体重指数与350万年轻瑞典成年人的死亡率的时间趋势
Time trends of the association of body mass index with mortality in 3.5 million young Swedish adults
影响因子:3.00000
分区:医学3区 / 公共卫生3区
发表日期:2024 Sep
作者:
Innocent B Mboya, Josef Fritz, Marisa da Silva, Ming Sun, Jens Wahlström, Patrik K E Magnusson, Sven Sandin, Weiyao Yin, Stefan Söderberg, Nancy L Pedersen, Ylva Trolle Lagerros, Bright I Nwaru, Hannu Kankaanranta, Abbas Chabok, Jerzy Leppert, Helena Backman, Linnea Hedman, Karolin Isaksson, Karl Michaëlsson, Christel Häggström, Tanja Stocks
摘要
我们调查了肥胖死亡率协会的时间趋势，对年龄，性别和特定原因的死亡的核算。我们在1963 - 2016年基线时分析了瑞典的全国性数据汇总数据，分别为3,472,310名17-39岁的人。 COX回归和灵活的参数生存模型研究了性别和基线日历年的BMI死亡率关联（男性：<1975，1975，1975-1985，≥1985和女性：<1985，1985，1985-1994，≥1995。 HR（95％CI）1.92（1.83-2.01）和1.70（1.58-1.82）用于全原因，1.72（1.58-1.87）和1.40（1.28-1.53）（1.28-1.53）用于<1975和≥1975和≥1985的“其他原因”死亡率，但增加了CVD的死亡率，但增加了CVD的死亡率； HR 2.71（2.51-2.94）和3.91（3.37-4.53）。 1975年之前死亡的年龄较高，与肥胖相关的死亡人数更高。此外，男性不同年龄的全因死亡率关联显示在时期之间没有明显的差异（p-interaction = 0.09），这表明在占年龄后没有日历效应。在女性中观察到类似但不太明显的结果。与癌症死亡率的联系没有显示男性或女性的明显趋势。在调查BMI-验尸时间趋势时，日历期之间的年龄和死亡原因差异可能会避免误解随着时间的推移而误解与肥胖有关的风险。
Abstract
We investigated time trends of the obesity-mortality association, accounting for age, sex, and cause-specific deaths.We analysed pooled nationwide data in Sweden for 3,472,310 individuals aged 17-39 years at baseline in 1963-2016. Cox regression and flexible parametric survival models investigated BMI-mortality associations in sub-groups of sex and baseline calendar years (men: <1975, 1975-1985, ≥1985 and women: <1985, 1985-1994, ≥1995).Comparing men with obesity vs. normal weight, all-cause and "other-cause" mortality associations decreased over periods; HR (95% CI) 1.92 (1.83-2.01) and 1.70 (1.58-1.82) for all-cause and 1.72 (1.58-1.87) and 1.40 (1.28-1.53) for "other-cause" mortality in <1975 and ≥1985, but increased for CVD mortality; HR 2.71 (2.51-2.94) and 3.91 (3.37-4.53). Higher age at death before 1975 coincided with more obesity-related deaths at higher ages. Furthermore, the all-cause mortality association for different ages in men showed no clear differences between periods (p-interaction=0.09), suggesting no calendar effect after accounting for attained age. Similar, but less pronounced, results were observed in women. Associations with cancer mortality showed no clear trends in men or in women.Accounting for differences in age and death causes between calendar periods when investigating BMI-mortality time trends may avoid misinterpreting the risks associated with obesity over time.