BMI and all-cause mortality among Chinese and Caucasians: the People's Republic of China and the Atherosclerosis Risk in Communities Studies

华人和高加索人的BMI与全因死亡率：中华人民共和国动脉粥样硬化风险的社区研究

Eva Erber Oakkar ； June Stevens ； Kimberly P Truesdale ； Jianwen Cai

《Asia Pacific Journal of Clinical Nutrition》 24卷3期 (2015/09) Pp. 472-479

https://doi.org/10.6133/apjcn.2015.24.3.12

摘要

背景：一些亚洲国家已经使用了比西方国家低的体质指数切点。但是，据我们所知，还没有研究在亚洲人和其他种族人群中直接使用同样的分析方法来比较体质指数与全因死亡率之间的关系。目的：通过比较华人和高加索人体质指数与全因死亡率之间的关系来判断是否亚洲人适用较低的体质指数切点。方法：使用Cox比例回归模型分析了5546名45-64岁的中国华人和9932美国高加索人的随访研究数据。结果：华人和高加索人的标化死亡率分别为6.88/1000人年（95%可信区间：5.75-8.24/1000人年）和5.50（95%可信区间：4.74-6.39/1000人年）。在小于70岁的华人中，不同体质指数组的标化死亡率相似，另外，其概率与体质指数为27.5至＜ 32.5的美国高加索人相似。华人和美国高加索人分别在体质指数为25.1和25.2时死亡风险最低。华人的死亡风险不随体质指数的增加而增加；而在美国高加索人群中，与体质指数为23.0-＜ 25.0的人相比，体质指数为30.0-＜ 32.5的人的死亡风险增加了35%。结论：这些研究结果不支持在中国人群中使用和高加索人群不同的体质指数切点。

關鍵字

体质指数 ； 全因死亡率 ； 华人 ； 高加索人 ； 体质指数切点

並列摘要

Background: Lower ethnic-specific body mass index (BMI) cutpoints have been proposed for Asians and adapted in some countries. However, to our knowledge, no study has directly compared Asians to other ethnic groups to test differences in associations between BMI and all-cause mortality using common methods. Objectives: We estimated the association between BMI and all-cause mortality in Chinese Asians and Caucasian Americans to determine if lower Asian-specific BMI cutpoints are warranted. Methods: Extant data of the People's Republic of China Study (1983-1997) including 5546 Chinese and the Atherosclerosis Risk in Communities Study (1987-2002) including 9932 Caucasians aged 45-64 years at baseline were used. All analyses were performed using Cox proportional regression models. Results: Standardized mortality rates were 6.88 (95% confidence interval (CI): 5.75-8.24) and 5.50 (95% CI: 4.74-6.39) per 1000 person-years for Chinese and Caucasians, respectively. Standardized mortality probabilities by age 70 were similar across all BMI categories among Chinese. Furthermore, the probabilities were similar to those among Caucasians with BMI of 27.5-＜ 32.5 kg/m^2. The BMI associated with lowest mortality risk was almost identical between Chinese (25.1 kg/m^2) and Caucasians (25.2 kg/m^2). The analysis of categorical BMI did not reveal an increased mortality risk at any BMI category among Chinese. In contrast, compared to those with a BMI of 23.0-＜ 25.0 kg/m^2, risk was elevated by 35% among Caucasians with a BMI of 30.0-＜ 32.5 kg/m^2. Conclusions: These findings do not support different BMI cutpoints for Chinese than Caucasians on the basis of mortality rates.

並列關鍵字

body mass index ； all-cause mortality ； Chinese ； Caucasians ； BMI cutpoint