【摘要】 目的 在社区自然人群队列中探索体质指数(BMI)、体圆指数(BRI)、腰围(WC)和腰臀比(WHR)等肥胖指标与死亡风险的关联。方法 本研究基于浦东新区慢性病社区人群队列，基线调查获取研究对象肥胖相关指标，收集随访期间的死亡情况，采用cox回归、限制性立方样条(RCS)回归、ROC曲线等方法分析肥胖指标与死亡风险的关联。结果 纳入分析的人数为9 448人，随访观察中位时间10.77年，期间发生全因死亡987例，研究人群全因死亡密度10.08/1 000人年。经多因素校正后，BRI每增加1个标准差，死亡风险增加7%(HR=1.07, 95%CI:1.01～1.14);WC每增加1个标准差，死亡风险增加12%(HR=1.12, 95%CI:1.05～1.20);WHR每增加1个标准差，死亡风险增加14%(HR=1.14; 95%CI:1.07～1.21)。BMI、BRI、WC与死亡风险呈U型的非线性剂量-反应关系，WHR与死亡风险呈线性的剂量-反应关系。BRI对死亡风险的预测能力优于其它肥胖指标，AUC为0.62(95%CI=0.60～0.64)。结论 肥胖是全因死亡的重要危险因素，合理控制体重和脂肪分布有助于提升人群的期望寿命。更多还原

【Abstract】 Objective To explore the association ofbody mass index(BMI), body roundness index(BRI), waist circumference(WC), and waist hip ratio(WHR) with the risk of all-cause mortality in a community-based cohort. Methods This study was based on a prospective cohort study conducted in Pudong New Area. Obesity-related indicators were obtained at the baseline survey, mortality data was collectedduring the follow-up period.The associations between BMI, BRI, WC, WHR and the risk of all-cause mortality were assessed using cox proportional hazard model, restricted cubic spline(RCS) regression model, and receiver operator characteristic(ROC) curve. Results A total of 9 448 participants was included in the analysis. The median follow-up time was 10.77 years, during which 987 deaths occurred, the all-cause mortality was 10.08/1 000 person-years.After multi-variable adjustment, the HR(95%CI) of elevated BRI, WC, and WHR were 1.07(1.01-1.14), 1.12(1.05-1.20), and 1.14(1.07-1.21), respectively.There were U-shaped dose-response relationship betweenBMI, BRI, WC and all-cause mortality; and alinear dose-response relationshipbetween WHR and all-cause mortality. BRI had the highest accuracy in predicting all-cause mortality, with the AUC of 0.62(95%CI=0.60-0.64).Conclusion Obesity is a significant risk factor for all-cause mortality, proper control of obesity and fat distribution can help reduce the risk of all-cause mortality.更多还原