Association between Class III Obesity (BMI of 40–59 kg/m2) and Mortality: A Pooled Analysis of 20 Prospective Studies

作者：Cari M. Kitahara, Alan Flint, Amy Berrington de González, Leslie Bernstein, Michelle Brotzman, Robert J. MacInnis, Steven C. Moore, Kim Robien, Philip S. Rosenberg, Pramil N. Singh, Elisabete Weiderpass, Hans Olov Adami, Hoda Anton‐Culver, Rachel Ballard‐Barbash, Julie E. Buring, D. Michal Freedman, Gary E. Fraser, Laura E. Beane Freeman, Susan M. Gapstur, John Michael Gaziano, Graham G. Giles, Niclas Håkansson, Jane A. Hoppin, Frank B. Hu, Karen L. Koenig, Martha S. Linet, Yikyung Park, Alpa V. Patel, Mark P. Purdue, Catherine Schairer, Howard D. Sesso, Kala Visvanathan, Emily White, Alicja Wolk, Anne Zeleniuch‐Jacquotte, Patricia Hartge · 发表于：PLoS Medicine · 年份：2014 · DOI：10.1371/journal.pmed.1001673 · 被引用次数：440 · 研究领域：Bariatric Surgery and Outcomes、Diabetes, Cardiovascular Risks, and Lipoproteins、Obesity, Physical Activity, Diet

BACKGROUND: The prevalence of class III obesity (body mass index [BMI]≥40 kg/m2) has increased dramatically in several countries and currently affects 6% of adults in the US, with uncertain impact on the risks of illness and death. Using data from a large pooled study, we evaluated the risk of death, overall and due to a wide range of causes, and years of life expectancy lost associated with class III obesity. METHODS AND FINDINGS: In a pooled analysis of 20 prospective studies from the United States, Sweden, and Australia, we estimated sex- and age-adjusted total and cause-specific mortality rates (deaths per 100,000 persons per year) and multivariable-adjusted hazard ratios for adults, aged 19-83 y at baseline, classified as obese class III (BMI 40.0-59.9 kg/m2) compared with those classified as normal weight (BMI 18.5-24.9 kg/m2). Participants reporting ever smoking cigarettes or a history of chronic disease (heart disease, cancer, stroke, or emphysema) on baseline questionnaires were excluded. Among 9,564 class III obesity participants, mortality rates were 856.0 in men and 663.0 in women during the study period (1976-2009). Among 304,011 normal-weight participants, rates were 346.7 and 280.5 in men and women, respectively. Deaths from heart disease contributed largely to the excess rates in the class III obesity group (rate differences = 238.9 and 132.8 in men and women, respectively), followed by deaths from cancer (rate differences = 36.7 and 62.3 in men and women, res...