| Меню сайта |
- Дистанционное образование
|
| Статистика |
Онлайн всего: 1 Гостей: 1 Пользователей: 0 |
|
| СНО терапии |
 |
Body-mass index and cause-specific mortality in 900 000 adults:collaborative analyses of 57 prospective studies
|
[
]
| 02.05.2009, 23:50 |
|
Summary
Background— The main associations of body-mass index (BMI) with overall and cause-specific
mortality can best be assessed by long-term prospective follow-up of large numbers of people. The
Prospective Studies Collaboration aimed to investigate these associations by sharing data from many
studies.
Methods— Collaborative analyses were undertaken of baseline BMI versus mortality in 57
prospective studies with 894 576 participants, mostly in western Europe and North America (61%
[n=541 452] male, mean recruitment age 46 [SD 11] years, median recruitment year 1979 [IQR
1975–85], mean BMI 25 [SD 4] kg/m 2). The analyses were adjusted for age, sex, smoking status,
and study. To limit reverse causality, the first 5 years of follow-up were excluded, leaving 66 552
deaths of known cause during a mean of 8 (SD 6) further years of follow-up (mean age at death 67
[SD 10] years): 30 416 vascular; 2070 diabetic, renal or hepatic; 22 592 neoplastic; 3770 respiratory;
7704 other.
Findings— In both sexes, mortality was lowest at about 22·5–25 kg/m2. Above this range, positive
associations were recorded for several specific causes and inverse associations for none, the absolute
excess risks for higher BMI and smoking were roughly additive, and each 5 kg/m 2 higher BMI was
on average associated with about 30% higher overall mortality (hazard ratio per 5 kg/m 2 [HR] 1·29
[95% CI 1·27–1·32]): 40% for vascular mortality (HR 1·41 [1·37–1·45]); 60–120% for diabetic, renal,
and hepatic mortality (HRs 2·16 [1·89–2·46], 1·59 [1·27–1·99], and 1·82 [1·59–2·09], respectively);
10% for neoplastic mortality (HR 1·10 [1·06–1·15]); and 20% for respiratory and for all other
mortality (HRs 1·20 [1·07–1·34] and 1·20 [1·16–1·25], respectively). Below the range 22·5–25 kg/
m 2, BMI was associated inversely with overall mortality, mainly because of strong inverse
associations with respiratory disease and lung cancer. These inverse associations were much stronger
for smokers than for non-smokers, despite cigarette consumption per smoker varying little with BMI.
Interpretation— Although other anthropometric measures (eg, waist circumference, waist-to-hip
ratio) could well add extra information to BMI, and BMI to them, BMI is in itself a strong predictor
of overall mortality both above and below the apparent optimum of about 22·5–25 kg/m 2. The
progressive excess mortality above this range is due mainly to vascular disease and is probably largely
causal. At 30–35 kg/m 2, median survival is reduced by 2–4 years; at 40–45 kg/m2, it is reduced by
8–10 years (which is comparable with the effects of smoking). The definite excess mortality below
22·5 kg/m 2 is due mainly to smoking-related diseases, and is not fully explained.
|
| Категория: Статьи | Добавил: nbylova
|
| Просмотров: 427 | Загрузок: 0
| Рейтинг: 0.0/0 |
|
Добавлять комментарии могут только зарегистрированные пользователи. [ Регистрация | Вход ] |
|
