1] Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland [2] Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
Eur J Clin Nutr. 2013 Dec;67(12):1298-302. doi: 10.1038/ejcn.2013.203. Epub 2013 Oct 23.
BACKGROUND/OBJECTIVES: Body mass index (BMI) is the most commonly used surrogate marker for evaluating the risk of cardiovascular disease (CVD) mortality in relation to general obesity, while abdominal obesity indicators have been proposed to be more informative in risk prediction.
SUBJECT/METHODS: A prospective cohort study consisting of 46 651 Europeans aged 24-99 years was conducted to investigate the relationship between CVD mortality and different obesity indicators including BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-stature ratio (WSR), A Body Shape Index (ABSI) and waist-to-hip-to-height ratio (WHHR). Hazard ratio (HR) was estimated by the Cox proportional hazards model using age as timescale, and compared using paired homogeneity test.
During a median follow-up of 7.9 years, 3435 participants died, 1409 from CVD. All obesity indicators were positively associated with increased risk of CVD mortality, with HRs (95% confidence intervals) per standard deviation increase of 1.19 (1.12-1.27) for BMI, 1.29 (1.21-1.37) for WC, 1.28 (1.20-1.36) for WHR, 1.35 (1.27-1.44) for WSR, 1.34 (1.26-1.44) for ABSI and 1.34 (1.25-1.42) for WHHR in men and 1.37 (1.24-1.51), 1.49 (1.34-1.65), 1.45 (1.31-1.60), 1.52 (1.37-1.69), 1.32 (1.18-1.48) and 1.45 (1.31-1.61) in women, respectively. The prediction was stronger with abdominal obesity indicators than with BMI or ABSI (P<0.05 for all paired homogeneity tests). WSR appeared to be the strongest predictor among all the indicators, with a linear relationship with CVD mortality in both men and women.
Abdominal obesity indicators such as WC, WHR, WSR and WHHR, are stronger predictors for CVD mortality than general obesity indicator of BMI.
背景/目的：体重指数（BMI）是评估心血管疾病（CVD）死亡率与一般肥胖相关风险的最常用替代标志物，而腹部肥胖指标在风险预测中被认为更具信息性。
进行了一项由 46651 名 24-99 岁欧洲人组成的前瞻性队列研究，以调查 CVD 死亡率与不同肥胖指标（包括 BMI、腰围（WC）、腰臀比（WHR）、腰高比（WSR）、A 体型指数（ABSI）和腰臀高比（WHHR））之间的关系。使用年龄作为时间尺度，通过 Cox 比例风险模型估计危险比（HR），并通过配对同质性检验进行比较。
在中位随访 7.9 年期间，有 3435 名参与者死亡，其中 1409 人死于 CVD。所有肥胖指标均与 CVD 死亡率增加呈正相关，男性 BMI 每标准差增加的 HR（95%置信区间）为 1.19（1.12-1.27），WC 为 1.29（1.21-1.37），WHR 为 1.28（1.20-1.36），WSR 为 1.35（1.27-1.44），ABSI 为 1.34（1.26-1.44），WHHR 为 1.34（1.25-1.42），女性为 1.37（1.24-1.51），1.49（1.34-1.65），1.45（1.31-1.60），1.52（1.37-1.69），1.32（1.18-1.48）和 1.45（1.31-1.61）。与 BMI 或 ABSI 相比，腹部肥胖指标的预测性更强（所有配对同质性检验 P<0.05）。WSR 似乎是所有指标中最强的预测指标，男女 CVD 死亡率均呈线性关系。
与 BMI 等一般肥胖指标相比，WC、WHR、WSR 和 WHHR 等腹部肥胖指标是 CVD 死亡率的更强预测指标。
