Harpsøe Maria C, Nielsen Nete M, Friis-Møller Nina, Andersson Mikael, Wohlfahrt Jan, Linneberg Allan, Nohr Ellen A, Jess Tine
Am J Epidemiol. 2016 Jun 1;183(11):1008-17. doi: 10.1093/aje/kwv300. Epub 2016 Apr 28.
We investigated the possible association between body mass index (BMI; weight (kg)/height (m)(2)) and hospitalization or treatment for acute infection in a prospective cohort study. We linked 75,001 women enrolled in the Danish National Birth Cohort from 1996 to 2002, who had information on BMI and a broad range of confounders, to data on infectious diseases and use of antimicrobial agents from the National Patient Register and the Danish Prescription Register. Associations were tested using Cox proportional hazards models. During 12 years of follow-up, we observed a U-shaped association between baseline BMI and later hospitalization for 1) any infectious disease and 2) infections of the respiratory tract, whereas a dose-response relationship was seen for skin infections. The most pronounced associations were seen for acute upper respiratory infections at multiple and unspecified sites (underweight (BMI <18.5): hazard ratio (HR) = 4.26, 95% confidence interval (CI): 1.69, 10.7; obesity (BMI ≥30): HR = 3.64, 95% CI: 1.62, 8.18), erysipelas (obesity: HR = 5.19, 95% CI: 3.38, 7.95), and fungal infections (underweight: HR = 3.19, 95% CI: 1.53, 6.66). Slightly greater use of antimicrobials was observed among overweight (BMI 25-<30; HR = 1.08, 95% CI: 1.06, 1.10) and obese (HR = 1.21, 95% CI: 1.17, 1.24) women. Among Danish women, underweight and obesity were associated with increased risk of community-acquired infectious diseases, especially infections of the upper respiratory tract and skin.
在一项前瞻性队列研究中，我们调查了体重指数（BMI；体重（千克）/身高（米）²）与急性感染住院或治疗之间的可能关联。我们将1996年至2002年纳入丹麦国家出生队列的75001名女性的数据与国家患者登记册和丹麦处方登记册中关于传染病和抗菌药物使用的数据相链接，这些女性有BMI及一系列混杂因素的信息。使用Cox比例风险模型检验关联。在12年的随访期间，我们观察到基线BMI与随后因以下情况住院之间呈U形关联：1）任何传染病；2）呼吸道感染，而皮肤感染则呈现剂量反应关系。在多个未明确部位的急性上呼吸道感染（体重过轻（BMI<18.5）：风险比（HR）=4.26，95%置信区间（CI）：1.69，10.7；肥胖（BMI≥30）：HR=3.64，95%CI：1.62，8.18）、丹毒（肥胖：HR=5.19，95%CI：3.38，7.95）和真菌感染（体重过轻：HR=3.19，95%CI：1.53，6.66）中观察到最显著的关联。超重（BMI 25-<30；HR=1.08，95%CI：1.06，1.10）和肥胖（HR=1.21，95%CI：1.17，1.24）女性使用抗菌药物的情况略多。在丹麦女性中，体重过轻和肥胖与社区获得性传染病风险增加相关，尤其是上呼吸道和皮肤感染。
