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主題:肥胖矛盾(obesity paradox)
發言 : scwang 時間 : 05/07/22(23:57:35) From : 203.187.37.126
Arch Intern Med. 2005 Jan 10;165(1):55-61.

The obesity paradox: body mass index and outcomes in patients with heart failure.

Curtis JP, Selter JG, Wang Y, Rathore SS, Jovin IS, Jadbabaie F, Kosiborod M, Portnay EL, Sokol SI, Bader F, Krumholz HM.

Department of Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT 06520-8088, USA.

BACKGROUND: In the general population, obesity is associated with increased risk of adverse outcomes. However, studies of patients with chronic disease suggest that overweight and obese patients may paradoxically have better outcomes than lean patients. We sought to examine the association of body mass index (BMI) and outcomes in stable outpatients with heart failure (HF). METHODS: We analyzed data from 7767 patients with stable HF enrolled in the Digitalis Investigation Group trial. Patients were categorized using baseline BMI (calculated as weight in kilograms divided by the square of height in meters) as underweight (BMI <18.5), healthy weight (BMI, 18.5-24.9, overweight (BMI, 25.0-29.9), and obese (BMI > or =30.0). Risks associated with BMI groups were evaluated using multivariable Cox proportional hazards models over a mean follow-up of 37 months. RESULTS: Crude all-cause mortality rates decreased in a near linear fashion across successively higher BMI groups, from 45.0% in the underweight group to 28.4% in the obese group (P for trend <.001). After multivariable adjustment, overweight and obese patients were at lower risk for death (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.80-0.96, and HR, 0.81; 95% CI, 0.72-0.92, respectively), compared with patients at a healthy weight (referent). In contrast, underweight patients with stable HF were at increased risk for death (HR 1.21; 95% CI, 0.95-1.53). CONCLUSIONS: In a cohort of outpatients with established HF, higher BMIs were associated with lower mortality risks; overweight and obese patients had lower risk of death compared with those at a healthy weight. Understanding the mechanisms and impact of the "obesity paradox" in patients with HF is necessary before recommendations are made concerning weight and weight control in this population.

滿有趣的主題!


回應 : 11 胖俠時間 : 2005/8/5 下午 11:47:58 From : 61.229.75.7

稍微肥胖一點的人其實跟正常人在體能上是沒什麼差異的
在我們之前的研究裡也發現這樣的現象
不過肥胖問題真的是因人而異,身體健康與否自己要負最大的責任
站在我們的立場僅能提供一些控制體重的方式


回應 : 12 JungleSun時間 : 2008/6/23 下午 05:35:36 From : 221.10.62.162

超重和肥胖是心血管疾病(cardiovascular disease,CVD)的獨立危險因素,肥胖與高血壓、高脂血症、糖尿病密切相關,從而導致CVD的高發。近年研究發現超重和肥胖可以降低CVD患者死亡的風險。這種矛盾現象被稱之為肥胖矛盾(Obesity paradox)。

肥胖增加CVD事件的發生率;肥胖降低心臟病患者死亡率。

同樣想到一個事件:
2008年6月17日,四川彭州龍門山鎮團山村12組萬興明家一頭肥豬在5月12日大地震被埋廢墟36天后奇跡獲救。原本重約300斤的豬,如今瘦得只剩100斤了,整整瘦了100公斤。

這只豬是不是也是依靠其龐大的體重的作用來維持生命呢?它真的很堅強。如果它不是300斤的體重,而是100斤的話,它是否還能熬過來?


回應 : 13 ACT時間 : 2008/6/24 上午 08:56:55 From : 61.60.126.22

所以這就是人體容易囤積脂肪的原因吧?



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