International Medical Department, Xidan Campus, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
College of Environmental Science and Engineering, China West Normal University, Nanchong, China.
PLoS One. 2024 Jul 8;19(7):e0305922. doi: 10.1371/journal.pone.0305922. eCollection 2024.
Obesity, as indicated by elevated Body Mass Index (BMI), is a well-established global health concern associated with increased morbidity and mortality across diverse populations. However, the influence of BMI on individuals in Agriculture, Forestry, and Fishing (AFF) occupations, characterized by unique challenges and environmental factors, has received limited research attention.
Our study, a prospective cohort analysis, utilized National Health and Nutrition Examination Survey (NHANES) data from 1999-2014, targeting adults above 18 in AFF occupations with comprehensive BMI data, omitting individuals with a history of cancer. Mortality outcomes were extracted from the NHANES mortality file, and BMI was segmented into eight categories. Essential covariates such as age, sex, race, and various health factors were incorporated. The statistical analysis encompassed Cox regression, generalized additive models, smooth curve fitting, and stratified analyses.
During 1,005 person-years with 201 all-cause and 57 CVD deaths, we observed L-shaped and U-shaped correlations of BMI with all-cause and CVD mortality, featuring a pivotal inflection at 26.69 and 27.40 kg/m2. Above this BMI threshold of 26.69 and 27.4 kg/m2, all-cause mortality association was not significant while CVD mortality was positive.
This study highlights a unique BMI-mortality association in AFF occupations, diverging from standard patterns. The rigorous labor and environmental conditions in AFF jobs suggest that a certain range of higher BMI could reduce mortality risk. This highlights the necessity for tailored health guidelines in different occupations. Future research should concentrate on diverse health indicators and enhanced risk assessment for physically strenuous occupations.
肥胖是一个全球性的健康问题，其表现为体重指数（BMI）升高，与不同人群的发病率和死亡率增加有关。然而，BMI 对农业、林业和渔业（AFF）职业人群的影响，这些人群面临着独特的挑战和环境因素，这方面的研究关注有限。
我们的研究是一项前瞻性队列分析，利用 1999-2014 年国家健康和营养检查调查（NHANES）的数据，针对 AFF 职业中 BMI 数据全面、年龄在 18 岁以上的成年人，排除有癌症病史的个体。死亡率结果从 NHANES 死亡率文件中提取，BMI 分为八个类别。纳入了年龄、性别、种族和各种健康因素等基本协变量。统计分析包括 Cox 回归、广义加性模型、平滑曲线拟合和分层分析。
在 1005 人年的随访中，有 201 例全因死亡和 57 例心血管疾病死亡，我们观察到 BMI 与全因和心血管疾病死亡率之间存在 L 型和 U 型关系，在 26.69 和 27.40 kg/m2 处有一个关键拐点。在这个 BMI 阈值 26.69 和 27.4kg/m2 以上，全因死亡率的关联不再显著，而心血管疾病死亡率呈阳性。
这项研究强调了 AFF 职业中 BMI 与死亡率之间的独特关联，与标准模式不同。AFF 工作中的艰苦劳动和环境条件表明，一定范围内较高的 BMI 可能降低死亡风险。这突出了为不同职业制定定制化健康指南的必要性。未来的研究应集中于不同的健康指标和对体力劳动强度高的职业进行风险评估。
