Berchtold P, Berger M, Gries F A, Zimmermann H
Fortschr Med. 1978 May 18;96(19):1003-9.
Epidemiological studies on the relationship of obesity, morbidity and mortality revealed the following results: In life insurance studies, excess mortality of obese people was found with more than 30 percent overweight. Mortality was caused by cardiovascular disease and diabetes mellitus. Obesity at issue of the policy in younger age was a greater risk than in the older age group. In prospective studies with long follow-up periods (greater than 16 years) it could be shown that obesity alone was a risk factor for coronary heart disease, the risk being greatest for men and middle aged women. However, the prevalence of accepted risk factors in an obese population is so high that the question whether obesity alone is a risk factor for coronary heart disease is of little interest. The correlations between obesity and risk factors were of minor magnitude; therefore other factors, such as age or HDL-cholesterol, should be considered in the elucidation of the relationship between obesity and coronary heart disease. HDL-cholesterol appears to be a powerful independent protective factor which is diminished in obesity. Despite the fact that studies proving a prolongation of life by treating obesity are not available, the treatment of obesity may be beneficial for the patient by diminishing risk factors.
关于肥胖、发病率和死亡率之间关系的流行病学研究得出了以下结果：在人寿保险研究中，发现超重超过30%的肥胖者死亡率过高。死亡原因是心血管疾病和糖尿病。年轻时投保时肥胖比老年组面临更大风险。在随访期较长（超过16年）的前瞻性研究中可以表明，单纯肥胖是冠心病的一个风险因素，男性和中年女性的风险最大。然而，肥胖人群中公认的风险因素患病率如此之高，以至于单纯肥胖是否是冠心病的风险因素这一问题意义不大。肥胖与风险因素之间的相关性较小；因此，在阐明肥胖与冠心病之间的关系时，应考虑其他因素，如年龄或高密度脂蛋白胆固醇。高密度脂蛋白胆固醇似乎是一种强大的独立保护因素，在肥胖状态下会减少。尽管尚无通过治疗肥胖来延长寿命的研究，但治疗肥胖可能通过降低风险因素对患者有益。
