Li Nan, Katzmarzyk Peter T, Horswell Ronald, Zhang Yonggang, Li Weiqin, Zhao Wenhui, Wang Yujie, Johnson Jolene, Hu Gang
Pennington Biomedical Research Center, Baton Rouge, LA Tianjin Women's and Children's Health Center, Tianjin, China.
Pennington Biomedical Research Center, Baton Rouge, LA.
Diabetes Care. 2014 Dec;37(12):3204-12. doi: 10.2337/dc14-1091. Epub 2014 Sep 23.
The association between obesity and coronary heart disease (CHD) risk remains debatable, and no studies have assessed this association among diabetic patients. The aim of our study was to investigate the association between BMI and CHD risk among patients with type 2 diabetes.
The sample included 30,434 diabetic patients (10,955 men and 19,479 women) 30-95 years of age without a history of CHD or stroke in the Louisiana State University Hospital-Based Longitudinal Study.
During a mean follow-up period of 7.3 years, 7,414 subjects developed CHD. The multivariable-adjusted hazard ratios for CHD across levels of BMI at baseline (18.5-24.9, 25-29.9, 30-34.9, 35-39.9, and ≥40 kg/m(2)) were 1.00, 1.14 (95% CI 1.00-1.29), 1.27 (1.12-1.45), 1.54 (1.34-1.78), and 1.42 (1.23-1.64) (Ptrend < 0.001) in men and 1.00, 0.95 (0.85-1.07), 0.95 (0.84-1.06), 1.06 (0.94-1.20), and 1.09 (1.00-1.22) (Ptrend < 0.001) in women, respectively. When we used an updated mean or last visit value of BMI, the positive association between BMI and CHD risk did not change in men. However, the positive association of BMI with CHD changed to a U-shaped association in women when we used the last visit value of BMI.
Our study suggests that there is a positive association between BMI at baseline and during follow-up with the risk of CHD among patients with type 2 diabetes. We indicate a U-shaped association between BMI at the last visit and the risk of CHD among women with type 2 diabetes.
肥胖与冠心病（CHD）风险之间的关联仍存在争议，且尚无研究评估糖尿病患者中的这种关联。我们研究的目的是调查2型糖尿病患者体重指数（BMI）与冠心病风险之间的关联。
样本包括路易斯安那州立大学医院纵向研究中30434名年龄在30至95岁之间、无冠心病或中风病史的糖尿病患者（10955名男性和19479名女性）。
在平均7.3年的随访期内，7414名受试者患上冠心病。基线时BMI各水平（18.5 - 24.9、25 - 29.9、30 - 34.9、35 - 39.9及≥40 kg/m²）的多变量调整后冠心病风险比，男性分别为1.00、1.14（95%CI 1.00 - 1.29）、1.27（1.12 - 1.45）、1.54（1.34 - 1.78）和1.42（1.23 - 1.64）（P趋势<0.001），女性分别为1.00、0.95（0.85 - 1.07）、0.95（0.84 - 1.06）、1.06（0.94 - 1.20）和1.09（1.00 - 1.22）（P趋势<0.001）。当我们使用BMI的更新均值或末次就诊值时，男性中BMI与冠心病风险之间的正相关关系未改变。然而，当我们使用BMI的末次就诊值时，女性中BMI与冠心病的正相关关系变为U型关联。
我们的研究表明，2型糖尿病患者基线时及随访期间的BMI与冠心病风险之间存在正相关关系。我们指出2型糖尿病女性末次就诊时的BMI与冠心病风险之间存在U型关联。
