Yoo Hye Jin
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
J Obes Metab Syndr. 2017 Mar;26(1):3-9. doi: 10.7570/jomes.2017.26.1.3. Epub 2017 Mar 30.
Although the prevalence of obesity, a well-known risk factor for various chronic diseases such as hypertension, type 2 diabetes and dyslipidemia, is rapidly increasing worldwide, the association of obesity with all-cause mortality remains controversial. Many previous epidemiologic studies have demonstrated a U-shaped relationship between obesity and mortality, suggesting that there is an obesity paradox. However, recent large-scale meta-analyses found contradictory results that both overweight and obese subjects exhibited a significant increase in all-cause mortality. This review summarizes the key epidemiologic studies on the association of obesity with mortality and thoroughly examines the causes of the obesity paradox and the precautions needed in the interpretation of this clinical evidence.
肥胖是高血压、2型糖尿病和血脂异常等多种慢性疾病的一个众所周知的危险因素,尽管其在全球范围内的患病率正在迅速上升,但肥胖与全因死亡率之间的关联仍存在争议。许多先前的流行病学研究表明,肥胖与死亡率之间呈U形关系,这表明存在肥胖悖论。然而,最近的大规模荟萃分析得出了相互矛盾的结果,即超重和肥胖受试者的全因死亡率均显著增加。本综述总结了关于肥胖与死亡率关联的关键流行病学研究,并深入探讨了肥胖悖论的成因以及解读这一临床证据时所需的注意事项。