Dai Yingnan, Wan Xiaojing, Li Xin, Jin Enze, Li Xueqi
The Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan Street, Habin, 150001, China.
Lipids Health Dis. 2016 Mar 5;15:46. doi: 10.1186/s12944-016-0218-3.
The distribution of adipose tissue has been evaluated in relation to cardiovascular risk factors and biochemical components of the metabolic syndrome. Neck circumference (NC) has been shown to have a strong relationship with cardiovascular disease (CVD) and may be a novel indicator of CVD. The aim of this study was to compare the incidence of CVD events in cohorts with different NC distributions, and to correlate NC with future CVD events and relative mortality.
A prospective cohort study was performed on 12,151 high-risk cardiology outpatients from 2004 until 2014. Anthropometric parameters like body mass index, NC, waist circumference, and hip circumference were measured at baseline and follow-up and compared in different cohorts with high, medium, and low NC. Fatal and non-fatal CVD events were compared in the follow-up study, and survival analysis was conducted. Independent Chi-square tests were performed to compare the incidence of CVD events and mortality among the cohorts and analyze the interactions.
The subjects comprised of 6696 women and 5819 men who completed a mean 8.8-year follow-up. All of the participants had two or more CVD risk factors at baseline. At the end of the study, 4049 CVD events had occurred in 2304 participants. The incidence of non-fatal CVD events was 14.08, 16,65, and 25.21 % in the low-NC, medium-NC, and high-NC cohorts, respectively (p < 0.001). The all-cause mortality was 9.77, 11.93, and 19.31 %, and CVD mortality, 4.00, 6.29, and 8.01 %, respectively (p < 0.001). Compared with baseline, the number of CVD risk factors in participants had increased from 2.6, 3.0, and 3.4 to 3.5, 4.1, and 4.7 in the low-, medium-, and high-NC cohorts (34, 36, and 38 %), respectively. The event-free survival rate was 95.32, 80.15, and 75.47 %, respectively.
A higher NC indicated a higher incidence of future fatal and non-fatal CVD events and all-cause mortality in both male and female high-risk participants. CVD risk factors increased more in the higher NC group. NC as a novel indicator of CVD showed good predictive ability for CVD events and mortality in a high-risk population.
已对脂肪组织分布与心血管危险因素及代谢综合征的生化成分进行了评估。颈围（NC）已被证明与心血管疾病（CVD）密切相关，可能是心血管疾病的一个新指标。本研究的目的是比较不同颈围分布队列中心血管疾病事件的发生率，并将颈围与未来心血管疾病事件及相对死亡率相关联。
对2004年至2014年期间的12151名高危心脏病门诊患者进行了一项前瞻性队列研究。在基线和随访时测量体重指数、颈围、腰围和臀围等人体测量参数，并在颈围高、中、低的不同队列中进行比较。在随访研究中比较致命和非致命心血管疾病事件，并进行生存分析。进行独立卡方检验以比较各队列中心血管疾病事件的发生率和死亡率，并分析相互作用。
受试者包括6696名女性和5819名男性，平均随访8.8年。所有参与者在基线时都有两种或更多的心血管疾病危险因素。在研究结束时，2304名参与者发生了4049例心血管疾病事件。低颈围、中颈围和高颈围队列中非致命心血管疾病事件的发生率分别为14.08%、16.65%和25.21%（p<0.001）。全因死亡率分别为9.77%、11.93%和19.31%，心血管疾病死亡率分别为4.00%、6.29%和8.01%（p<0.001）。与基线相比，低、中、高颈围队列中参与者的心血管疾病危险因素数量分别从2.6、3.0和3.4增加到3.5、4.1和4.7（分别增加34%、36%和38%）。无事件生存率分别为95.32%、80.15%和75.47%。
较高的颈围表明高危男性和女性参与者未来致命和非致命心血管疾病事件的发生率及全因死亡率更高。颈围较高组中心血管疾病危险因素增加得更多。颈围作为心血管疾病的一个新指标，在高危人群中对心血管疾病事件和死亡率显示出良好的预测能力。
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