Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Cardiovasc Ther. 2017 Aug;35(4). doi: 10.1111/1755-5922.12271.
Although numerous studies, to date, have demonstrated a specific phenomenon called the "obesity paradox" in patients after percutaneous coronary intervention (PCI), studies performed in China thus far have consistently shown an absence of this phenomenon.
"Obesity paradox" does exist in Chinese PCI patients.
10 724 consecutive Chinese patients who had undergone PCI treatment at a single center from January 2013 to December 2013 were prospectively recruited. Patients were divided into four groups: underweight (body mass index [BMI<18.5 kg/m ]), normal weight (18.5 kg/m ≤BMI<24.0 kg/m ), overweight (24.0 kg/m ≤BMI<28.0 kg/m ), and obese (BMI≥28.0 kg/m ). Two-year clinical outcomes were compared across the groups.
Overall, mean (±SD) BMI of all the patients was 25.9±3.2 kg/m . The 2-year mortality across underweight, normal weight, overweight, and obese patients in different BMI groups was 2.2%, 1.7%, 1.1%, and 1.0%, respectively (P=.035). Kaplan-Meier curves revealed that normal weight patients had higher incidence of all-cause mortality than overweight and obese (P=.015 and P=.020, respectively). Multivariable Cox regression analysis indicated that overweight was an independent predictor of all-cause mortality compared with normal weight (HR 0.64, 95% CI 0.41-0.98, P=.042).
Overweight patients have lower risk of mortality after PCI treatment; therefore, the phenomenon of "obesity paradox" also seems to exist in Chinese PCI patients.
虽然迄今为止有许多研究表明经皮冠状动脉介入治疗(PCI)后患者存在一种特定现象,即“肥胖悖论”,但中国的研究迄今一直未发现这种现象。
中国 PCI 患者中存在“肥胖悖论”。
前瞻性纳入 2013 年 1 月至 12 月在单中心接受 PCI 治疗的 10724 例连续中国患者。患者被分为四组:体重不足(体重指数[BMI]<18.5kg/m2)、正常体重(18.5kg/m2≤BMI<24.0kg/m2)、超重(24.0kg/m2≤BMI<28.0kg/m2)和肥胖(BMI≥28.0kg/m2)。比较各组患者 2 年临床结局。
总体而言,所有患者的平均(±SD)BMI 为 25.9±3.2kg/m2。不同 BMI 组中体重不足、正常体重、超重和肥胖患者的 2 年死亡率分别为 2.2%、1.7%、1.1%和 1.0%(P=0.035)。Kaplan-Meier 曲线显示,正常体重患者的全因死亡率高于超重和肥胖患者(P=0.015 和 P=0.020)。多变量 Cox 回归分析表明,与正常体重相比,超重是全因死亡的独立预测因素(HR 0.64,95%CI 0.41-0.98,P=0.042)。
超重患者 PCI 治疗后死亡风险较低,因此,“肥胖悖论”现象似乎也存在于中国 PCI 患者中。