de Cosio Federico Gerardo, Diaz-Apodaca Beatriz, Baker Amanda, Cifuentes Miriam Patricia, Ojeda-Casares Hector, Constandce Daniel, Becerra Francisco
College of Health Science, University of Texas at El Paso, 1851 Wiggins Rd., El Paso, 79968 Texas USA.
Pan American Health Organization Venezuela, Caracas, Venezuela.
SN Compr Clin Med. 2021;3(6):1334-1343. doi: 10.1007/s42399-021-00850-2. Epub 2021 Apr 5.
This study aims to assess the effect of obesity as an underlying cause of death in association with four main noncommunicable diseases (NCDs) as contributing causes of mortality on the age of death in White, Black, and Hispanic individuals in the USA. To estimate mortality hazard ratios, we ran a Cox regression on the US National Center for Health Statistics mortality integrated datasets from 1999 to 2017, which included almost 48 million cases. The variable in the model was the age of death in years as a proxy for time to death. The cause-of-death variable allowed for the derivation of predictor variables of obesity and the four main NCDs. The overall highest obesity mortality HR when associated with NCD contributing conditions for the year 1999-2017 was diabetes (2.15; 95% CI: 2.11-2.18), while Whites had the highest HR (2.46; 95% CI: 2.41-2.51) when compared with Black (1.32; 95% CI: 1.27-1.38) and Hispanics (1.25; 95% CI: 1.18-1.33). Hispanics had lower mortality HR for CVD (1.21; 95% CI: 1.15-1.27) and diabetes (1.25; 95% CI: 1.18-1.33) of the three studied groups. The obesity death mean was 57.3 years for all groups. People who die from obesity are, on average, 15.4 years younger than those without obesity. Although Hispanics in the USA have a higher prevalence of diabetes and cardiovascular disease (CVD), they also have the lowest mortality HR for obesity as an underlying cause of death when associated with CVD and cancer. While there is no obvious solution for obesity and its complications, continued efforts to address obesity are needed.
本研究旨在评估肥胖作为潜在死因，与四种主要非传染性疾病（NCDs）作为促成死亡原因，对美国白人、黑人和西班牙裔人群死亡年龄的影响。为了估计死亡风险比，我们对美国国家卫生统计中心1999年至2017年的死亡率综合数据集进行了Cox回归分析，该数据集包含近4800万个病例。模型中的变量是死亡年龄（以年为单位），作为死亡时间的替代指标。死因变量可用于推导肥胖和四种主要非传染性疾病的预测变量。1999年至2017年，肥胖与非传染性疾病促成情况相关时，总体最高肥胖死亡率风险比是糖尿病（2.15；95%置信区间：2.11 - 2.18），而与黑人（1.32；95%置信区间：1.27 - 1.38）和西班牙裔（1.25；95%置信区间：1.18 - 1.33）相比，白人的风险比最高（2.46；95%置信区间：2.41 - 2.51）。在三个研究组中，西班牙裔因心血管疾病（CVD）（1.21；95%置信区间：1.15 - 1.27）和糖尿病（1.25；95%置信区间：1.18 - 1.33）的死亡率风险比更低。所有组的肥胖死亡平均年龄为57.3岁。死于肥胖的人平均比非肥胖者年轻15.4岁。尽管美国的西班牙裔糖尿病和心血管疾病（CVD）患病率较高，但当肥胖作为与CVD和癌症相关的潜在死因时，他们的死亡率风险比也是最低的。虽然肥胖及其并发症没有明显的解决办法，但仍需要继续努力应对肥胖问题。
