Capuano Vincenzo, Bambacaro Antonella, D'Arminio Teodora, Vecchio Giuseppe, Cappuccio Loredana
Unità Operativa di Cardiologia ed Utic, Ospedale Amico G Fucito, Mercato San Severino, SA, Italy.
Monaldi Arch Chest Dis. 2003 Dec;60(4):295-300.
In this study we examine the association between body mass index and a wide range of metabolic coronary heart disease risk factors in a female population of South Italy.
Observational study named "VIP Project" divided in three phases: collection of data, follow-up of the population and new controls within five and ten years. Data presented are about the transversal phase of the study.
1200, 600 males and 600 females, age ranging from 25 to 74 years, were enrolled at random from the electoral lists of the towns of Mercato San Severino and Baronissi, near Salerno, in Southern Italy.
Weight (electronic scale), height (ruler attached to the wall), blood pressure (sphygmomanometer), fasting venous blood to determine: total cholesterol, HDL and LDL cholesterol, triglycerides, uric acid, blood glucose, haemocrome, insulinaemia, fibrinogen, C3 and creatinine. Smoking habit and the practice of sports were determined by an interview.
The distribution of BMI in the population, increases with reference to the age. Between BMI and the classical risk factors, there is a significant correlation with triglycerides, glycaemia, total cholesterol, diastolic blood pressure, systolic blood pressure, insulin, C3. In the decades from 35-44 years to 45-54 years, it can be observed a notable increasing of the following risk factors in percentage for female population: hypertriglyceridemia from 3.9% to 33.9%, diabetes from 4.4% to 10.2%, hypertension from 9.1% to 25.8%, obesity from 22.5% to 42.5% and hypercholesterolaemia from 3.6% to 25%. Only the number of smokers is decreasing from 38.3% to 19.2%.
The association between body mass index and increasing coronary heart disease risk in women is partly explained by a rise in blood pressure, lipid profile and blood glucose across the range of body mass index. Most approaches to weight loss recommend a target or optimal weight based on body mass index alone. Our data show that this assumption is unwarranted and that body mass index should not be used as the sole basis for intervention in individuals. Successful weight loss should be defined in terms of a reduction in metabolic risk, which can often be achieved by relatively modest weight loss.
在本研究中,我们调查了意大利南部女性人群中体重指数与一系列代谢性冠心病风险因素之间的关联。
名为“VIP项目”的观察性研究分为三个阶段:数据收集、人群随访以及五年和十年内的新对照。呈现的数据是关于该研究的横向阶段。
从意大利南部萨勒诺附近的梅尔卡托圣塞韦里诺镇和巴罗尼西镇的选民名单中随机选取了1200人,其中男性600人,女性600人,年龄在25至74岁之间。
体重(电子秤)、身高(墙上的尺子)、血压(血压计),空腹静脉血用于测定:总胆固醇、高密度脂蛋白和低密度脂蛋白胆固醇、甘油三酯、尿酸、血糖、血红蛋白、胰岛素血症、纤维蛋白原、C3和肌酐。通过访谈确定吸烟习惯和运动情况。
人群中体重指数的分布随年龄增加。在体重指数与经典风险因素之间,与甘油三酯、血糖、总胆固醇、舒张压、收缩压、胰岛素、C3存在显著相关性。在35 - 44岁到45 - 54岁这几十年间,可以观察到女性人群中以下风险因素的百分比显著增加:高甘油三酯血症从3.9%增至33.9%,糖尿病从4.4%增至10.2%,高血压从9.1%增至25.8%,肥胖从22.5%增至42.5%,高胆固醇血症从3.6%增至25%。只有吸烟者数量从38.3%降至19.2%。
体重指数与女性冠心病风险增加之间的关联部分可由体重指数范围内血压、血脂谱和血糖的升高来解释。大多数减肥方法仅基于体重指数推荐一个目标体重或理想体重。我们的数据表明这种假设是不合理的,体重指数不应作为个体干预的唯一依据。成功的减肥应以代谢风险的降低来定义,这通常可以通过相对适度的体重减轻来实现。