Sung Ki-Chul, Ryu Seungho, Lee Jong-Young, Lee SungHo, Cheong EunSun, Kim Jang-Young, Wild Sarah H, Byrne Christopher D
Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Occupational and Environmental Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Int J Cardiol. 2016 Dec 1;224:271-278. doi: 10.1016/j.ijcard.2016.09.056. Epub 2016 Sep 17.
The aim was to investigate associations between underweight, overweight and obesity and all cause, cancer and cardiovascular disease (CVD) mortality, excluding subjects with known CVD, diabetes, hypertension and components of the metabolic syndrome (MetS) at baseline.
The study population consisted of examinees participating in a health screening in Korea from 2002 to 2013. Data were analyzed in 162,194 subjects (in a retrospective cohort study design-median (interquartile range (IQR) follow-up 4.9 (1.8-8.5years))). The outcomes were all cause mortality, cancer and CVD.
The mean (age range) and median age (IQR) at baseline were 36.9(20.0-85.3) and 35.2 (30.8-40.6) years. There were 436 deaths during follow-up. For men and women together, the fully adjusted HR for underweight and all cause mortality, cancer and CVD was 1.53 (95% CIs 1.06-2.20), 1.21 (95% CIs 0.68-2.14) and 1.34 (95% CIs 0.40-4.49) respectively. In contrast, the fully adjusted HR for overweight/obesity combined and all cause mortality was 0.77 (95%CIs 0.63-0.95) and there were non significant trends towards decreased cancer and CVD mortality. The association between overweight/obesity and all cause mortality was similar for men and women considered separately and for overweight and obesity as separate BMI categories. Smoking did not seem to explain the increased HR in the underweight BMI category.
In a young metabolically healthy adult cohort, underweight was associated with increased all cause mortality and overweight/obesity was associated with decreased all cause mortality if CVD, diabetes, hypertension and components of the metabolic syndrome (MetS) are excluded.
目的是研究体重过轻、超重和肥胖与全因死亡率、癌症和心血管疾病（CVD）死亡率之间的关联，排除基线时已知患有CVD、糖尿病、高血压和代谢综合征（MetS）各组分的受试者。
研究人群包括2002年至2013年在韩国参加健康筛查的受检者。对162194名受试者的数据进行了分析（采用回顾性队列研究设计，中位（四分位间距（IQR））随访时间为4.9（1.8 - 8.5年））。结局指标为全因死亡率、癌症和CVD。
基线时的平均（年龄范围）和中位年龄（IQR）分别为36.9（20.0 - 85.3）岁和35.2（30.8 - 40.6）岁。随访期间有436例死亡。对于男性和女性总体而言，体重过轻与全因死亡率、癌症和CVD的完全调整后风险比（HR）分别为1.53（95%置信区间（CIs）1.06 - 2.20）、1.21（95% CIs 0.68 - 2.14）和1.34（95% CIs 0.40 - 4.49）。相比之下，超重/肥胖合并与全因死亡率的完全调整后HR为0.77（95% CIs 0.63 - 0.95），癌症和CVD死亡率有下降趋势但不显著。超重/肥胖与全因死亡率之间的关联在分别考虑男性和女性以及将超重和肥胖作为单独的体重指数（BMI）类别时相似。吸烟似乎无法解释体重过轻BMI类别中升高的HR。
在年轻的代谢健康成年队列中，如果排除CVD、糖尿病、高血压和代谢综合征（MetS）各组分，体重过轻与全因死亡率增加相关，超重/肥胖与全因死亡率降低相关。
