Zhang X, Shu X O, Gao Y-T, Yang G, Matthews C E, Li Q, Li H, Jin F, Zheng W
Department of Medicine, Center for Health Services Research, Vanderbilt University, Nashville, TN, USA.
Int J Obes Relat Metab Disord. 2004 Jun;28(6):734-40. doi: 10.1038/sj.ijo.0802634.
To evaluate the associations of body size and fat distribution with incidence of coronary heart disease (CHD) in Chinese women.
Population-based, prospective cohort study.
A total of 67 334 women aged 40-70 y, who had no prior history of CHD, stroke, and cancer at study recruitment.
Weight, standing and sitting heights, circumferences of waist and hip, and ratios of the anthropometric measurements.
incidence of CHD (non-fatal myocardial infarction (MI) or fatal CHD).
After a mean follow-up of 2.5 y (168 164 person-years), there were 70 incident cases of CHD (49 non-fatal MIs and 21 CHD deaths). Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-standing height ratio (WHtR), waist-to-sitting height ratio (WsHtR), and conicity index were all positively associated with the risk of CHD. With the exception of WHR, all other anthropometric indexes only predicted the risk of CHD among women </=55 y of age at enrollment. The relative risks (RRs) between extreme tertiles of BMI were 9.0 (95% CI, 2.0-41.5; P for trend=0.002) for younger women vs 1.3 (0.6-3.0; P for trend=0.83) for older women. Similarly, the RRs for WC, WHtR, WsHtR, and conicity index were 6.1 (1.8-21.4) vs 1.9 (0.6-5.4), 9.4 (2.6-33.8) vs 1.2 (0.5-3.1), 15.2 (3.3-69.1) vs 1.0 (0.4-2.5), and 7.8 (2.2-28.0) vs 0.9 (0.4-2.3) for the young and elderly, respectively. In contrast, the RR for WHR was 3.2 (1.1-9.1) for the young and 2.9 (1.0-8.4) for the elderly.
WHR was positively associated with the risk of CHD in both younger and older women, while other anthropometrics, including BMI, were related to CHD risk primarily among younger women.
评估中国女性的体型和脂肪分布与冠心病（CHD）发病率之间的关联。
基于人群的前瞻性队列研究。
共有67334名年龄在40 - 70岁之间的女性，她们在研究招募时无冠心病、中风和癌症病史。
体重、站立和坐高、腰围和臀围以及人体测量指标的比值。
冠心病发病率（非致命性心肌梗死（MI）或致命性冠心病）。
平均随访2.5年（168164人年）后，有70例冠心病发病病例（49例非致命性心肌梗死和21例冠心病死亡）。体重指数（BMI）、腰围（WC）、腰臀比（WHR）、腰高比（WHtR）、腰坐高比（WsHtR）和锥度指数均与冠心病风险呈正相关。除WHR外，所有其他人体测量指标仅能预测入组时年龄≤55岁女性的冠心病风险。较年轻女性中BMI极端三分位数之间的相对风险（RRs）为9.0（95%CI，2.0 - 41.5；趋势P值 = 0.002），而较年长女性为1.3（0.6 - 3.0；趋势P值 = 0.83）。同样，较年轻和较年长女性中WC、WHtR、WsHtR和锥度指数的RRs分别为6.1（1.8 - 21.4）对1.9（0.6 - 5.4）、9.4（2.6 - 33.8）对1.2（0.5 - 3.1）、15.2（3.3 - 69.1）对1.0（0.4 - 2.5）以及7.8（2.2 - 28.0）对0.9（0.4 - 2.3）。相比之下，较年轻和较年长女性中WHR的RR分别为3.2（1.1 - 9.1）和2.9（1.0 - 8.4）。
WHR在年轻和年长女性中均与冠心病风险呈正相关，而其他人体测量指标，包括BMI，主要与较年轻女性的冠心病风险相关。
