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体重指数与死亡的前瞻性研究
引用本文:赵连成,周北凡,武阳丰,李莹,杨军.体重指数与死亡的前瞻性研究[J].中华流行病学杂志,2002,23(1):24-27.
作者姓名:赵连成  周北凡  武阳丰  李莹  杨军
作者单位:100037,北京,中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院流行病学研究室
基金项目:国家“九五”科技攻关资助项目 ( 96 90 6 0 2 0 1)
摘    要:目的:探讨不同体重指数(BMI)水平与总死亡及不同死因死亡的关系。方法;1982-1985年在我国不同地区的10组人群中(年龄35-39岁)进行心血管病危险因素调查,并对研究对象中无脑卒中、无心肌梗死及无恶性肿瘤史的30560人(男性15723人,女性14837人),随访至1999-2000年,登记各种死亡的发生情况。结果:在平均15.2年的随访中,共死亡3212例,其中冠心病和脑卒中共死亡676例,恶性肿瘤死亡1281例,其他原因死亡1255例。用Cox比例风险回归模型(调整年龄、性别0估计低BMI组(BMI<18.5)、正常BMI组(BMI为18.5-23.9)、超重组(BMI为24-27.9)和肥胖组(BMI≥28)总死亡的相对危险分别为1.21,1.00,0.901,1.12,呈“U”形关系,当同时剔除前5年死亡病例及吸烟者后,低BMI组死亡的相对危险降低,而肥胖组增加,正常BMI组的相对危险最小。 随着BMI水平的上升,冠心病和脑卒中死亡的相对危险增加,恶性肿瘤死亡的相对危险降低,其他原因死亡的相对危险与BMI水平呈“U”形关系,当剔除早期死亡病例及吸烟者后,这些趋势依然存在。结论:BMI在正常范围内,总死亡的相对危险较低,且冠心病和脑卒中死亡,恶性肿瘤死亡及其它原因死亡的 综合风险也处于相对较低水平,有着重要的公共卫生学意义。

关 键 词:体重指数  死亡率  相对危险度  心血管病
收稿时间:2001/8/29 0:00:00
修稿时间:2001年8月29日

A prospective study on body mass index and mortality
ZHAO Liancheng,ZHOU Beifan,WU Yangfeng,LI Ying and YANG Jun.A prospective study on body mass index and mortality[J].Chinese Journal of Epidemiology,2002,23(1):24-27.
Authors:ZHAO Liancheng  ZHOU Beifan  WU Yangfeng  LI Ying and YANG Jun
Institution:Department of Epidemiology, Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China.
Abstract:OBJECTIVE: To assess the relationship between body mass index (BMI, weight in kilograms divided by the square of height in meters) and both all-causes mortality and mortality from specific cause. METHODS: Cardiovascular disease (CVD) risk factors were studied in 1982 - 1985 on more than 30 thousands participants aged 35 - 59 from 10 Chinese populations. 30 560 participants (15 723 for men, 148 837 for women) without known myocardial infraction, stroke or cancer was followed from 1999 to 2000. All-causes of death were documented. RESULTS: Three thousand two hundred and twelve death cases occurred during follow-up of average 15.2 years, including 676 CVD (coronary heart disease and stroke) deaths, 1 281 cancer deaths and 1 255 deaths for other reasons. Cox proportional hazards model adjusting age and gender showed that the relative risks of all causes of death in groups of low BMI (BMI < 18.5), normal BMI (BMI from 18.5 to 23.9), overweight (BMI from 24 to 27.9) and obesity (BMI >/= 28) which were defined according to the strata of BMI for Chinese were 1.21 (95% CI: 1.10 - 1.33), 1.00, 0.91 (95% CI: 0.82 - 1.01) and 1.12 (95% CI: 0.93 - 1.37), respectively ("U" shaped relation). The relative risk of low BMI group (RR = 1.01, 95% CI: 0.84 - 1.21) was not significant different and the relative risk of obesity significantly increased (RR = 1.36, 95% CI: 1.04 - 1.80) while the lowest relative risk was in normal BMI group. The relative risks increased for CVD death, but decreased for cancer death with increased levels of BMI and a "U" shaped relationship was found between BMI groups and mortality for other reasons, which remained after excluding the early death and smokers. CONCLUSION: BMI in normal level was not only related to low risk of all causes of death, but also with relative low risk of CVD, cancer and other deaths. Data were important to public health.
Keywords:Body mass index(BMI)  Mortality  Prospective study  Relative risk
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