterward was associated with increased mortality.
在经济快速发展过程中 BMI 的变化是否会影响随后的死亡率尚不清楚。
我们分析了参与者在 1976 年和 1994 年的 BMI 以及 1976-1994 年间 BMI 的变化是否能够预测心血管疾病（CVD）和全因死亡率。该研究随访了中国西安的一个 35 年队列中的 1696 名参与者（男性 1124 人，女性 572 人，年龄 35-65 岁）。参与者被分为体重不足（<18.5kg/m²）、正常体重（18.5-24.9kg/m²）和超重（≥25.0kg/m²）。
在 51611 人年的随访期间，我们共观察到 655 例全因死亡和 234 例 CVD 死亡。从 1976 年到 1994 年，超重的患病率从 9.2%上升到 27.8%。与 1976 年 BMI 的每个单位增加相对应，多变量危险比（HR）（95%CI）分别为 CVD 0.78（0.72-0.84）和全因死亡率 0.91（0.87-0.95）。相比之下，1994 年 BMI 的相应 HR 分别为 1.14（1.08-1.19）和 1.05（1.01-1.08）。1976 年至 1994 年 BMI 变化每单位增加的 HR 分别为 CVD 1.35（1.25-1.41）和全因死亡率 1.09（1.05-1.13）。与 1976 年和 1994 年稳定的正常体重参与者相比，1976 年正常体重但 1994 年超重以及 1976-1994 年期间一直超重的参与者的全因死亡率 HR 分别为 1.42（1.12-1.80）和 1.80（1.04-3.14）。
在中国经济发展过程中，中年人 BMI 增加导致体重增加与全因和 CVD 死亡率升高有关。经济发展前测量的 BMI 较高与较低的死亡率风险相关，而经济发展后测量的 BMI 较高与较高的死亡率风险相关。
