Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mayo Clin Proc. 2013 May;88(5):487-94. doi: 10.1016/j.mayocp.2013.01.014. Epub 2013 Mar 26.
To assess the impact of short-term changes in body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio on the risk of future coronary heart disease (CHD) among women.
The study sample consisted of 2468 women aged 30 years or older without cardiovascular disease at baseline who underwent 2 consecutive examinations, the first between January 31, 1999, and August 21, 2001, and second between October 20, 2001, and September 22, 2005, and were followed up until March 31, 2010. Cox proportional hazard regression was performed to estimate the hazard ratios (HRs) of the anthropometric measures for CHD events.
During a mean follow-up of 6.6 years, CHD occurred in 127 of the study participants (5.1%). There were significant interactions between a BMI of 30 kg/m(2) or greater and anthropometric changes in prediction of CHD events (all P<.04). Among nonobese individuals, a 1-SD increase in HC changes, independent of WC and BMI changes, was inversely associated with risk of CHD events (HR, 0.60 [95% CI, 0.44-0.83]). Among obese individuals, a 1-SD increase in WC, independent of other changes, increased the risk of CHD. Conversely, a 1-SD increase in BMI decreased the risk of CHD by 35% (HR, 0.65 [95% CI, 0.45-0.94]).
In this study, the impact of changes in anthropometric measures on CHD was modified by obesity at baseline. Among nonobese women, increases in HC could significantly reduce the risk of CHD events. Among obese individuals, although increases in WC were associated with a higher risk of CHD, increases in BMI decreased the risk.
评估短期体重指数（BMI）、腰围（WC）、臀围（HC）和腰臀比变化对女性未来冠心病（CHD）风险的影响。
研究样本由 2468 名年龄在 30 岁或以上、基线时无心血管疾病的女性组成，她们接受了两次连续检查，第一次在 1999 年 1 月 31 日至 2001 年 8 月 21 日之间进行，第二次在 2001 年 10 月 20 日至 2005 年 9 月 22 日之间进行，并随访至 2010 年 3 月 31 日。使用 Cox 比例风险回归估计人体测量指标对 CHD 事件的风险比（HR）。
在平均 6.6 年的随访期间，研究参与者中有 127 人（5.1%）发生 CHD。BMI 为 30kg/m²或更高和人体测量学变化在预测 CHD 事件方面存在显著的交互作用（均 P<.04）。在非肥胖个体中，HC 变化的 1-SD 增加与 CHD 事件的风险呈负相关，独立于 WC 和 BMI 变化（HR，0.60[95%CI，0.44-0.83]）。在肥胖个体中，WC 的 1-SD 增加，独立于其他变化，增加了 CHD 的风险。相反，BMI 的 1-SD 增加降低了 CHD 的风险 35%（HR，0.65[95%CI，0.45-0.94]）。
在这项研究中，人体测量指标变化对 CHD 的影响受到基线肥胖的影响。在非肥胖女性中，HC 的增加可显著降低 CHD 事件的风险。在肥胖个体中，尽管 WC 的增加与 CHD 风险增加相关，但 BMI 的增加降低了风险。
