Division of Clinical Research, The First Hospital of Jilin University, No.1, Xinmin Street, Changchun, 130021, China.
Department of Medical Informatics, School of Public Health, Jilin University, Changchun, 130021, China.
Sci Rep. 2024 Nov 7;14(1):27126. doi: 10.1038/s41598-024-75787-2.
Most current studies use body mass index (BMI) or waist circumference (WC) to define obesity, and BMI, which reflects subcutaneous fat independent of visceral fat, is the most commonly used indicator of obesity. WC reflects subcutaneous and visceral fat. This research aims to investigate the effect of obesity on mortality in people with digestive diseases. According to BMI and WC, we divided patients with obesity into the following four groups: general obesity, abdominal obesity, combined obesity, and non-obese. The effects of different obesity types on mortality in a population with digestive diseases were analysed via Cox regression and inverse probability-weighted Cox regression. Our research employed multivariate imputation via the chained equations method to interpolate missing values. A total of 254,445 participants, with a mean age of 57.8 ± 7.8 years, were included in the analysis. Of these participants, 227,111 (89.3%) participants were censored, and 27,334 (10.7%) participants died. Abdominal obesity and combined obesity were independent predictors of mortality in patients with digestive diseases. The combination of BMI and WC was valuable and significant for considering the type of obesity. In addition, our study revealed that sex, socioeconomic status, lifestyle habits, and physical activity were also associated with death in people with digestive disorders. Combined obesity, which is determined by both BMI and WC, is an important factor that influences mortality in a population with digestive diseases, and it plays a stronger role than abdominal obesity alone. These modifiable risk factors for mortality can provide guidance to populations with digestive diseases to avoid poor lifestyles and prolong survival time.
大多数当前的研究使用身体质量指数（BMI）或腰围（WC）来定义肥胖，而 BMI 反映了独立于内脏脂肪的皮下脂肪，是最常用的肥胖指标。WC 反映了皮下和内脏脂肪。本研究旨在探讨肥胖对消化系统疾病患者死亡率的影响。根据 BMI 和 WC，我们将肥胖患者分为以下四组：普通肥胖、腹部肥胖、合并肥胖和非肥胖。通过 Cox 回归和逆概率加权 Cox 回归分析不同肥胖类型对消化系统疾病人群死亡率的影响。我们使用链式方程法的多变量插补对缺失值进行了估计。共纳入 254445 名参与者，平均年龄为 57.8±7.8 岁。在这些参与者中，227111 名（89.3%）参与者被删失，27334 名（10.7%）参与者死亡。腹部肥胖和合并肥胖是消化系统疾病患者死亡的独立预测因素。BMI 和 WC 的组合对于考虑肥胖类型是有价值且重要的。此外，我们的研究还表明，性别、社会经济地位、生活方式习惯和身体活动与消化系统疾病患者的死亡也有关。BMI 和 WC 共同决定的合并肥胖是影响消化系统疾病人群死亡率的一个重要因素，其作用比单纯的腹部肥胖更强。这些可改变的死亡风险因素可以为消化系统疾病患者提供指导，避免不良的生活方式并延长生存时间。
