Flegal Katherine M, Graubard Barry I, Williamson David F, Gail Mitchell H
Vital Health Stat 3. 2018 Jun(42):1-21.
As the prevalence of obesity has increased over time in the United States (1,2), concern over the association between body weight and excess mortality also increased. In 2005, an analysis of estimated excess deaths, relative to the normal weight category (body mass index [BMI] 18.5-24.9), that were associated with underweight (BMI less than 18.5), overweight (BMI 25.0-29.9), and obesity (BMI greater than or equal to 30) in U.S. adults in 2000 was published (3). Both underweight and obesity, particularly higher levels of obesity, were associated with increased mortality relative to the normal weight category. Obesity was estimated to be associated with 111,909 excess deaths (95% confidence interval [CI]: 53,754 to 170,064) in 2000 relative to the normal weight category, and underweight with 33,746 excess deaths (95% CI: 15,726 to 51,766). Overweight was associated with reduced mortality (-86,094 deaths; 95% CI: -161,223 to -10,966). This report evaluates several potential sources of bias in that analysis.
随着美国肥胖症患病率随时间推移而上升（1,2），对体重与超额死亡率之间关联的担忧也与日俱增。2005年，发表了一项分析，该分析针对2000年美国成年人中与体重过轻（体重指数[BMI]低于18.5）、超重（BMI 25.0 - 29.9）和肥胖（BMI大于或等于30）相关的估计超额死亡人数，这些超额死亡人数相对于正常体重类别（BMI 18.5 - 24.9）而言（3）。体重过轻和肥胖，尤其是较高程度的肥胖，与相对于正常体重类别而言的死亡率增加相关。据估计，2000年肥胖相对于正常体重类别而言与111,909例超额死亡相关（95%置信区间[CI]：53,754至170,064），体重过轻与33,746例超额死亡相关（95% CI：15,726至51,766）。超重与死亡率降低相关（-86,094例死亡；95% CI：-161,223至-10,966）。本报告评估了该分析中几个潜在的偏差来源。
