Kabat Geoffrey C, Heo Moonseong, Van Horn Linda V, Kazlauskaite Rasa, Getaneh Asqual, Ard Jamy, Vitolins Mara Z, Waring Molly E, Zaslavsky Oleg, Wassertheil-Smoller Sylvia, Rohan Thomas E
Ann Epidemiol. 2014 Dec;24(12):896-902. doi: 10.1016/j.annepidem.2014.10.007.
Some studies suggest that anthropometric measures of abdominal obesity may be superior to body mass index (BMI) for the prediction of cardiometabolic risk factors; however, most studies have been cross-sectional. Our aim was to prospectively examine the association of change in BMI, waist-to-hip ratio (WHR), waist circumference (WC), and waist circumference-to-height ratio (WCHtR) with change in markers of cardiometabolic risk in a population of postmenopausal women.
We used a subsample of participants in the Women's Health Initiative aged 50 to 79 years at entry with available fasting blood samples and anthropometric measurements obtained at multiple time points over 12.8 years of follow-up (n = 2672). The blood samples were used to measure blood glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides at baseline, and at years 1, 3, and 6. We conducted mixed-effects linear regression analyses to examine associations at baseline and longitudinal associations between change in anthropometric measures and change in cardiometabolic risk factors, adjusting for covariates.
In longitudinal analyses, change in BMI, WC, and WCHtR robustly predicted change in cardiometabolic risk, whereas change in WHR did not. The strongest associations were seen for change in triglycerides, glucose, and HDL-C (inverse association).
Increase in BMI, WC, and WCHtR strongly predicted increases in serum triglycerides and glucose, and reduced HDL-C. WC and WCHtR were superior to BMI in predicting serum glucose, HDL-C, and triglycerides. WCHtR was superior to WC only in predicting serum glucose. BMI, WC, and WCHtR were all superior to WHR.
一些研究表明，腹部肥胖的人体测量指标在预测心脏代谢风险因素方面可能优于体重指数（BMI）；然而，大多数研究都是横断面研究。我们的目的是前瞻性地研究在绝经后女性人群中，BMI、腰臀比（WHR）、腰围（WC）和腰围身高比（WCHtR）的变化与心脏代谢风险标志物变化之间的关联。
我们使用了女性健康倡议研究中年龄在50至79岁之间的参与者的一个子样本，这些参与者在入组时提供了空腹血样，并在12.8年的随访期间的多个时间点进行了人体测量（n = 2672）。血样用于在基线、第1年、第3年和第6年测量血糖、胰岛素、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇（HDL-C）和甘油三酯。我们进行了混合效应线性回归分析，以检查基线时的关联以及人体测量指标变化与心脏代谢风险因素变化之间的纵向关联，并对协变量进行了调整。
在纵向分析中，BMI、WC和WCHtR的变化有力地预测了心脏代谢风险的变化，而WHR的变化则没有。甘油三酯、血糖和HDL-C的变化（负相关）显示出最强的关联。
BMI、WC和WCHtR的增加强烈预测血清甘油三酯和血糖的增加以及HDL-C的降低。WC和WCHtR在预测血清葡萄糖、HDL-C和甘油三酯方面优于BMI。WCHtR仅在预测血清葡萄糖方面优于WC。BMI、WC和WCHtR均优于WHR。
