Håheim Lise Lund, Tonstad Serena, Hjermann Ingvar, Leren Paul, Holme Ingar
Norwegian Health Service Research Centre, Department of Preventive Cardiology, Preventive Medicine Clinic, Ullevål University Hospital, Oslo, Norway.
Scand J Public Health. 2007;35(1):4-10. doi: 10.1080/14034940510032293.
To test the association between body mass index (BMI) and other coronary risk factors and the risk of a fatal coronary heart disease (CHD) event in different time periods during follow-up.
Prospective cohort study with a 21 year follow-up period. A screened sample of 14,403 men aged 40-49 years initially free of CHD. Risk of fatal CHD was calculated for 21 years' cumulative follow-up and for four consecutive 5-year periods.
After adjustment for age and the other risk factors, total cholesterol and systolic blood pressure retained their predictive strength for CHD mortality throughout follow-up. Though cigarette smoking remained a significant predictor, the relative risk decreased with time (test of trend: p=0.01). Intermediate to vigorous physical activity at leisure was protective for 10 years of follow-up and a question on mental stress for 5 years. The test of trend indicated that the risk associated with BMI increased with the duration of follow-up (p=0.002).
Our data show that coronary risk factors predicted CHD mortality differently according to the length of follow-up, and suggest that the harm associated with obesity may take more than a decade to become evident, in contrast to the classical CHD risk factors.
检验体重指数（BMI）及其他冠心病危险因素与随访期间不同时间段致命性冠心病（CHD）事件风险之间的关联。
进行为期21年随访的前瞻性队列研究。对14403名年龄在40 - 49岁、最初无冠心病的男性进行筛查。计算21年累积随访以及四个连续5年时间段内致命性冠心病的风险。
在对年龄和其他危险因素进行调整后，总胆固醇和收缩压在整个随访期间对冠心病死亡率仍保持其预测强度。虽然吸烟仍是一个显著的预测因素，但相对风险随时间降低（趋势检验：p = 0.01）。休闲时中等强度至剧烈的体力活动在10年随访期间具有保护作用，关于精神压力的一个问题在5年随访期间有影响。趋势检验表明，与BMI相关的风险随随访时间延长而增加（p = 0.002）。
我们的数据表明，冠心病危险因素对冠心病死亡率的预测因随访时间长短而异，这表明与肥胖相关的危害可能需要十多年才会显现，这与经典的冠心病危险因素不同。
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