华中科技大学潘安教授课题组分析了成年期体重变化与全因和特定因素死亡率的关系。2019年10月16日，《英国医学杂志》在线发表了这一成果。

这项前瞻性队列研究分析了美国国家健康与营养调查（NHANES）1988-1994和1999-2014年间的数据，共有36051名参与者，他们的年龄均超过40岁，测量基线体重与身高，并回忆25岁和10年前的体重。

平均随访12.3年后，共有10500人死亡。与保持正常体重的参与者比，从青年至中年开始变胖的参与者的全因死亡率和心脏病死亡率分别高出22%和49%，风险比为1.22和1.49，而从青年至中年由胖变不胖的参与者与死亡风险不相关。从中年至老年时期由胖变不胖的参与者的全因死亡和心脏病因素死亡的风险增加，风险比分别为1.30和1.48，而从中年至老年变胖的参与者与死亡风险不相关。

在整个成年期均肥胖的参与者始终与全因死亡率的增加有关：从青年至中年的风险比为1.72，从青年至老年的风险比为1.61，从中年至老年的风险比为1.20。最大超重与成年期死亡率之间弱相关或零相关。不同体重变化的模式与癌症死亡率之间并没有显著的相关性。

总之，成年期一直肥胖、青年至中年体重增加、中年至晚年体重减轻均与死亡率增加有关。若整个成年期保持正常体重，特别是青年期就防止体重增加，对于预防老年早死很重要。

潘安，华中科技大学同济医学院公共卫生学院教授、博导。主要从事营养流行病学和慢性代谢性流行病学方面的研究工作。研究方向：通过前瞻性的队列研究深入探讨肥胖、代谢综合征、2型糖尿病、心脑血管疾病等代谢性疾病的发生发展的主要基因变异和营养等环境因素，以及基因-环境（营养、生活方式等）和基因-表型间的相互作用，建立早期预测和高危个体筛选模型等。（来源：华中科技大学）

附：英文原文

Title: Weight change across adulthood in relation to all cause and cause specific mortality: prospective cohort study

Author: Chen Chen, Yi Ye, Yanbo Zhang, Xiong-Fei Pan, An Pan

Issue&Volume: 2019/10/16

Abstract: 

Objective To investigate the association between weight changes across adulthood and mortality.

Design Prospective cohort study.

Setting US National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2014.

Participants 36 051 people aged 40 years or over with measured body weight and height at baseline and recalled weight at young adulthood (25 years old) and middle adulthood (10 years before baseline).

Main outcome measures All cause and cause specific mortality from baseline until 31 December 2015.

Results During a mean follow-up of 12.3 years, 10 500 deaths occurred. Compared with participants who remained at normal weight, those moving from the non-obese to obese category between young and middle adulthood had a 22% (hazard ratio 1.22, 95% confidence interval 1.11 to 1.33) and 49% (1.49, 1.21 to 1.83) higher risk of all cause mortality and heart disease mortality, respectively. Changing from obese to non-obese body mass index over this period was not significantly associated with mortality risk. An obese to non-obese weight change pattern from middle to late adulthood was associated with increased risk of all cause mortality (1.30, 1.16 to 1.45) and heart disease mortality (1.48, 1.14 to 1.92), whereas moving from the non-obese to obese category over this period was not significantly associated with mortality risk. Maintaining obesity across adulthood was consistently associated with increased risk of all cause mortality; the hazard ratio was 1.72 (1.52 to 1.95) from young to middle adulthood, 1.61 (1.41 to 1.84) from young to late adulthood, and 1.20 (1.09 to 1.32) from middle to late adulthood. Maximum overweight had a very modest or null association with mortality across adulthood. No significant associations were found between various weight change patterns and cancer mortality.

Conclusions Stable obesity across adulthood, weight gain from young to middle adulthood, and weight loss from middle to late adulthood were associated with increased risks of mortality. The findings imply that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, is important for preventing premature deaths in later life.

DOI: 10.1136/bmj.l5584

Source: https://www.bmj.com/content/367/bmj.l5584