Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Torino, 10126 Torino, Italy.
Department of Medical Sciences, University of Torino, 10126 Torino, Italy.
Nutrients. 2024 Oct 10;16(20):3433. doi: 10.3390/nu16203433.
To assess the complementary role of the Body Mass Index (BMI) and Edmonton Obesity Staging System (EOSS) in predicting all-cause and cause-specific mortality in people living with overweight and obesity (PLwOW/O).
A longitudinal analysis of prospectively collected data from the 1999-2018 cycles of the National Health and Nutrition Examination Survey (NHANES) was conducted. The association between BMI, EOSS, and mortality was evaluated through Cox regression models, adjusted for confounders.
The analysis included 36,529 subjects; 5329 deaths occurred over a median follow-up of 9.1 years (range: 0-20.8). An increased mortality risk was observed for obesity class II and III (HR = 1.21, 95% CI 1.08-1.36, = 0.001 and HR = 1.58, 95% CI 1.39-1.80, < 0.001; compared to overweight), and for EOSS stage 2 and 3 (HR = 1.36, 95% CI 1.16-1.58, < 0.001 and HR = 2.66, 95% CI 2.26-3.14, < 0.001; compared to stage 0/1). The prognostic role of BMI was more pronounced in younger patients, males, and non-Black individuals, while that of EOSS was stronger in women. Both BMI and EOSS independently predicted cardiovascular- and diabetes-related mortality. EOSS stage 3 was the only predictor of death from malignancy or renal causes.
BMI and EOSS independently predict all-cause and cause-specific mortality in PLwOW/O. Their integrated use seems advisable to best define the obesity-related mortality risk.
评估身体质量指数（BMI）和埃德蒙顿肥胖分期系统（EOSS）在预测超重和肥胖人群（PLwOW/O）全因和特定原因死亡率方面的补充作用。
对 1999-2018 年全国健康和营养检查调查（NHANES）前瞻性收集数据进行纵向分析。通过 Cox 回归模型评估 BMI 和 EOSS 与死亡率之间的关联，调整混杂因素。
该分析纳入 36529 名受试者；中位随访 9.1 年（范围：0-20.8 年）期间发生 5329 例死亡。肥胖 II 级和 III 级（HR=1.21，95%CI1.08-1.36，=0.001 和 HR=1.58，95%CI1.39-1.80，<0.001；与超重相比）和 EOSS 第 2 期和第 3 期（HR=1.36，95%CI1.16-1.58，<0.001 和 HR=2.66，95%CI2.26-3.14，<0.001；与第 0/1 期相比）的死亡风险增加，BMI 在年轻患者、男性和非黑人中预后作用更为明显，而 EOSS 在女性中作用更强。BMI 和 EOSS 均可独立预测心血管疾病和糖尿病相关死亡率。EOSS 第 3 期是恶性肿瘤或肾脏疾病相关死亡的唯一预测因素。
BMI 和 EOSS 可独立预测 PLwOW/O 的全因和特定原因死亡率。两者结合使用似乎可以更好地确定肥胖相关的死亡率风险。
