Borrelli R, Isernia C, Di Biase G, Contaldo F
Istituto di Medicina Interna e Malattie Dismetaboliche, 2a Facoltà di Medicina, Università di Napoli.
Int J Vitam Nutr Res. 1988;58(3):343-50.
Several studies have investigated the relationship between obesity and mortality or cardiovascular disease (CVD) reporting conflicting results. The very few data collected on extremely obese patients have shown an increased mortality in these patients compared to the general population. Two hundred and sixtyfour (182 f, 82 m) severely obese patients (BMI greater than or equal to 35 w/h2) living in Southern Italy (hospitalized from 1972 to 1985 in our Metabolic Unit for a weight reduction program) were followed-up for a mean period of 7.1 years. Twentynine (20f, 9m) deaths were recorded during the follow-up. Higher mortality was found at all ages and in both sexes in these patients when compared to the general italian population. The excess mortality reached its peak in the age range 25-54 yrs (observed/expected mortality rate was 6.9 in females and 4.32 in males) diminishing by aging in both sexes (3.52 in females and 1.56 in males in age range 55-72 yrs). Death from CV disease was found more frequent than in the general italian population but it was unable to fully explain the excess mortality. Predictive factors of mortality were: in females age, BMI, and serum glucose and in males only age. In conclusion severely obese patients living in Southern Italy have a very high mortality rate. The excess mortality is not fully explained by cardiovascular disease.
多项研究调查了肥胖与死亡率或心血管疾病（CVD）之间的关系，结果相互矛盾。针对极度肥胖患者收集的数据极少，显示这些患者的死亡率高于普通人群。对264名（182名女性，82名男性）重度肥胖患者（体重指数大于或等于35kg/m²）进行了随访，这些患者生活在意大利南部（1972年至1985年在我们的代谢科接受减肥项目住院治疗），平均随访时间为7.1年。随访期间记录了29例（20名女性，9名男性）死亡病例。与意大利普通人群相比，这些患者在各年龄段和两性中均发现有更高的死亡率。超额死亡率在25 - 54岁年龄组达到峰值（女性观察到的/预期死亡率为6.9，男性为4.32），随着年龄增长，两性的超额死亡率均有所下降（55 - 72岁年龄组女性为3.52，男性为1.56）。发现死于心血管疾病的情况比意大利普通人群更频繁，但这无法完全解释超额死亡率。死亡率的预测因素为：女性为年龄、体重指数和血糖，男性仅为年龄。总之，生活在意大利南部的重度肥胖患者死亡率非常高。心血管疾病无法完全解释超额死亡率。
