National Heart and Lung Institute, Imperial College London, 4th Floor, ICTEM Building, 72 Du Cane Road, London, W12 0NN, UK.
BMC Endocr Disord. 2021 Jul 3;21(1):144. doi: 10.1186/s12902-021-00805-7.
Although obesity, defined by body mass index (BMI), has been associated with a higher risk of hospitalisation and more severe course of illness in Covid-19 positive patients amongst the British population, it is unclear if this translates into increased mortality. Furthermore, given that BMI is an insensitive indicator of adiposity, the effect of adipose volume on Covid-19 outcomes is also unknown.
We used the UK Biobank repository, which contains clinical and anthropometric data and is linked to Public Health England Covid-19 healthcare records, to address our research question. We performed age- and sex- adjusted logistic regression and Chi-squared test to compute the odds for Covid-19-related mortality as a consequence of increasing BMI, and other more sensitive indices of adiposity such as waist:hip ratio (WHR) and percent body fat, as well as concomitant cardiometabolic illness.
13,502 participants were tested for Covid-19 (mean age 70 ± 8 years, 48.9% male). 1582 tested positive (mean age 68 ± 9 years, 52.8% male), of which 305 died (mean age 75 ± 6 years, 65.5% male). Increasing adiposity was associated with higher odds for Covid-19-related mortality. For every unit increase in BMI, WHR and body fat, the odds of death amongst Covid19-positive participants increased by 1.04 (95% CI 1.01-1.07), 10.71 (95% CI 1.57-73.06) and 1.03 (95% CI 1.01-1.05), respectively (all p < 0.05). Referenced to Covid-19 positive participants with a normal weight (BMI 18.5-25 kg/m), Covid-19 positive participants with BMI > 35 kg/m had significantly higher odds of Covid-19-related death (OR 1.70, 95% CI 1.06-2.74, p < 0.05). Covid-19-positive participants with metabolic (diabetes, hypertension, dyslipidaemia) or cardiovascular morbidity (atrial fibrillation, angina) also had higher odds of death.
Anthropometric indices that are more sensitive to adipose volume and its distribution than BMI, as well as concurrent cardiometabolic illness, are associated with higher odds of Covid-19-related mortality amongst the UK Biobank cohort that tested positive for the infection. These results suggest adipose volume may contribute to adverse Covid-19-related outcomes associated with obesity.
在英国人群中，肥胖（通过身体质量指数 BMI 定义）与新冠肺炎阳性患者住院风险增加和疾病严重程度增加相关，但 BMI 并不能反映脂肪体积对新冠肺炎结局的影响。
我们使用英国生物库数据库，该数据库包含临床和人体测量数据，并与英国公共卫生部新冠肺炎医疗记录相关联，以解决我们的研究问题。我们进行了年龄和性别调整的逻辑回归和卡方检验，以计算 BMI 增加、其他更敏感的肥胖指标（腰臀比 WHR 和体脂百分比）以及同时存在的心血管代谢疾病与新冠肺炎相关死亡率之间的比值比。
13502 名参与者接受了新冠肺炎检测（平均年龄 70±8 岁，48.9%为男性）。1582 人检测呈阳性（平均年龄 68±9 岁，52.8%为男性），其中 305 人死亡（平均年龄 75±6 岁，65.5%为男性）。随着肥胖程度的增加，新冠肺炎相关死亡率的比值比也随之增加。对于 BMI、WHR 和体脂每增加一个单位，新冠肺炎阳性参与者死亡的比值比分别增加 1.04（95%CI 1.01-1.07）、10.71（95%CI 1.57-73.06）和 1.03（95%CI 1.01-1.05）（均 p<0.05）。与体重正常（BMI 18.5-25kg/m）的新冠肺炎阳性参与者相比，BMI>35kg/m 的新冠肺炎阳性参与者新冠肺炎相关死亡的比值比显著更高（OR 1.70，95%CI 1.06-2.74，p<0.05）。患有代谢性（糖尿病、高血压、血脂异常）或心血管疾病（心房颤动、心绞痛）的新冠肺炎阳性参与者死亡的比值比也更高。
与 BMI 相比，更能反映脂肪体积及其分布的人体测量指标以及同时存在的心血管代谢疾病，与英国生物库队列中新冠肺炎检测呈阳性的患者的新冠肺炎相关死亡率比值比更高。这些结果表明，脂肪体积可能导致肥胖与新冠肺炎相关的不良结局。
