Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.
Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.
Mayo Clin Proc. 2018 Jun;93(6):709-720. doi: 10.1016/j.mayocp.2018.01.027. Epub 2018 Apr 12.
To assess the association of overweight without central obesity with risks of mortality.
We included 14,299 participants in the Third National Health and Nutrition Examination Survey (from October 18, 1988, through October 15, 1994). According to their body mass index and waist circumference, participants were categorized into 7 anthropometric groups. Logistic regression models were used to assess the relation of cardiovascular risk factors (hypertension, diabetes, or hypercholesterolemia) and 10-year cardiovascular risk to anthropometric groups. Cox proportional hazards models were used to assess the risk of all-cause mortality, and competing-risks regression models were used for calculating cardiovascular and noncardiovascular mortality.
Compared with those with normal body mass index and waist circumference, overweight men without central obesity were more likely to have all 3 cardiovascular risk factors and a high cardiovascular risk, whereas women in this anthropometric group were more likely to have hypercholesterolemia. In proportional hazards models, overweight without central obesity was associated with lower all-cause mortality among men in the population with cardiovascular risk factors (hazard ratio, 0.71; 95% CI, 0.56-0.89; P=.004) and the general population (hazard ratio, 0.72; 95% CI, 0.60-0.87; P=.001), whereas results of these comparisons among women were not significant (P>.05). In competing risk analyses, overweight men without central obesity had a lower risk of noncardiovascular mortality, but not cardiovascular mortality.
Although overweight without central obesity was associated with cardiovascular risk factors and a high cardiovascular risk among men, men in this anthropometric group had a lower mortality risk.
评估非中心性肥胖超重与死亡率风险的关联。
我们纳入了 14299 名参加第三次全国健康和营养调查的参与者（1988 年 10 月 18 日至 1994 年 10 月 15 日）。根据他们的体重指数和腰围，参与者被分为 7 个体型组。使用逻辑回归模型评估心血管危险因素（高血压、糖尿病或高胆固醇血症）与 10 年心血管风险与体型组的关系。使用 Cox 比例风险模型评估全因死亡率风险，使用竞争风险回归模型计算心血管和非心血管死亡率。
与正常体重指数和腰围的人相比，非中心性肥胖超重的男性更有可能出现所有 3 种心血管危险因素和高心血管风险，而该体型组的女性更有可能出现高胆固醇血症。在比例风险模型中，超重但无中心性肥胖与具有心血管危险因素的男性人群（风险比，0.71；95%置信区间，0.56-0.89；P=.004）和一般人群（风险比，0.72；95%置信区间，0.60-0.87；P=.001）的全因死亡率降低相关，而女性的这些比较结果不显著（P>.05）。在竞争风险分析中，非中心性肥胖超重的男性患非心血管死亡率的风险较低，但心血管死亡率无差异。
尽管非中心性肥胖超重与男性的心血管危险因素和高心血管风险相关，但该体型组的男性死亡率风险较低。
