Lee Joo Young, Kim Hyeon Chang, Kim Changsoo, Park Keeho, Ahn Song Vogue, Kang Dae Ryong, Khaw Kay-Tee, Willett Walter C, Suh Il
1Department of Preventive Medicine,Yonsei University College of Medicine,50-1 Yonsei-ro,Seodaemun-gu,Seoul 120-752,Republic of Korea.
2Cancer Policy Branch,National Cancer Center,Ilsan-ro,Ilsandong-gu,Gyeonggi-do,Republic of Korea.
Public Health Nutr. 2016 Jul;19(10):1751-6. doi: 10.1017/S136898001500302X. Epub 2015 Oct 15.
According to most prospective studies, being underweight (BMI<18·5 kg/m2) is associated with significantly higher mortality than being of normal weight, especially among smokers. We aimed to explore in a generally lean population whether being underweight is significantly associated with increased all-cause mortality.
Prospective cohort study.
Korea Medical Insurance Corporation study with 14 years of follow-up.
After excluding deaths within the first 5 years of follow-up (1993-1997) to minimize reverse causation and excluding participants without information about smoking and health status, 94 133 men and 48 496 women aged 35-59 years in 1990 were included.
We documented 5411 (5·7 %) deaths in men and 762 (1·6 %) in women. Among never smokers, hazard ratios (HR) for underweight individuals were not significantly higher than those for normal-weight individuals (BMI=18·5-22·9 kg/m2): HR=0·87 (95 % CI 0·41, 1·84, P=0·72) for underweight men and HR=1·12 (95 % CI 0·76, 1·65, P=0·58) for underweight women. Among ex-smokers, HR=0·86 (95 % CI 0·38, 1·93, P=0·72) for underweight men and HR=3·77 (95 % CI 0·42, 32·29, P=0·24) for underweight women. Among current smokers, HR=1·60 (95 % CI 1·28, 2·01, P<0·001) for underweight men and HR=2·07 (95 % CI 0·43, 9·94, P=0·36) for underweight women.
The present study does not support that being underweight per se is associated with increased all-cause mortality in Korean men and women.
根据大多数前瞻性研究，体重过轻（体重指数<18.5千克/平方米）与死亡率显著高于正常体重者相关，尤其是在吸烟者中。我们旨在探讨在总体偏瘦的人群中，体重过轻是否与全因死亡率增加显著相关。
前瞻性队列研究。
韩国医疗保险机构进行的一项有14年随访的研究。
排除随访前5年（1993 - 1997年）内的死亡病例以尽量减少反向因果关系，并排除没有吸烟和健康状况信息的参与者后，纳入了1990年年龄在35 - 59岁的94133名男性和48496名女性。
我们记录到男性死亡5411例（5.7%），女性死亡762例（1.6%）。在从不吸烟者中，体重过轻者的风险比（HR）并不显著高于正常体重者（体重指数=18.5 - 22.9千克/平方米）：体重过轻男性的HR = 0.87（95%置信区间0.41，1.84，P = 0.72），体重过轻女性的HR = 1.12（9%置信区间0.76，1.65，P = 0.58）。在前吸烟者中，体重过轻男性的HR = 0.86（95%置信区间0.38，1.93，P = 0.72），体重过轻女性的HR = 3.77（95%置信区间0.42，32.29，P = 0.24）。在当前吸烟者中，体重过轻男性的HR = 1.60（95%置信区间1.28，2.01，P<0.001），体重过轻女性的HR = 2.07（95%置信区间0.43，9.94，P = 0.36）。
本研究不支持体重过轻本身与韩国男性和女性全因死亡率增加相关这一观点。
