참고자료

[비만] 체질량지수(BMI)를 이용한 과체중 및 비만과 사망률 분석

미국의 국가보건통계청(NCHS) 연구팀이 2013년 1월에 미국의학협회저널(JAMA)에 발표한
체질량지수(BMI)를 이용한 과체중 및 비만과 사망률 분석 논문입니다.

미국인 288만 명의 체질량 지수를 이용한 비만도와 27만 건의 사망 사례를 비교 분석한
내용입니다.

정상체중(BMI of 18.5-<25), 과체중(BMI of 25-<30), 비만(BMI of 30-<35) 지표 사용

정상체중인 사람보다 과체중인 사람의 사망률이 6% 낮은 것으로 나타남.
체질량지수(BMI) 기준의 척도에 관한 논란 제기됨.

====================

JAMA. 2013 Jan 2;309(1):71-82. doi: 10.1001/jama.2012.113905.

Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis.

Source

National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Rd, Room 4336, Hyattsville, MD 20782, USA. kmf2@cdc.gov

http://www.ncbi.nlm.nih.gov/pubmed/23280227

Abstract

IMPORTANCE:

Estimates of the relative mortality risks associated with normal weight, overweight, and obesity may help to inform decision making in the clinical setting.

OBJECTIVE:

To perform a systematic review of reported hazard ratios (HRs) of all-cause mortality for overweight and obesity relative to normal weight in the general population.

DATA SOURCES:

PubMed and EMBASE electronic databases were searched through September 30, 2012, without language restrictions.

STUDY SELECTION:

Articles that reported HRs for all-cause mortality using standard body mass index (BMI) categories from prospective studies of general populations of adults were selected by consensus among multiple reviewers. Studies were excluded that used nonstandard categories or that were limited to adolescents or to those with specific medical conditions or to those undergoing specific procedures. PubMed searches yielded 7034 articles, of which 141 (2.0%) were eligible. An EMBASE search yielded 2 additional articles. After eliminating overlap, 97 studies were retained for analysis, providing a combined sample size of more than 2.88 million individuals and more than 270,000 deaths.

DATA EXTRACTION:

Data were extracted by 1 reviewer and then reviewed by 3 independent reviewers. We selected the most complex model available for the full sample and used a variety of sensitivity analyses to address issues of possible overadjustment (adjusted for factors in causal pathway) or underadjustment (not adjusted for at least age, sex, and smoking).

RESULTS:

Random-effects summary all-cause mortality HRs for overweight (BMI of 25-<30), obesity (BMI of ≥30), grade 1 obesity (BMI of 30-<35), and grades 2 and 3 obesity (BMI of ≥35) were calculated relative to normal weight (BMI of 18.5-<25). The summary HRs were 0.94 (95% CI, 0.91-0.96) for overweight, 1.18 (95% CI, 1.12-1.25) for obesity (all grades combined), 0.95 (95% CI, 0.88-1.01) for grade 1 obesity, and 1.29 (95% CI, 1.18-1.41) for grades 2 and 3 obesity. These findings persisted when limited to studies with measured weight and height that were considered to be adequately adjusted. The HRs tended to be higher when weight and height were self-reported rather than measured.

CONCLUSIONS AND RELEVANCE:

Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.

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