医師の一分

アクセスカウンタ

zoom RSS 肥満の子どもは55才までに死亡するリスクが2倍

<<   作成日時 : 2010/02/12 20:53   >>

驚いた ブログ気持玉 4 / トラックバック 0 / コメント 0

画像 長期の追跡研究で、肥満の子どもは55才までに死亡する確率がやせた子どもの2倍になるという。
 いわゆる前糖尿病pre-diabetesの子どもは55才以前の死亡リスクが2倍であり、高血圧でもリスクは高い。肥満が最も早すぎる死亡と関連している。
 肥満が広く問題となる前から肥満やU型糖尿病が問題となったPima と Tohono O’odham インディアンのデータを分析して研究が行われた。
 米国では現在3人に1人の子どもが肥満や体重増加であり、今週ファーストレディのミッシェル・オバマが小児肥満予防のキャンペーンを開始した。
 1945年から1984年に生まれ、11才時にBMI,耐糖能、血圧、コレステロールを測定された、アメリカ・インディアンの子どもを対象にデータ分析研究が行われた。2003年までに559人が死亡し、166人は糖尿病関連の疾患で死亡している。
-----------------------
学校のカフェテリアはダイエット中/米国の子どもの肥満
http://kurie.at.webry.info/200709/article_15.html
肥満との戦いに国家的戦略が必要/米国肥満マップ
http://kurie.at.webry.info/200708/article_49.html
-肥満に関連した病気による医療費の増加/米国医療事情
http://kurie.at.webry.info/200907/article_41.html
---------------------------------------------------
Child Obesity Risks Death at Early Age, Study Finds
http://www.nytimes.com/2010/02/11/health/11fat.html

By RONI CARYN RABIN
Published: February 10, 2010

A rare study that tracked thousands of children through adulthood found the heaviest youngsters were more than twice as likely as the thinnest to die prematurely, before age 55, of illness or a self-inflicted injury.

Youngsters with a condition called pre-diabetes were at almost double the risk of dying before 55, and those with high blood pressure were at some increased risk. But obesity was the factor most closely associated with an early death, researchers said.

The study, published Thursday in The New England Journal of Medicine, analyzed data gathered from Pima and Tohono O’odham Indians, whose rates of obesity and Type 2 diabetes soared decades before weight problems became widespread among other Americans. It is one of the largest studies to have tracked children for several decades after detailed information on weight and risk factors like high cholesterol were gathered.

“This suggests,” said Helen C. Looker, senior author of the paper and assistant professor of medicine at Mount Sinai Medical Center in New York City, “that obesity in children, even prepubescent children, may have very serious long-term health effects through midlife ― that there is something serious being set in motion by obesity at early ages.” Dr. Looker added, “We all expect to get beyond 55 these days.”

Nearly one in three American children is now considered to be either overweight or obese, and this week, the first lady, Michelle Obama, kicked off a campaign intended to end childhood obesity.

The new study analyzed data gathered about 4,857 nondiabetic American Indian children born between 1945 and 1984, when the children were 11 years old on average, and assessed the extent to which body mass index, glucose tolerance, blood pressure and total cholesterol levels predicted premature death.

By 2003, 559 participants had died, including 166 who died of causes other than accidents and homicides, like cardiovascular disease, infections, cancer, diabetes, alcohol poisoning or drug overdose and a large number who died of alcoholic liver disease, which the study’s authors suggested might be exacerbated by diabetes.

Adults who had the highest body mass index scores as children were 2.3 times as likely to have died early as those with the lowest scores, and those with the highest glucose levels were 73 percent as likely to have died prematurely.

“This really points a finger at impaired glucose tolerance, or pre-diabetes, in ways we have not seen before,” said Edward W. Gregg, who is with the diabetes branch of the Centers for Disease Control and Prevention, and wrote an editorial accompanying the article. “We’ve been aware that pre-diabetes in adults is related to a lot of adverse outcomes, but the relationship in youth has not been as clear. There are not as many long-term studies to document a risk factor like pre-diabetes in youth all the way to adult outcomes.”

The study found that high blood pressure in childhood was only a weak predictor of early death and high cholesterol was not associated with premature death, but experts suggested those factors were easier to control with medication.

And though the American Indian community is not representative of the nation’s population as a whole, Dr. Gregg said its experience was instructive because “they’ve tended to be just a decade or two ahead of the rest of the U.S. population” in obesity.

“The message here is that if you take your kid to the doctor and the doctor says, ‘Well, their blood pressure is O.K., their cholesterol is O.K. and their sugar’s O.K..,’ the kid who’s obese still warrants our attention,” said Dr. Peter F. Belamarich, chief of specialty medicine at the Children’s Hospital at Montefiore in the Bronx.

----------------------------------------------------
NEJM Volume 362:485-493 February 11, 2010 Number 6

Childhood Obesity, Other Cardiovascular Risk Factors, and Premature Death

Paul W. Franks, Ph.D., Robert L. Hanson, M.D., M.P.H., William C. Knowler, M.D., Dr.P.H., Maurice L. Sievers, M.D., Peter H. Bennett, M.B., F.R.C.P., and Helen C. Looker, M.B., B.S.

ABSTRACT

Background The effect of childhood risk factors for cardiovascular disease on adult mortality is poorly understood.

Methods In a cohort of 4857 American Indian children without diabetes (mean age, 11.3 years; 12,659 examinations) who were born between 1945 and 1984, we assessed whether body-mass index (BMI), glucose tolerance, and blood pressure and cholesterol levels predicted premature death. Risk factors were standardized according to sex and age. Proportional-hazards models were used to assess whether each risk factor was associated with time to death occurring before 55 years of age. Models were adjusted for baseline age, sex, birth cohort, and Pima or Tohono O'odham Indian heritage.

Results There were 166 deaths from endogenous causes (3.4% of the cohort) during a median follow-up period of 23.9 years. Rates of death from endogenous causes among children in the highest quartile of BMI were more than double those among children in the lowest BMI quartile (incidence-rate ratio, 2.30; 95% confidence interval [CI], 1.46 to 3.62). Rates of death from endogenous causes among children in the highest quartile of glucose intolerance were 73% higher than those among children in the lowest quartile (incidence-rate ratio, 1.73; 95% CI, 1.09 to 2.74). No significant associations were seen between rates of death from endogenous or external causes and childhood cholesterol levels or systolic or diastolic blood-pressure levels on a continuous scale, although childhood hypertension was significantly associated with premature death from endogenous causes (incidence-rate ratio, 1.57; 95% CI, 1.10 to 2.24).

Conclusions Obesity, glucose intolerance, and hypertension in childhood were strongly associated with increased rates of premature death from endogenous causes in this population. In contrast, childhood hypercholesterolemia was not a major predictor of premature death from endogenous causes.

テーマ

関連テーマ 一覧


月別リンク

ブログ気持玉

クリックして気持ちを伝えよう!
ログインしてクリックすれば、自分のブログへのリンクが付きます。
→ログインへ
気持玉数 : 4
驚いた 驚いた 驚いた
ナイス

トラックバック(0件)

タイトル (本文) ブログ名/日時

トラックバック用URL help


自分のブログにトラックバック記事作成(会員用) help

タイトル
本 文

コメント(0件)

内 容 ニックネーム/日時

コメントする help

ニックネーム
本 文
肥満の子どもは55才までに死亡するリスクが2倍 医師の一分/BIGLOBEウェブリブログ
文字サイズ:       閉じる