Cho Sooyoung, Shin Aesun, Choi Ji-Yeob, Lee Jong-Koo, Kang Daehee
Genomic Medicine Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Epidemiol Health. 2024;46:e2024073. doi: 10.4178/epih.e2024073. Epub 2024 Sep 2.
We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study.
We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality.
A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both males and females with BMIs of less than 21.0 kg/m2 and greater than or equal to 30.0 kg/m2 are at increased risk. The results showed that males with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.73 to 2.91) and cardiovascular mortality (aHR, 2.27; 95% CI, 1.23 to 4.20). Similarly, males with a WHR of less than 0.80 (aHR, 1.38; 95% CI, 1.08 to 1.77), 0.90 to less than 0.95 (aHR, 1.15; 95% CI, 1.02 to 1.29), and greater than or equal to 0.95 (aHR, 1.28; 95% CI, 1.11 to 1.47) showed an increased risk of all-cause mortality. In females, a BMI of less than 18.0 kg/m2 was linked to a higher risk of cardiovascular mortality (aHR, 2.67; 95% CI, 1.13 to 6.33).
Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in males who were slightly overweight with a BMI of 23.0-25.0 kg/m2.
我们旨在利用健康体检者研究的数据，评估肥胖对中年韩国人死亡率的影响。
我们使用了那些在身体尺寸方面有完整信息且同意将其数据与国家死亡证明数据相链接的参与者的数据。采用Cox比例风险模型来估计体重指数（BMI）和腰臀比（WHR）对于全因死亡率、心血管疾病死亡率和癌症死亡率的风险比及95%置信区间（CI）。
共有115,961名参与者纳入本研究。结果显示BMI与死亡率之间呈U形关联，表明BMI小于21.0kg/m²和大于或等于30.0kg/m²的男性和女性死亡风险均增加。结果显示，BMI小于18.5kg/m²的男性全因死亡率（校正风险比[aHR]，2.24；95%CI，1.73至2.91）和心血管疾病死亡率（aHR，2.27；95%CI，1.23至4.20）显著更高。同样，腰臀比小于0.80（aHR，1.38；95%CI，1.08至1.77）、0.90至小于0.95（aHR，1.15；95%CI，1.02至1.29）以及大于或等于0.95（aHR，1.28；95%CI，1.11至1.47）的男性全因死亡风险增加。在女性中，BMI小于18.0kg/m²与心血管疾病死亡率较高相关（aHR，2.67；95%CI，1.13至6.33）。
体重过轻与两性的死亡风险增加相关，而BMI为23.0 - 25.0kg/m²的轻度超重男性死亡风险最低。
