对于许多女孩来说，体重是个永恒的话题。对于医生来说，这也是个很重要的健康指标。近日，一项发表在顶级期刊Lancet Diabetes Endocrinol的研究显示，体重指数（Body mass index，BMI）与死亡率呈“J”型相关，即高于或低于最佳体重，均会增加死亡风险。
研究人员共采集了3632674名人员的体重信息，其中不吸烟者1969648位。亚裔占比4.8%。研究人员致力于分析体重与各因素所致死亡的关系，并对性别、年龄、香烟及酒精使用情况等混杂因素做出了调整。结果显示，BMI为25-27时死亡风险最低。在死亡原因的一级分类中，BMI分别为26、25、27时，因传染性疾病、非传染性疾病及外伤致死的风险最低。
其中，比较特殊的是行为暴力，随着BMI的增加，自杀的风险稳定下降。看来，古人所言“心宽体胖”，还是非常有道理的。
研究人员还利用皮尔森模型计算了不同BMI人群的期望寿命。对于女性来说，BMI小于18.5相对于18.5-24.9，预期寿命将减少4年，与BMI超过35的大胖子相当。18.5的BMI是什么概念呢？如果你身高1.65米，那么对应的体重是100斤。
所以什么“体重不过百”的目标，听听就好啦，毕竟对大多数人来说，相对于身上那几斤肉，还是长寿更重要一点的吧。
Summary
Background
BMI is known to be strongly associated with all-cause mortality, but few studies have been large enough to reliably examine associations between BMI and a comprehensive range of cause-specific mortality outcomes. Methods In this population-based cohort study, we used UK primary care data from the Clinical Practice Research Datalink (CPRD) linked to national mortality registration data and fitted adjusted Cox regression models to examine associations between BMI and all-cause mortality, and between BMI and a comprehensive range of cause-specific mortality outcomes (recorded by International Classification of Diseases, 10th revision [ICD10] codes). We included all individuals with BMI data collected at age 16 years and older and with subsequent followup time available. Follow up began at whichever was the latest of: start of CPRD researchstandard follow up, the 5year anniversary of the first BMI record, or on Jan 1, 1998 (start date for death registration data); followup ended at death or on March 8, 2016. Fully adjusted models were stratified by sex and adjusted for baseline age, smoking, alcohol use, diabetes, index of multiple deprivation, and calendar period. Models were fitted in both never-smokers only and the full study population. We also did an extensive range of sensitivity analyses. The expected age of death for men and women aged 40 years at baseline, by BMI category, was estimated from a Poisson model including BMI, age, and sex.
Findings
3 632 674 people were included in the full study population; the following results are from the analysis of never-smokers, which comprised 1 969 648 people and 188 057 deaths. BMI had a J-shaped association with overall mortality; the estimated hazard ratio per 5 kg/m² increase in BMI was 0·81 (95% CI 0·80–0·82) below 25 kg/m² and 1·21 (1·20–1·22) above this point. BMI was associated with all cause of death categories except for transport-related accidents, but the shape of the association varied. Most causes, including cancer, cardiovascular diseases, and respiratory diseases, had a J-shaped association with BMI, with lowest risk occurring in the range 21–25 kg/m². For mental and behavioural, neurological, and accidental (non-transport-related) causes, BMI was inversely associated with mortality up to 24–27 kg/m², with little association at higher BMIs; for deaths from self-harm or interpersonal violence, an inverse linear association was observed. Associations between BMI and mortality were stronger at younger ages than at older ages, and the BMI associated with lowest mortality risk was higher in older individuals than in younger individuals. Compared with individuals of healthy weight (BMI 18·5–24·9 kg/m²), life expectancy from age 40 years was 4·2 years shorter in obese (BMI ≥30·0 kg/m²) men and 3·5 years shorter in obese women, and 4·3 years shorter in underweight (BMI <18·5 kg/m²) men and 4·5 years shorter in underweight women. When smokers were included in analyses, results for most causes of death were broadly similar, although marginally stronger associations were seen among people with lower BMI, suggesting slight residual confounding by smoking.
Interpretation
BMI had J-shaped associations with overall mortality and most specific causes of death; for mental and behavioural, neurological, and external causes, lower BMI was associated with increased mortality risk.
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