期刊
INTERNATIONAL JOURNAL OF OBESITY
卷 34, 期 8, 页码 1231-1238出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/ijo.2010.71
关键词
obesity paradox; aging; mortality rate; statistics; mathematical modeling; longevity
资金
- NHLBI NIH HHS [T32 HL072757-07, T32 HL072757] Funding Source: Medline
- NIDDK NIH HHS [R01 DK076771, P30 DK056336-06, R01 DK076771-03, P30 DK056336] Funding Source: Medline
Objective: Current clinical guidelines and public health statements generically prescribe body mass index (BMI; kg m(-2)) categories regardless of the individual's situation (age, risk for diseases, and so on). However, regarding BMI and mortality rate, two well-established observations are (1) there is a U-shaped (that is, concave) association-people with intermediate BMIs tend to outlive people with higher or lower BMIs; and (2) the nadirs of these curves tend to increase monotonically with age. Multiple hypotheses have been advanced to explain either of these two observations. In this study, we introduce a new hypothesis that may explain both phenomena, by drawing on the so-called obesity paradox: the unexpected finding that obesity is often associated with increased survival time among people who have some serious injury or illness in spite of being associated with reduced survival time among the general population. Results: We establish that the obesity paradox offers one potential explanation for two curious but consistently observed phenomena in the obesity field. Conclusion: Further research is needed to determine the extent to which the obesity paradox is actually an explanation for these phenomena, but if our hypothesis proves true the common practice of prescribing overweight patients to lower their BMI should currently be applied with caution. In addition, the statistical modeling technique used here could be applied in such other areas involving survival analysis of disjoint subgroups, to explain possible interacting causal associations and to determine clinical practice. International Journal of Obesity (2010) 34, 1231-1238; doi: 10.1038/ijo.2010.71; published online 4 May 2010
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