Srikanthan Preethi, Horwich Tamara B, Tseng Chi Hong
Division of Endocrinology, Department of Medicine, University of California, Los Angeles, California.
Division of Cardiology, Department of Medicine, University of California, Los Angeles, California.
Am J Cardiol. 2016 Apr 15;117(8):1355-60. doi: 10.1016/j.amjcard.2016.01.033. Epub 2016 Feb 2.
We evaluated the relation between components of body composition and mortality in patients with cardiovascular disease (CVD). Dual x-ray absorptiometry body composition data from the National Health and Nutrition Examination Survey 1999 to 2004 was linked to total and CVD mortality data 1999 to 2006 in 6,451 patients with CVD. Kaplan-Meier survival analysis for the end points of total and CVD mortality was plotted by quartiles of muscle mass, fat mass, and categories of body mass index (BMI). Subjects were stratified into 4 groups (low muscle/low fat mass, low muscle/high fat mass, high muscle/low fat mass, and high muscle/high fat mass). Adjusted Cox proportional hazards regression determined hazard ratios for total and CVD mortality. Rates of cardiovascular/total mortality were lower in higher quartiles of muscle mass, fat mass, and higher categories of BMI (p <0.001). The high muscle/low fat mass group had a lower risk of CVD and total mortality (risk-adjusted hazard ratios of 0.32, 95% confidence interval 0.14 to 0.73 and 0.38, 95% confidence interval 0.22 to 0.68, for CVD and total mortality, respectively). Thus, increasing fat mass, muscle mass, and BMI were all correlated with improved survival. The specific subgroup of high muscle and low fat mass had the lowest mortality risk compared with other body composition subtypes. This suggests the importance of body composition assessment in the prediction of cardiovascular and total mortality in patients with CVD.
我们评估了心血管疾病（CVD）患者身体成分各组成部分与死亡率之间的关系。将1999年至2004年美国国家健康与营养检查调查中的双能X线吸收法身体成分数据，与6451例CVD患者1999年至2006年的全因死亡率和CVD死亡率数据相关联。根据肌肉量、脂肪量的四分位数以及体重指数（BMI）类别，绘制了全因死亡率和CVD死亡率终点的Kaplan-Meier生存分析图。受试者被分为4组（低肌肉量/低脂肪量、低肌肉量/高脂肪量、高肌肉量/低脂肪量和高肌肉量/高脂肪量）。经调整的Cox比例风险回归确定了全因死亡率和CVD死亡率的风险比。在肌肉量、脂肪量的较高四分位数以及较高BMI类别中，心血管疾病/全因死亡率较低（p<0.001）。高肌肉量/低脂肪量组的CVD和全因死亡风险较低（CVD死亡率和全因死亡率的风险调整后风险比分别为0.32，95%置信区间为0.14至0.73和0.38，95%置信区间为0.22至0.68）。因此，脂肪量、肌肉量和BMI的增加均与生存率提高相关。与其他身体成分亚型相比，高肌肉量和低脂肪量的特定亚组死亡率风险最低。这表明身体成分评估在预测CVD患者的心血管疾病和全因死亡率方面具有重要意义。
