伊朗成年人三年内体重变化与全因、心血管和癌症死亡率的关系：德黑兰血脂和血糖研究超过十年的随访结果。

Three-year weight change and risk of all-cause, cardiovascular, and cancer mortality among Iranian adults: over a decade of follow-up in the Tehran Lipid and Glucose Study.

机构信息

Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Parvaneh Street, Velenjak Tehran, Iran.

Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

BMC Public Health. 2022 Sep 16;22(1):1762. doi: 10.1186/s12889-022-14126-4.

DOI:10.1186/s12889-022-14126-4

PMID:36114528

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9482273/

Abstract

BACKGROUND

We investigated the impact of weight change on mortality in a population-based cohort setting.

METHODS

We conducted two weight measurements for 5436 participants aged ≥ 30 years with an approximate 3-year interval. Based on their weight change, we categorized participants to: > 5% weight loss, 3-5% weight loss, stable weight (± < 3%), 3-5% weight gain, > 5% weight gain. We followed participants for mortality annually up to March 20th 2018. We applied the multivariable Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of weight change categories for all-cause, cardiovascular (CV), and cancer mortality, considering stable weight as reference. The Cox models was adjusted for age, sex, educational level, body mass index, smoking status, hypertension, hypercholesterolemia, diabetes, and cardiovascular disease (CVD) at baseline.

RESULTS

During a median follow-up of 14.4 years, 629 deaths (247 CV and 126 cancer deaths) have occurred. Over 5% weight loss and gain were associated with increased risk of all-cause mortality in multivariable analysis with HRs of 1.47 [95% CI: 1.17-1.85] and 1.27 [1.02-1.57], respectively; however, a 3-5% loss or gain did not alter the risk of all-cause mortality significantly. These significant risks for wight change > 5% were not modified by the presence of diabetes, obesity, and smoking status; however, the unfavorable impact of weight change on mortality events was more prominent in those older than > 65 years (P-value for interaction: 0.042). After excluding those with history of CVD, diabetes, and cancer during the weight measurements period, these associations significantly attenuated (HR: 1.29 [0.89-1.87] for > 5% weight loss and 1.12 [0.84-1.50] for > 5% weight gain). Additionally, a > 5% weight loss was also associated with about 60% higher risk for CV mortality (HR: 1.62 [1.15-2.28]), and a 3-5% weight loss was associated with about 95% higher risk of cancer mortality (HR: 1.95 [1.13-3.38]).

CONCLUSIONS

Our findings showed a U-shaped association across weight change categories for all-cause mortality risk with over 5% weight gain and loss causing higher risk. Moreover, weight loss can have adverse impact on CV and cancer mortality events.

摘要

背景

我们在一项基于人群的队列研究中调查了体重变化对死亡率的影响。

方法

我们对 5436 名年龄≥30 岁的参与者进行了两次体重测量，两次测量的间隔约为 3 年。根据体重变化，我们将参与者分为：体重减轻>5%、体重减轻 3-5%、体重稳定（±<3%）、体重增加 3-5%、体重增加>5%。我们每年对参与者进行一次随访，直到 2018 年 3 月 20 日。我们应用多变量 Cox 比例风险模型来估计体重变化类别与全因、心血管（CV）和癌症死亡率的风险比（HRs）和 95%置信区间（CIs），将体重稳定视为参考。Cox 模型调整了年龄、性别、教育水平、体重指数、吸烟状况、高血压、高胆固醇血症、糖尿病和基线时的心血管疾病（CVD）。

结果

在中位数为 14.4 年的随访期间，发生了 629 例死亡（247 例 CV 和 126 例癌症死亡）。多变量分析显示，体重减轻>5%和增加>5%与全因死亡率的风险增加相关，HRs 分别为 1.47[95%CI：1.17-1.85]和 1.27[1.02-1.57]；然而，体重减轻或增加 3-5%并没有显著改变全因死亡率的风险。体重变化>5%的这些显著风险不受糖尿病、肥胖和吸烟状况的影响；然而，体重变化对死亡率事件的不利影响在年龄大于>65 岁的人群中更为明显（交互检验 P 值：0.042）。排除体重测量期间患有 CVD、糖尿病和癌症的患者后，这些关联显著减弱（体重减轻>5%的 HR：1.29[0.89-1.87]和体重增加>5%的 HR：1.12[0.84-1.50]）。此外，体重减轻>5%还与 CV 死亡率增加约 60%相关（HR：1.62[1.15-2.28]），体重减轻 3-5%与癌症死亡率增加约 95%相关（HR：1.95[1.13-3.38]）。