Peking University Institute for Global Health and Development, Beijing, China.
Peking University Institute for Global Health and Development, Beijing, China
BMJ Open. 2024 Jul 9;14(7):e083443. doi: 10.1136/bmjopen-2023-083443.
Obesity is a well-established risk factor for disease. Controversy exists regarding the relative risk of morbidity and mortality in individuals who are overweight or underweight compared with individuals with a normal body mass index (BMI). In this study, we investigated the associations between BMI and three non-communicable diseases (hypertension, diabetes and heart disease) in older adults.
Cohort study.
This study used data from the China Health and Retirement Longitudinal Study. The baseline survey was carried out in 2011, and follow-up surveys were conducted in 2013, 2015 and 2018.
Participants who reported having no doctor-diagnosed chronic disease at baseline were included in this study.
We analysed the association between baseline BMI and disease incidence using Cox proportional hazards models. Disease information included self-reported diagnosed conditions. BMI was categorised according to the standard Chinese criteria: underweight (<18.5 kg/m), normal body weight (18.5-23.9 kg/m), overweight (24.0-27.9 kg/m) and obese (≥28.0 kg/m).
A total of 5605 participants were included at baseline. Based on the Kaplan-Meier estimation, the participants who were obese had the highest incidence of all three diseases. Compared with normal weight participants, overweight participants had a greater disease incidence (log-rank tests are p<0.01). Cox regression models showed that with increasing BMI, the HRs of diseases increased accordingly (eg, for hypertension, compared with the BMI group <18.5 kg/m, the HRs for the BMI groups 18.5-23.9, 24.0-27.9 and ≥28.0 were 1.43 (95% CI 1.00 to 2.05), 2.19 (95% CI 1.51 to 3.18) and 2.89 (95% CI 1.91 to 4.36), respectively).
A higher BMI was associated with an increased risk of hypertension, diabetes and heart disease in the population aged 45 years and older. Even within normal BMI ranges, a higher BMI was associated with an increased risk of disease. Actions are urgently needed at the population level to address the growing public health challenge of excess weight in the context of an ageing population.
肥胖是疾病的一个既定危险因素。与体重正常的个体相比，超重或体重不足的个体患发病和死亡的相对风险存在争议。本研究旨在探讨老年人的 BMI 与三种非传染性疾病（高血压、糖尿病和心脏病）之间的关联。
队列研究。
本研究使用了中国健康与退休纵向研究的数据。基线调查于 2011 年进行，2013 年、2015 年和 2018 年进行了随访调查。
本研究纳入了基线时报告无医生诊断的慢性疾病的参与者。
我们使用 Cox 比例风险模型分析了基线 BMI 与疾病发生率之间的关系。疾病信息包括自我报告的诊断情况。BMI 按照中国标准进行分类：体重不足（<18.5kg/m）、正常体重（18.5-23.9kg/m）、超重（24.0-27.9kg/m）和肥胖（≥28.0kg/m）。
共纳入 5605 名参与者作为基线人群。基于 Kaplan-Meier 估计，肥胖参与者的三种疾病发病率最高。与体重正常的参与者相比，超重参与者的疾病发病率更高（对数秩检验 p<0.01）。Cox 回归模型显示，随着 BMI 的增加，疾病的 HR 相应增加（例如，高血压方面，与 BMI<18.5kg/m 组相比，BMI 组 18.5-23.9kg/m、24.0-27.9kg/m 和≥28.0kg/m 的 HR 分别为 1.43（95%CI 1.00-2.05）、2.19（95%CI 1.51-3.18）和 2.89（95%CI 1.91-4.36））。
较高的 BMI 与 45 岁及以上人群的高血压、糖尿病和心脏病风险增加有关。即使在正常 BMI 范围内，较高的 BMI 也与疾病风险增加有关。在人口层面上迫切需要采取行动，以应对人口老龄化背景下日益严重的超重公共卫生挑战。
