350 万瑞典年轻人体重指数与死亡率关联的时间趋势。
Time trends of the association of body mass index with mortality in 3.5 million young Swedish adults.
发表日期：2024 Jul 15
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
来源：
ANNALS OF EPIDEMIOLOGY
摘要：
我们调查了肥胖与死亡率关联的时间趋势，考虑了年龄、性别和特定原因死亡。我们分析了 1963 年至 2016 年基线时瑞典 3,472,310 名 17-39 岁个体的全国汇总数据。 Cox 回归和灵活参数生存模型调查了性别亚组和基线日历年的 BMI 与死亡率之间的关联（男性：<1975 年、1975-1985 年、≥1985 年，女性：<1985 年、1985-1994 年、≥1995 年）。比较男性与肥胖相比，正常体重、全因和“其他原因”死亡率的关联随着时间的推移而下降； 1975 年以下和 1985 年以上的全因死亡率 HR (95% CI) 为 1.92 (1.83-2.01) 和 1.70 (1.58-1.82)，“其他原因”死亡率为 1.72 (1.58-1.87) 和 1.40 (1.28-1.53) ，但 CVD 死亡率有所增加； HR 2.71 (2.51-2.94) 和 3.91 (3.37-4.53)。 1975 年之前，死亡年龄较高，同时肥胖相关死亡也较多。此外，男性不同年龄的全因死亡率关联显示不同时期之间没有明显差异（p交互作用= 0.09），表明在考虑达到的年龄后没有日历效应。在女性中也观察到了类似但不太明显的结果。癌症死亡率的关联在男性或女性中没有显示出明显的趋势。在调查 BMI 死亡率时间趋势时考虑日历周期之间年龄和死亡原因的差异可能会避免误解与肥胖相关的风险。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。
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.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.