The paradoxical association between overweight and mortality is reversed in analyses incorporating weight history. The analyses included 3 prospective cohort studies. A total of 32 571 deaths in 225 072 men and women were observed over a mean of 12.3 years of follow-up. Maximum BMIs in the overweight (25.0 to 29.9 kg/m2, multivariate hazard ratio [HR], 1.06), obese I (30.0 to 34.9 kg/m2, HR, 1.24), and obese II (≥35.0 kg/m2, HR, 1.73) categories were associated with increases in risk for all-cause death. The pattern of excess risk with a maximum BMI above normal weight was maintained across strata defined by smoking status, sex, and age, but the excess was greatest among those younger than 70 years and never-smokers. In contrast, a significant inverse association between overweight and mortality (HR, 0.96) was observed when BMI was defined using a single baseline measurement. Maximum overweight was also associated with increased cause-specific mortality, including death from cardiovascular disease and coronary heart disease. Maximum BMI may be a useful metric to minimize reverse causation bias associated with a single baseline BMI assessment. Source: http://annals.org/
超重和死亡率之间的矛盾关系在包括体重史的分析中相反。该分析包括3项前瞻性群组研究。在平均12.3年的随访中观察到，225072名男性和女性中共有32571人死亡。最大体重指数在超重（25.0〜29.9 kg / m2，多变量风险比1.06），1级肥胖（30.0〜34.9 kg / m2， 风险比1.24），2级肥胖（≥35.0 kg / m2， 风险比1.73）类别中均与全因死亡风险增加有关。在各种吸烟状况，性别和年龄层间，都保持了这种超过正常体重最大体重指数的高风险模式，而以70岁以下和从未吸烟者的风险增加最多。相比之下，仅以单次测量基线体重指数时，则观察到超重和死亡率之间为显着的逆相关（风险比0.96）。最大超重也与病因特异性死亡率增加有关，包括死于心血管病和冠心病。最大体重指数可作为一个有用的指标，以缩减与单次基线体重指数检测相关的反向因果关系偏差。来源：http://annals.org/