Chei C L, Iso H, Yamagishi K, Inoue M, Tsugane S
Department of Public Health Medicine, Doctoral Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki-ken, Japan.
Int J Obes (Lond). 2008 Jan;32(1):144-51. doi: 10.1038/sj.ijo.0803686. Epub 2007 Jul 17.
Obesity and weight gain are associated with increased risk of coronary heart disease in Western countries. However, their impact is not well elucidated in Asia, where body mass index (BMI) levels are generally lower than in Western countries. We examined associations of BMI (kg/m(2)) and weight change with risk of coronary heart disease in Japanese people.
A total of 43 235 men and 47 444 women aged 40-69 years living in communities were followed up from 1990 to 2001 in the Japan Public Health Center-based (JPHC) prospective study . During 879 619 person-years of follow-up, we documented 399 cases of coronary heart disease (334 myocardial infarction and 65 sudden cardiac death) for men and 119 (95 myocardial infarction and 24 sudden cardiac death) for women. Compared with persons with BMI 23.0-24.9, men, but not women, with BMI >/=30.0 had higher risk of coronary heart disease and myocardial infarction; the multivariable relative risks for men were 1.8 (1.1-3.0) and 1.9 (1.1-3.2), respectively. When weight change was examined according to BMI at age 20 years, men with initial BMI <21.7 who gained more than 10 kg compared with men of no weight change had a twofold higher risk of coronary heart disease. Both men and women with initial BMI >/=21.7 showed no association between weight loss and the risk.
High BMI was associated with increased risk of coronary heart disease among men. Also, weight gain was associated with increased risk among lean men.
在西方国家，肥胖和体重增加与冠心病风险增加相关。然而，在亚洲，体重指数（BMI）水平普遍低于西方国家，其影响尚未得到充分阐明。我们研究了BMI（kg/m²）和体重变化与日本人冠心病风险的关联。
在日本公共卫生中心前瞻性研究中，对居住在社区的43235名40 - 69岁男性和47444名女性进行了1990年至2001年的随访。在879619人年的随访期间，我们记录了男性399例冠心病（334例心肌梗死和65例心源性猝死）和女性119例（95例心肌梗死和24例心源性猝死）。与BMI为23.0 - 24.9的人相比，BMI≥30.0的男性而非女性患冠心病和心肌梗死的风险更高；男性的多变量相对风险分别为1.8（1.1 - 3.0）和1.9（1.1 - 3.2）。根据20岁时的BMI检查体重变化，初始BMI<21.7且体重增加超过10kg的男性与体重无变化的男性相比，患冠心病的风险高出两倍。初始BMI≥21.7的男性和女性体重减轻与风险之间均无关联。
高BMI与男性冠心病风险增加相关。此外，体重增加与瘦男性的风险增加相关。
