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[中国成年人中心性肥胖与心脏病风险的关联:一项前瞻性研究]

[Association between central obesity and risk for heart disease in adults in China: a prospective study].

作者信息

Tian Y, Yang S C, Yu C Q, Guo Y, Bian Z, Tan Y L, Pei P, Chen J S, Chen Z M, Lyu J, Li L M

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.

Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Sep 10;39(9):1172-1178. doi: 10.3760/cma.j.issn.0254-6450.2018.09.006.

Abstract

To understand the association between central obesity, assessed by waist circumference, and the risks for ischemic heart disease (IHD), major coronary event (MCE), and IHD death. After excluding participants with heart disease, stroke, cancer, COPD, and diabetes at baseline survey, we included a total of 428 595 participants from the China Kadoorie Biobank for the analysis. The baseline survey was conducted from June 2004 to July 2008. We used Cox proportional hazards model to estimate the hazard ratio () and 95. During an average 9.1 years of follow-up (3 803 637 person-years), we documented 26 900 incident cases of IHD, 4 320 cases of MCE, and 2 787 of deaths from IHD. After adjustment for possible confounders and BMI, central obesity was found to be associated with increased risks for IHD, MCE, and IHD death. The adjusted s (for the participants who had waist circumference of 85.0-89.9 cm in men and 80.0-84.9 cm in women were 1.13 (95: 1.09-1.17) for IHD, 1.15 (95: 1.05-1.26) for MCE and 1.11 (95: 0.98-1.24) for IHD death. The respective s for those central obese participants (men ≥90.0 cm, women ≥85.0 cm) were 1.29 (95: 1.24-1.34), 1.30 (95: 1.17-1.44) and 1.32 (95: 1.16-1.51). Further stratification analysis according to BMI showed that the risks for incident IHD, MCE, and IHD death increased along with the increase of waist circumference even in the participants with normal weight. This large-scale prospective study revealed that central obesity was an independent risk factor for IHD in adults in China, and the risk of IHD would increase with the increase of waist circumference.

摘要

为了解通过腰围评估的中心性肥胖与缺血性心脏病(IHD)、主要冠状动脉事件(MCE)及IHD死亡风险之间的关联。在基线调查中排除患有心脏病、中风、癌症、慢性阻塞性肺疾病(COPD)和糖尿病的参与者后,我们纳入了中国嘉道理生物银行的428595名参与者进行分析。基线调查于2004年6月至2008年7月进行。我们使用Cox比例风险模型来估计风险比(HR)和95%置信区间。在平均9.1年的随访期(3803637人年)内,我们记录了26900例IHD发病病例、4320例MCE病例以及2787例IHD死亡病例。在对可能的混杂因素和体重指数(BMI)进行调整后,发现中心性肥胖与IHD、MCE及IHD死亡风险增加相关。调整后的HR(对于男性腰围为85.0 - 89.9厘米且女性腰围为80.0 - 84.9厘米的参与者),IHD为1.13(95%置信区间:1.09 - 1.17),MCE为1.15(95%置信区间:1.05 - 1.26),IHD死亡为1.11(95%置信区间:0.98 - 1.24)。对于那些中心性肥胖参与者(男性≥90.0厘米,女性≥85.0厘米),相应的HR分别为1.29(95%置信区间:1.24 - 1.34)、1.30(95%置信区间:1.17 - 1.44)和1.32(95%置信区间:1.16 - 1.51)。根据BMI进行的进一步分层分析表明,即使在体重正常的参与者中,IHD发病、MCE及IHD死亡风险也随着腰围的增加而增加。这项大规模前瞻性研究表明,中心性肥胖是中国成年人IHD的独立危险因素,且IHD风险会随着腰围的增加而升高。

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