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目的 探讨体重指数 (BMI)与全死因死亡率的关系。方法 对 1984～ 1986和 1992年进行心血管病危险因素调查的江苏省金坛县农民 3 2 0 4人 (男 145 7人 ,女 1747人 )随访 ,采用COX回归估计体重过低对全死因死亡率的相对危险性 (RelativeRisk ,RR)。结果 平均随访 12 .40年 ,共死亡30 7例 (男 187例 ,女 12 0例 ) ;不同体重指数组间死亡粗率差异显著 ;以BMI 18.5～ 2 4.9kg/m2 为参考组 ,体重过低 (BMI<18.5kg/m2 )组总死亡率的RR为 1.5 8(95 %CI 1.16～ 2 .14) ;吸烟和收缩压升高也是增加总死亡率的独立危险因素 ;排除随访早期 5年内因肿瘤死亡的 45例后 ,体重过低组总死亡率的RR仍达 1.49(95 %CI 1.0 7～ 2 .0 7)。结论 体重过低是增加总死亡率的危险因素 ,不能完全以吸烟、亚临床肿瘤的混杂效应来解释。
Objective To investigate the relationship between body mass index (BMI) and all-cause mortality. Methods A total of 3204 peasants (male 145 7 and female 1747) were surveyed in 1984-1986 and 1992 risk factors for cardiovascular disease in Jiangsu Jintan County. Cox regression was used to estimate the risk of underweight and all-cause mortality. The relative risk of the rate (RelativeRisk, RR). Results The average follow-up time was 12.40 years, and a total of 307 deaths (187 males and 120 females) occurred; the difference in death rate between groups with different body mass index was significant; the reference group with BMI 18.5-24.9 kg/m2 was too low; The RR of total mortality (BMI < 18.5 kg/m2) was 1.5 8 (95% CI 1.16 to 2.14); smoking and elevated systolic blood pressure were also independent risk factors for increasing total mortality; the cause was excluded within 5 years of follow-up. After 45 deaths from tumors, the RR of total mortality in the underweight group was still 1.49 (95% CI 1.0 7 to 2.07). Conclusions Low body weight is a risk factor for increasing total mortality and cannot be completely explained by the mixed effects of smoking and subclinical tumors.