Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, United States of America.
PLoS One. 2011 Apr 26;6(4):e18582. doi: 10.1371/journal.pone.0018582.
Whether waist circumference provides clinically meaningful information not delivered by body-mass index regarding prediction of cause-specific death is uncertain.
We prospectively examined waist circumference (WC) and body-mass index (BMI) in relation to cause-specific death in 225,712 U.S. women and men. Cox regression was used to estimate relative risks and 95% confidence intervals (CI). Statistical analyses were conducted using SAS version 9.1.
During follow-up from 1996 through 2005, we documented 20,977 deaths. Increased WC consistently predicted risk of death due to any cause as well as major causes of death, including deaths from cancer, cardiovascular disease, and non-cancer/non-cardiovascular diseases, independent of BMI, age, sex, race/ethnicity, smoking status, and alcohol intake. When WC and BMI were mutually adjusted in a model, WC was related to 1.37 fold increased risk of death from any cancer and 1.82 fold increase risk of death from cardiovascular disease, comparing the highest versus lowest WC categories. Importantly, WC, but not BMI showed statistically significant positive associations with deaths from lung cancer and chronic respiratory disease. Participants in the highest versus lowest WC category had a relative risk of death from lung cancer of 1.77 (95% CI, 1.41 to 2.23) and of death from chronic respiratory disease of 2.77 (95% CI, 1.95 to 3.95). In contrast, subjects in the highest versus lowest BMI category had a relative risk of death from lung cancer of 0.94 (95% CI, 0.75 to 1.17) and of death from chronic respiratory disease of 1.18 (95% CI, 0.89 to 1.56).
Increased abdominal fat measured by WC was related to a higher risk of deaths from major specific causes, including deaths from lung cancer and chronic respiratory disease, independent of BMI.
腰围（WC）能否提供体质指数（BMI）无法提供的有关特定原因死亡的预测的临床有意义的信息尚不确定。
我们前瞻性地研究了 225712 名美国男女的腰围（WC）和 BMI 与特定原因死亡之间的关系。使用 Cox 回归估计相对风险和 95％置信区间（CI）。使用 SAS 版本 9.1 进行统计分析。
在 1996 年至 2005 年的随访期间，我们记录了 20977 例死亡。WC 持续升高可预测所有原因以及主要死亡原因的风险，包括癌症、心血管疾病和非癌症/非心血管疾病的死亡，独立于 BMI、年龄、性别、种族/族裔、吸烟状况和饮酒量。当 WC 和 BMI 在模型中相互调整时，WC 与任何癌症死亡风险增加 1.37 倍以及心血管疾病死亡风险增加 1.82 倍有关，比较最高与最低 WC 类别。重要的是，WC 而不是 BMI 与肺癌和慢性呼吸道疾病的死亡呈统计学显著正相关。最高 WC 类别与最低 WC 类别的参与者相比，死于肺癌的相对风险为 1.77（95％CI，1.41 至 2.23），死于慢性呼吸道疾病的风险为 2.77（95％CI，1.95 至 3.95）。相比之下，最高 BMI 类别与最低 BMI 类别的参与者相比，死于肺癌的相对风险为 0.94（95％CI，0.75 至 1.17），死于慢性呼吸道疾病的风险为 1.18（95％CI，0.89 至 1.56）。
腹部脂肪增加（由 WC 测量）与主要特定原因死亡的风险增加有关，包括肺癌和慢性呼吸道疾病死亡，独立于 BMI。
