Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Obesity (Silver Spring). 2012 Sep;20(9):1936-41. doi: 10.1038/oby.2011.320. Epub 2011 Oct 20.
While several studies have reported a positive association between overall adiposity and heart failure (HF) risk, limited and inconsistent data are available on the relation between central adiposity and incident HF in older adults. We sought to examine the association between waist circumference (WC) and incident HF and assess whether sex modifies the relation between WC and HF. Prospective study using data on 4,861 participants of the Cardiovascular Health Study (1989-2007). HF was adjudicated by a committee using information from medical records and medications. We used Cox proportional hazard models to compute hazard ratio (HR). The mean age was 73.0 years for men and 72.3 years for women; 42.5% were men and 15.3% were African Americans. WC was positively associated with an increased risk of HF: each standard deviation of WC was associated with a 14% increased risk of HF (95% CI: 3%-26%) in a multivariable model. There was not a statistically significant sex-by-WC interaction (P = 0.081). BMI was positively associated with incident HF (HR: 1.22 (95% CI: 1.15-1.29) per standard deviation increase of BMI); however, this association was attenuated and became nonstatistically significant upon additional adjustment for WC (HR: 1.09 (95% CI: 0.99-1.21)). In conclusion, a higher WC is associated with an increased risk of HF independent of BMI in community-living older men and women.
虽然有几项研究报告称总体肥胖与心力衰竭 (HF) 风险之间存在正相关，但关于中心性肥胖与老年人心力衰竭事件之间的关系，数据有限且不一致。我们旨在研究腰围 (WC) 与心力衰竭事件之间的关联，并评估性别是否改变 WC 与心力衰竭之间的关系。这是一项使用心血管健康研究 (1989-2007 年) 4861 名参与者数据的前瞻性研究。HF 通过委员会使用病历和药物信息进行裁决。我们使用 Cox 比例风险模型计算危险比 (HR)。男性的平均年龄为 73.0 岁，女性为 72.3 岁；42.5%为男性，15.3%为非裔美国人。WC 与心力衰竭风险增加呈正相关：多变量模型中，WC 的每一个标准差与 HF 风险增加 14%相关 (95%CI：3%-26%)。性别与 WC 之间没有统计学上显著的交互作用 (P = 0.081)。BMI 与心力衰竭事件呈正相关 (HR：1.22 (95% CI：1.15-1.29) 每增加一个标准差 BMI)；然而，这种关联在进一步调整 WC 后减弱且变得无统计学意义 (HR：1.09 (95% CI：0.99-1.21))。总之，在社区居住的老年男性和女性中，较高的 WC 与心力衰竭风险增加相关，而与 BMI 无关。
