Suh Jungki, Cho Yoon Jeong, Kim Hyun Ji, Choi Seong Soo
Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
Korean J Fam Med. 2021 Jul;42(4):297-302. doi: 10.4082/kjfm.20.0170. Epub 2021 Jul 20.
Obesity is associated with increased mortality as a significant risk factor for chronic diseases, including cardiovascular diseases and cancer. Several people believe that weight gain is harmful, and weight loss helps maintain health. However, some studies have shown that weight loss, particularly among older adults, is more likely to increase the risk of mortality than weight gain.
We used data for the cohort of the Korean Longitudinal Study of Aging, which is a nationwide stratified multi-stage sample of adults aged 45 years. The all-cause mortality risk was assessed using the survival status and the number of months of survival calculated from 2006 (baseline year) to 2016. Cox proportional hazard regression were used to study the causal link between weight change and all-cause mortality risk.
The results showed interactive associations between weight loss and mortality among middle-aged and older adults. The hazard ratio was 1.62 (95% confidence interval [CI], 1.10-2.40) for the participants aged 45-65 years with weight losses greater than 5 kg and 1.56 (95% CI, 1.29-1.89) for those older than 65 years with weight losses greater than 5 kg. The results for the group with weight gain above 5 kg were not significant. Middle-aged and older men showed an increase in all-cause mortality associated with weight loss of more than 5 kg, but only the older women showed significant results.
This large-scale cohort study in Korea showed a relationship between weight loss and all-cause mortality in middle-aged and older individuals.
肥胖作为包括心血管疾病和癌症在内的慢性疾病的重要风险因素，与死亡率增加相关。一些人认为体重增加有害，而体重减轻有助于维持健康。然而，一些研究表明，体重减轻，尤其是在老年人中，比体重增加更有可能增加死亡风险。
我们使用了韩国老年纵向研究队列的数据，该研究是对45岁及以上成年人进行的全国分层多阶段抽样。使用生存状态和从2006年（基线年份）到2016年计算的生存月数来评估全因死亡风险。采用Cox比例风险回归研究体重变化与全因死亡风险之间的因果关系。
结果显示中年和老年人中体重减轻与死亡率之间存在交互关联。45至65岁体重减轻超过5公斤的参与者的风险比为1.62（95%置信区间[CI]，1.10 - 2.40），65岁以上体重减轻超过5公斤的参与者的风险比为1.56（95%CI，1.29 - 1.89）。体重增加超过5公斤组的结果不显著。中年和老年男性体重减轻超过5公斤与全因死亡率增加相关，但只有老年女性显示出显著结果。
这项在韩国进行的大规模队列研究表明中年和老年人中体重减轻与全因死亡率之间存在关联。
