Wakabayashi Ichiro
Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Gend Med. 2012 Aug;9(4):267-77. doi: 10.1016/j.genm.2012.05.004. Epub 2012 Jun 28.
Obesity is a main risk factor in metabolic syndrome. Gender is known to influence the risk of obesity and other cardiovascular risk factors. However, it remains to be determined whether there is a gender-specific difference in the relationship between obesity and accumulation of other cardiometabolic risk factors such as hypertension, dyslipidemia, and diabetes.
The aim of this study was to determine whether the association between obesity and a cluster of other cardiometabolic risk factors is modified by gender.
The subjects were 17,791 Japanese men and women who were divided into younger (35-40 years) and older (60-70 years) age groups. The relationships between obesity (body mass index [BMI] ≥25 kg/m(2) or waist-to-height ratio [WHtR] ≥0.5) and multiple cardiometabolic risk factors (≥2 of the risk factors of high blood pressure, dyslipidema, and hyperglycemia) were compared between men and women in each age group.
In the younger group, the crude odds ratios (ORs) for multiple cardiometabolic risk factors in obese versus nonobese subjects were significantly higher in women than in men (BMI: 6.23 [range, 5.53-7.02] in men vs 16.63 [range, 12.37-22.37] in women, P < 0.01; WHtR: 6.04 [range, 5.36-6.81] in men vs 9.77 [range, 7.14-13.37] in women, P < 0.01), whereas this difference was not found in the older group (BMI: 3.03 [range, 2.69-3.42] in men vs 2.92 [range, 2.33-3.67] in women P = 0.076; WHtR: 3.11 [range, 2.78-3.47] in men vs 2.50 [range, 2.02-3.09] in women, P < 0.05). On multivariate logistic regression analysis, the ORs for multiple cardiometabolic risk factors after adjusting for age, smoking, alcohol consumption, and regular exercise in subjects with versus subjects without a large waist circumference tended to be higher in women than in men in the younger group but not in the older group. The ORs of the interaction term consisting of gender and each adiposity index for multiple cardiometabolic risk factors were significantly higher than a reference level of 1.00 in the younger group (BMI: 2.68 [range, 1.95-3.69], P < 0.01; WHtR: 1.62 [range, 1.16-2.27], P < 0.01) but not in the older group (BMI: 0.95 [range, 0.74-1.23], P = 0.712; WHtR: 0.80 [range, 0.63-1.02], P = 0.066).
The results suggest that the association between obesity and a cluster of cardiometabolic risk factors is stronger in women than in men, and this gender-specific difference exists in younger (35-40 years) but not in older (60-70 years) individuals.
肥胖是代谢综合征的主要危险因素。已知性别会影响肥胖风险及其他心血管危险因素。然而，肥胖与其他心血管代谢危险因素（如高血压、血脂异常和糖尿病）的累积之间是否存在性别特异性差异仍有待确定。
本研究旨在确定肥胖与一组其他心血管代谢危险因素之间的关联是否因性别而异。
研究对象为17791名日本男性和女性，分为年轻（35 - 40岁）和年长（60 - 70岁）年龄组。比较了各年龄组男性和女性中肥胖（体重指数[BMI]≥25 kg/m²或腰高比[WHtR]≥0.5）与多种心血管代谢危险因素（高血压、血脂异常和高血糖危险因素中≥2种）之间的关系。
在年轻组中，肥胖与非肥胖受试者相比，多种心血管代谢危险因素的粗比值比（OR）在女性中显著高于男性（BMI：男性为6.23[范围5.53 - 7.02]，女性为16.63[范围12.37 - 22.37]，P < 0.01；WHtR：男性为6.04[范围5.36 - 6.81]，女性为9.77[范围7.14 - 13.37]，P < 0.01），而在年长组中未发现这种差异（BMI：男性为3.03[范围2.69 - 3.42]，女性为2.92[范围2.33 - 3.67]，P = 0.076；WHtR：男性为3.11[范围2.78 - 3.47]，女性为2.50[范围2.02 - 3.09]，P < 0.05）。在多因素逻辑回归分析中，调整年龄、吸烟、饮酒和规律运动后，腰围较大与腰围正常的受试者相比，多种心血管代谢危险因素的OR在年轻组女性中往往高于男性，但在年长组中并非如此。年轻组中，由性别和各肥胖指数组成的交互项对多种心血管代谢危险因素的OR显著高于参考水平1.00（BMI：2.68[范围1.95 - 3.69]，P < 0.01；WHtR：1.62[范围1.16 - 2.27]，P < 0.01），而在年长组中并非如此（BMI：0.95[范围0.74 - 1.23]，P = 0.712；WHtR：0.80[范围0.63 - 1.02]，P = 0.066）。
结果表明，肥胖与一组心血管代谢危险因素之间存在关联，女性比男性更强，且这种性别特异性差异存在于年轻（35 - 40岁）个体中，而不存在于年长（60 - 70岁）个体中。
