BACKGROUND Previous studies have shown an association between body mass index (BMI) and infections, but the literature on type-specific community acquired infections is still limited. METHODS We included 39 163 Swedish adults who completed a questionnaire in September 1997 and were followed through record-linkages until December 2016. Information on BMI was self-reported and infections were identified from the Swedish National Patient Register using International Classification of Diseases (ICD), Tenth Revision (ICD-10) codes. We fitted multivariable Cox proportional hazards models for time-to-first-event analysis, and we used extensions of the standard Cox model when repeated events were included. RESULTS During a 19-year follow-up 32% of the subjects had at least one infection requiring health care contact, leading to a total of 27 675 events. We found an increased incidence of any infection in obese women [hazard ratio (HR) = 1.22; 95% confidence interval (CI) = 1.12; 1.33] and obese men (HR = 1.25; 95% CI = 1.09; 1.43) compared with normal weight subjects. For specific infections, higher incidences were observed for skin infections in both genders (HR = 1.76; 95% CI = 1.47; 2.12 for obese females and HR = 1.74; 95% CI = 1.33; 2.28 for obese males) and gastrointestinal tract infections (HR = 1.44; 95% CI = 1.19; 1.75), urinary tract infections (HR = 1.30; 95% CI = 1.08; 1.55) and sepsis (HR = 2.09; 95% CI = 1.46; 2.99) in obese females. When accounting for repeated events, estimates similar to the aforementioned ones were found. CONCLUSIONS Obesity was associated with an increased risk of infections in both genders. Results from multiple-failure survival analysis were consistent with those from classic Cox models.

中文翻译：

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肥胖和感染风险：瑞典国家游行队列中男性和女性的结果。

背景技术先前的研究表明，体重指数（BMI）与感染之间存在关联，但是有关特定类型社区获得性感染的文献仍然有限。方法我们纳入了39163名瑞典成年人，他们于1997年9月完成了问卷调查，并通过记录链接进行追踪，直到2016年12月。有关BMI的信息是自我报告的，感染是根据《国际疾病分类》（ICD）从瑞典国家患者登记簿中识别出来的，第十修订版（ICD-10）代码。我们将多变量Cox比例风险模型拟合为首次事件时间，当包含重复事件时，我们使用标准Cox模型的扩展。结果在为期19年的随访中，有32％的受试者至少有一种感染需要与医疗机构联系，导致总共27 675次事件。我们发现肥胖妇女的任何感染发生率均增加[危险比（HR）= 1.22; 95％置信区间（CI）= 1.12；[1.33]和肥胖的男性（HR = 1.25； 95％CI = 1.09； 1.43）与正常体重的受试者相比。对于特定感染，两种性别的皮肤感染和胃肠道感染的发生率均较高（HR = 1.76； 95％CI = 1.47；肥胖女性HR = 1.74； 95％CI = 1.33； 2.28肥胖男性）。肥胖女性的HR = 1.44; 95％CI = 1.19; 1.75），尿路感染（HR = 1.30; 95％CI = 1.08; 1.55）和败血症（HR = 2.09; 95％CI = 1.46; 2.99）。当考虑重复事件时，发现与上述估计相似的估计。结论肥胖与两种性别的感染风险增加有关。