МАССА ТЕЛА И ЕЕ ВКЛАД В СМЕРТНОСТЬ ОТ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ И ВСЕХ ПРИЧИН СРЕДИ РОССИЙСКОГО НАСЕЛЕНИЯ

The current status of obesity (O) as a global problem justifies the use of the term “obesity epidemic”, since the prevalence of O has increased substantially, in contrast to the decreasing prevalence of other risk factors (RFs). Aim. This analysis assessed the all-cause (AC) and cardiovascular disease (CVD) mortality levels by body mass index (BMI) in a middleaged Russian population. Material and methods. The present analysis included the data from seven studies performed by the State Research Centre for Preventive Medicine in 1975–2001. The total number of participants was 17821: 12887 men and 4934 women, aged 35–74 years. All participants were examined following the same protocol. The following parameters were analysed: socio-demographic and behavioural characteristics, lipid and carbohydrate metabolism disturbances, and clinical parameters. All participants were divided into seven categories by their BMI values: from BMI <21 kg/m 2 (first category) to BMI ≥36 kg/m 2 (sixth category). Results. There were positive associations between BMI and systolic blood pressure, diastolic blood pressure, triglycerides, and coronary heart disease presence. At the same time, BMI was negatively associated with smoking and excessive alcohol consumption. No associations were observed for BMI and left ventricular hypertrophy, heart blocks, or cholesterol levels. After adjustment for age, there was a U-shaped association between BMI and AC mortality. With the category “BMI <21 kg/m 2” as a reference group, mortality risk levels were decreasing for the second and third BMI categories, with an increased risk for the sixth category. In women, age-adjusted relative risk (RR) of AC mortality was only slightly lower than that in men. After additional adjustment for RFs and clinical parameters, RR of AC mortality was relatively similar across all BMI categories in both genders, without any significant differences compared to the reference group. Among lower BMI categories in men, RR of CVD mortality was close to RR for AC mortality. However, in higher BMI categories, the former was substantially higher than the latter. No similar patterns were registered for women. Conclusion. The observed tendency of elevated CVD risk in people with O suggests that particular attention should be paid to this risk factor. Adverse effects of O have also been demonstrated for people with arterial hypertension and diabetes mellitus. For the latter, its prevalence has substantially increased in Russia over the past years.