Kim K S, Owen W L, Williams D, Adams-Campbell L L
Division of Epidemiology and Biostatistics, Howard University Cancer Center, Washington, DC 20060, USA.
Ann Epidemiol. 2000 Oct;10(7):424-31. doi: 10.1016/s1047-2797(00)00065-x.
This study examined the relationship of mortality and morbidity of coronary heart disease with body mass index (BMI) and Conicity index (CI).
Among 5209 Framingham Heart Study participants, 1882 men and 2373 women had waist and weight measurement at the 4th examination period and height measured on the 5th visit. These were used for BMI and CI.
During a 24-year follow-up, 597 men and 468 women developed CHD and 248 men and 150 women died from CHD associated causes. In men the relative risks (RR) (95% confidence interval) adjusted for age, hypertension, diabetes, smoking status, and total cholesterol for CHD incidence in 2nd, 3rd, and 4th quartiles of BMI were 1.28 (1.0, 1.65), 1.45 (1.13, 1.86), and 1.53 (1.19, 1.96). The RR for CHD incidence in the 4th quartile of BMI in women was 1.56 (1.16, 2.08). No CI quartiles were risk factors for CHD incidence. There was 86% higher risk of CHD related death in the 4th quartile of BMI than the 1st quartile of BMI in women. In men no significantly higher risks of death were found across the quartiles of BMI. No associations were found between CI quartiles and CHD mortality.
Obesity as measured by BMI is an important risk factor for CHD incidence in men and women and for CHD mortality in women. CI was not associated with an increase in CHD incidence or mortality. Thus, BMI is a better marker than CI for predicting CHD incidence and mortality.
本研究探讨冠心病死亡率和发病率与体重指数(BMI)和锥度指数(CI)之间的关系。
在5209名弗雷明汉心脏研究参与者中,1882名男性和2373名女性在第4次检查时测量了腰围和体重,并在第5次就诊时测量了身高。这些数据用于计算BMI和CI。
在24年的随访期间,597名男性和468名女性患冠心病,248名男性和150名女性死于冠心病相关原因。在男性中,根据年龄、高血压、糖尿病、吸烟状况和总胆固醇调整后,BMI第二、第三和第四四分位数组冠心病发病率的相对风险(RR)(95%置信区间)分别为1.28(1.0,1.65)、1.45(1.13,1.86)和1.53(1.19,1.96)。女性BMI第四四分位数组冠心病发病率的RR为1.56(1.16,2.08)。CI四分位数组均不是冠心病发病率的危险因素。女性BMI第四四分位数组冠心病相关死亡风险比第一四分位数组高86%。在男性中,BMI各四分位数组未发现显著更高的死亡风险。未发现CI四分位数组与冠心病死亡率之间存在关联。
以BMI衡量的肥胖是男性和女性冠心病发病率以及女性冠心病死亡率的重要危险因素。CI与冠心病发病率或死亡率的增加无关。因此,BMI比CI更适合作为预测冠心病发病率和死亡率的指标。