Song Xin, Tabák Adam G, Zethelius Björn, Yudkin John S, Söderberg Stefan, Laatikainen Tiina, Stehouwer Coen D A, Dankner Rachel, Jousilahti Pekka, Onat Altan, Nilsson Peter M, Satman Ilhan, Vaccaro Olga, Tuomilehto Jaakko, Qiao Qing
Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.
Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
Cardiovasc Diabetol. 2014 Oct 19;13:144. doi: 10.1186/s12933-014-0144-5.
To estimate cardiovascular disease (CVD) mortality in relation to obesity and gender.
Data from 11 prospective cohorts from four European countries including 23 629 men and 21 965 women, aged 24 to 99 years, with a median follow-up of 7.9 years were analyzed. Hazards ratios (HR) for CVD mortality in relation to baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were estimated using Cox proportional hazards models with age as the timescale.
Men had higher CVD mortality than women in all four BMI categories (<25.0, 25.0-29.9, 30.0-34.9 and ≥35.0 kg/m(2)). Compared with the lowest BMI category in women, multivariable adjusted HRs (95% confidence intervals) for higher BMI categories are 1.0 (0.8-1.4), 1.6 (1.1-2.1) and 2.8 (2.0-3.8) in women and 2.8 (2.2-3.6), 3.1 (2.5-3.9), 3.8 (2.9-4.9) and 5.4 (3.8-7.7) in men, respectively. Similar findings were observed for abdominal obesity defined by WC, WHR or WHtR. The gender difference was slightly smaller in obese than in non-obese individuals; but the interaction was statistically significant only between gender and WC (p = 0.02), and WHtR (p = 0.01). None of the interaction terms was significant among non-diabetic individuals.
Men had higher CVD mortality than women across categories of anthropometric measures of obesity. The gender difference was attenuated in obese individuals, which warrants further investigation.
评估与肥胖及性别相关的心血管疾病（CVD）死亡率。
分析来自四个欧洲国家11个前瞻性队列的数据，包括23629名男性和21965名女性，年龄在24至99岁之间，中位随访时间为7.9年。使用以年龄为时间尺度的Cox比例风险模型，估计与基线体重指数（BMI）、腰围（WC）、腰臀比（WHR）和腰高比（WHtR）相关的CVD死亡率的风险比（HR）。
在所有四个BMI类别（<25.0、25.0 - 29.9、30.0 - 34.9和≥35.0kg/m²）中，男性的CVD死亡率均高于女性。与女性中最低BMI类别相比，多变量调整后的HR（95%置信区间）在女性较高BMI类别中分别为1.0（0.8 - 1.4）、1.6（1.1 - 2.1）和2.8（2.0 - 3.8），在男性中分别为2.8（2.2 - 3.6）、3.1（2.5 - 3.9）、3.8（2.9 - 4.9）和5.4（3.8 - 7.7）。对于由WC、WHR或WHtR定义的腹部肥胖，观察到类似的结果。肥胖个体中的性别差异略小于非肥胖个体；但仅性别与WC（p = 0.02）和WHtR（p = 0.01）之间的相互作用具有统计学意义。在非糖尿病个体中，没有一个相互作用项具有显著性。
在肥胖的人体测量指标类别中，男性的CVD死亡率高于女性。肥胖个体中的性别差异有所减弱，这值得进一步研究。
