上海市中老年男性体重指数与死亡的前瞻性研究  

A prospective cohort study on body mass index and mortality among middle-aged and elderly men in urban Shanghai

作　　者：王俊[1] 高玉堂[1] 王学励[1] 刘恩菊[1] 张玉兰[1] 袁剑敏[1] 

机构地区：[1]上海市肿瘤研究所流行病学研究室

出　　处：《中华流行病学杂志》2005年第6期394-399,共6页Chinese Journal of Epidemiology

摘　　要：目的探讨上海市区中老年男性体重指数(BMI)与死亡的关系及年龄对这种关系的影响。方法1986年1月至1989年9月调查上海市区45～64岁男性居民18244人,每年上门随访一次;用Cox比例风险模型计算相对危险度(RR)。结果至2002年度随访结束,全队列共随访235762人年,人均随访12.9年,在此期间共死亡3365人。在不吸烟者中,相对于正常BMI组(BMI18.5～23.9),低BMI组(BMI<18.5)、超重组(BMI24～27.9)和肥胖组(BMI≥28)总死亡RR值分别为1.20、1.12和1.61;在不吸烟者中去除随访开始头5年随访资料后,三组相应的RR值分别为1.01、1.12和1.75。结肠癌和心脑血管疾病死亡危险性随BMI增加而上升;除肿瘤和心脑血管疾病之外的死亡,其中主要为一些感染性疾病死亡的危险性在低BMI组显著升高,去除随访开始头5年随访资料对此结果无明显影响。在基线调查时≥55岁的对象中,肥胖组总死亡危险性上升更明显;而在<55岁的对象中,BMI与总死亡无显著相关。结论上海市区的中老年男性中肥胖会增加总死亡危险性,在年龄较大者中这种趋势更明显;结肠癌及心脑血管疾病死亡危险性随BMI增加而上升;感染性疾病的死亡危险性则在低BMI组显著升高。Objective To examine the association between body mass index (BMI) and mortality as well as the effect of age on it among middle-aged and elderly men in urban area of Shanghai. Methods A total of 18 244 male subjects aged 45-64 years resided in urban area of Shanghai were enrolled in the study during January 1, 1986 through September 30, 1989, and were actively followed under annual visits. ‘Cox proportional hazards model’ was used to estimate the relative risks(RR). Results By the end of the follow-up process in 2002, a total number of 235 762 person-years was accumulated in the cohort, with an average of 12.9 years per subject. A total number of 3365 deaths including 1381 from cancer and 1165 from cardio- and cerebro-vascular diseases(CVD), was identified during the follow-up period. Compared with those under normal BMI(BMI 18.5- 23.9), the RRs of death for all causes of death among groups at low BMI( BMI< 18.5), overweight(BMI 24- 27.9) and obesity( BMI≥28) were 1.20, 1.12 and 1.61, respectively, among non-smokers after adjustment for age, alcohol consumption and level of education. After excluding the numbers observed during the first 5 years of follow-up, the corresponding RRs became 1.01, 1.12, and 1.75, respectively. The risk of deaths from colon cancer or CVD increased along with the increase of BMI, while the risk of non-cancer and non-CVD deaths, mostly deaths from infectious diseases, increased significantly in the group of low BMI. Among those aged ≥55 years at baseline survey, the risk for all causes of death increased more significantly with those having obesity. However, among those who were younger than 55 years of age, no significant correlation between BMI and overall mortality was noticed. Conclusion A positive relationship between obesity and total mortality was observed in the middle-aged and elderly men in urban Shanghai. The association was more obvious among the elderly while the risk of deaths from colon cancer or CVD rose along with the increase of BMI. The risk of death from inf

关 键 词：中老年男性 体重指数 前瞻性研究 COX比例风险模型 心脑血管疾病 死亡危险性 上海市区 2002年度 不吸烟者 随访资料 BMI 1989年 相对危险度 感染性疾病 男性居民 疾病死亡 基线调查 结肠癌 肥胖 上升 年龄 R值 去除 升高 

分 类 号：R195[医药卫生—卫生统计学]