Alternative Title肥満と全原因死亡率との関連に基礎疾患と年齢が及ぼす影響
Note (General)type:Thesis
Background: Studies on the association between obesity and all-cause mortality have found that the degree of obesity is directly proportional to all-cause mortality. In contrast, there have been studies indicating that obese people with underlying diseases have a higher survival rate. We hypothesized that age and underlying diseases lead to such contrasting results. Therefore, we conducted a study to clarify the influence of post-middle age obesity and underlying diseases on all-cause mortality. Methods: This study used data from longitudinal studies in the United States, which conducted follow-up for 19 years on 33,708 participants in different age groups: ≥45, 45 - 64, and ≥65 years. Hazard ratio (HR) was determined using the Cox proportional hazards model to analyze a group consisting of all participants, a group of those with underlying diseases, and a group of those without underlying diseases, considering age, gender, education history, marital status, household income, smoking history, and BMI category as covariates. Results: In the group aged ≥65 without underlying diseases, HR was almost 1 in those with BMI 25 - <30, 30 - <35, and BMI > 35 kg/m2. Further, HR was higher in the 45 - 64 age group without underlying diseases if BMI was >35 kg/m2. However, HR was approximately 1 in the ≥65 age group. Conclusions: The study revealed that among individuals aged ≥65 years without underlying diseases, there was no association between obesity and all-cause mortality. Among individuals without underlying diseases, HR was higher in the 45 - 64 age group with BMI > 35 kg/m2 but was approximately 1 among those aged ≥65 years. Therefore, an interaction based on age was detected. These findings may lead to recommendations regarding the need to modify the advice and education provided to obese individuals in different age groups.
博士（医学）・甲第691号・平成30年11月30日
Copyright © 2018 by authors and Scientific Research Publishing Inc.This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).http://creativecommons.org/licenses/by/4.0/
identifier:Health Vol.10 No.9 p.1171-1184 (2018 Sep)
identifier:19494998
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3502
identifier:Health, 10(9): 1171-1184
DOIinfo:doi/10.4236/health.2018.109089
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2019-03-03T03:58:25+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション