Kong Kyoung Ae, Park Junbeom, Hong So-Hyeon, Hong Young Sun, Sung Yeon-Ah, Lee Hyejin
Department of Preventive Medicine, Ewha Womans University, College of Medicine, Seoul, Korea.
Division of Cardiology, Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea.
PLoS One. 2017 Sep 15;12(9):e0185024. doi: 10.1371/journal.pone.0185024. eCollection 2017.
BACKGROUND/OBJECTIVES: The relationship between body mass index (BMI) and mortality remains controversial. Furthermore, the association between BMI and cardiovascular events (CVE) is not conclusive and may differ by ethnicity. We aimed to estimate the associations between the BMI and mortality or cardiovascular disease in a general Korean population.
SUBJECTS/METHODS: This study was based on a sample cohort database released by the Korean National Health Insurance Service. We analyzed a total of 415,796 adults older than 30 years of age who had undergone a national health examination at least once from 2002 to 2012. Hazard ratios for death and cardiovascular events were calculated using Cox proportional hazards models.
For both men and women, BMI and overall mortality showed a U-shaped association, with the lowest mortality rate among those with a BMI of 25-27.4 kg/m2. Compared with them, subjects with a BMI ≥ 30kg/m2, men with a BMI < 25 kg/m2, and women with a BMI < 22.5 kg/m2 showed significantly higher overall mortality. Additionally, men with a BMI < 22.5 kg/m2 and women with a BMI < 20 kg/m2 displayed an increased risk of cardiovascular mortality. Unlike the mortality trend, the CVD events trend showed a linearly positive association. The risk of a CVE was the lowest in men with a BMI ranging from 20 to 22.4 kg/m2 and in women with a BMI < 20 kg/m2.
The BMI showed a U-shaped association with overall mortality, where slightly obese subjects showed the lowest rate of mortality. The CVE exhibited a linear association with the BMI, where the lowest risk was observed for normal weight subjects in a general Korean population.
背景/目的：体重指数（BMI）与死亡率之间的关系仍存在争议。此外，BMI与心血管事件（CVE）之间的关联尚无定论，且可能因种族而异。我们旨在评估韩国普通人群中BMI与死亡率或心血管疾病之间的关联。
受试者/方法：本研究基于韩国国民健康保险服务机构发布的样本队列数据库。我们分析了2002年至2012年期间至少接受过一次全国健康检查的415796名30岁以上成年人。使用Cox比例风险模型计算死亡和心血管事件的风险比。
对于男性和女性，BMI与总死亡率均呈U形关联，BMI为25-27.4kg/m²的人群死亡率最低。与他们相比，BMI≥30kg/m²的受试者、BMI<25kg/m²的男性以及BMI<22.5kg/m²的女性总死亡率显著更高。此外，BMI<22.5kg/m²的男性和BMI<20kg/m²的女性心血管死亡率增加。与死亡率趋势不同，CVD事件趋势呈线性正相关。BMI在20至22.4kg/m²之间的男性和BMI<20kg/m²的女性发生CVE的风险最低。
BMI与总死亡率呈U形关联，轻度肥胖者死亡率最低。CVE与BMI呈线性关联，在韩国普通人群中，正常体重者发生CVE的风险最低。
