Oda Eiji, Goto Masayuki, Matsushita Hirooki, Takarada Ken, Tomita Makoto, Saito Atsushi, Fuse Koichi, Fujita Satoru, Ikeda Yoshio, Kitazawa Hitoshi, Takahashi Minoru, Sato Masahito, Okabe Masaaki, Aizawa Yoshifusa
Medical Check-up Center, Tachikawa Medical Center, Nagachou 2-2-16, Nagaoka, Niigata, 940-0053, Japan,
Heart Vessels. 2013 Sep;28(5):551-8. doi: 10.1007/s00380-012-0280-3. Epub 2012 Sep 14.
Controversies concerning the association between obesity and acute myocardial infarction (AMI) are still ongoing in Japan. We investigated the association between obesity defined by body mass index of 25 kg/m(2) or higher and AMI by a case-control study using data from 1199 AMI cases and 4056 apparently healthy controls. The analysis was performed in age- and sex-matched samples of 621 case-control pairs younger than 80 years and in crude samples aged 40-79 years divided into 10-year age groups. Prevalence of obesity, diabetes, current smoking, hypertension, and hypercholesterolemia were compared between cases and controls, and a multivariable odds ratio (OR) of AMI was calculated for each risk factor in various age groups. The OR (95 % confidence interval (CI)) of AMI for obesity was 1.63 (1.23-2.17), P = 0.0008 in men younger than 80 years; 2.65 (1.41-5.00), P = 0.0025 in women younger than 80 years; 2.23 (1.46-3.41), P = 0.0002 in men aged 59 years or younger; 1.34 (0.90-2.01), P = 0.1510 in men aged 60-79 years; and 2.98 (1.56-5.71), P = 0.0010 in women aged 60-79 years using paired samples. The OR (95 % CI) of AMI for obesity was 4.92 (2.53-9.58), P < 0.0001 in men aged 40-49 years; 1.54 (1.07-2.21), P = 0.0197 in men aged 50-59 years; 1.07 (0.69-1.66), P = 0.7717 in men aged 60-69 years; 2.24 (1.20-4.20), P = 0.0118 in men aged 70-79 years; 2.48 (1.12-5.48), P = 0.0245 in women aged 60-69 years; and 3.05 (1.46-6.37), P = 0.0029 in women aged 70-79 years using crude samples. The association between obesity and AMI was age- and gender-dependent in a Japanese population.
在日本，关于肥胖与急性心肌梗死（AMI）之间关联的争议仍在持续。我们通过一项病例对照研究，利用1199例AMI病例和4056例明显健康对照的数据，调查了体重指数（BMI）为25kg/m²及以上所定义的肥胖与AMI之间的关联。分析在年龄和性别匹配的621对80岁以下病例对照样本中进行，以及在40 - 79岁按10岁年龄组划分的原始样本中进行。比较了病例组和对照组中肥胖、糖尿病、当前吸烟、高血压和高胆固醇血症的患病率，并计算了各年龄组中每个风险因素的AMI多变量比值比（OR）。在80岁以下男性中，肥胖导致AMI的OR（95%置信区间（CI））为1.63（1.23 - 2.17），P = 0.0008；80岁以下女性中为2.65（1.41 - 5.00），P = 0.0025；59岁及以下男性中为2.23（1.46 - 3.41），P = 0.0002；60 - 79岁男性中为1.34（0.90 - 2.01），P = 0.1510；60 - 79岁女性中为2.98（1.56 - 5.71），P = 0.0010（使用配对样本）。在40 - 49岁男性中，肥胖导致AMI的OR（95% CI）为4.92（2.53 - 9.58），P < 0.0001；50 - 59岁男性中为1.54（1.07 - 2.21），P = 0.0197；60 - 69岁男性中为1.07（0.69 - 1.66），P = 0.7717；70 - 79岁男性中为2.24（1.20 - 4.20），P = 0.0118；60 - 69岁女性中为2.48（1.12 - 5.48），P = 0.0245；70 - 79岁女性中为3.05（1.46 - 6.37），P = 0.0029（使用原始样本）。在日本人群中，肥胖与AMI之间的关联存在年龄和性别依赖性。
