60 岁及以上人群的生命历程 BMI 与生物标志物：美国与哥斯达黎加的比较。
Life-course BMI and biomarkers in persons aged 60 years or older: a comparison of the USA and Costa Rica.
机构信息
Stanford University School of Medicine, Department of Medicine, Division of Primary Care and Population Health, 1070 Arastradero Road, Room 280, Palo Alto, CA94304, USA.
University of California, Berkeley, School of Public Health, Berkeley, CA, USA.
出版信息
Public Health Nutr. 2019 Feb;22(2):314-323. doi: 10.1017/S1368980018002276. Epub 2018 Oct 11.
OBJECTIVE
There is a large literature linking current BMI to levels of cardiovascular risk biomarkers, but it is unknown whether measures of BMI earlier in the life course and maximum BMI are predictive of current levels of biomarkers. The objective of the current study was to determine how current, maximum and age-25 BMI among individuals over the age of 60 years are associated with their current levels of cardiovascular risk biomarkers.
DESIGN
Cross-sectional study with retrospective recall.
SETTING
Costa Rica (n 821) and the USA (n 4110).
SUBJECTS
Nationally representative samples of adults aged 60 years or over.
RESULTS
We used regression models to examine the relationship between multiple meaures of BMI with four established cardiovascular risk biomarkers. The most consistent predictor of current levels of systolic blood pressure, TAG and HDL-cholesterol was current BMI. However, maximum BMI was the strongest predictor of glycosylated Hb (HbA1c) and was also related to HDL-cholesterol and TAG. HbA1c was independent of current BMI. We found that these relationships are consistent between Costa Rica and the USA for HbA1c and for HDL-cholesterol.
CONCLUSIONS
Current levels of cardiovascular risk biomarkers are not only the product of current levels of BMI, but also of maximum lifetime BMI, particularly for levels of HbA1c and for HDL-cholesterol. Managing maximum obtained BMI over the life course may be most critical for maintaining the healthiest levels of cardiovascular risk.
目的
大量文献将当前 BMI 与心血管风险生物标志物水平联系起来，但尚不清楚生命早期的 BMI 测量值和最大 BMI 是否可预测当前生物标志物水平。本研究的目的是确定 60 岁以上人群的当前、最大和 25 岁时 BMI 与当前心血管风险生物标志物水平的关系。
设计
横断面研究，回顾性回忆。
地点
哥斯达黎加（n=821）和美国（n=4110）。
受试者
年龄在 60 岁及以上的成年人的全国代表性样本。
结果
我们使用回归模型来检查多种 BMI 指标与四种已建立的心血管风险生物标志物之间的关系。当前 BMI 是收缩压、TAG 和 HDL-胆固醇当前水平的最一致预测因子。然而，最大 BMI 是糖化血红蛋白（HbA1c）的最强预测因子，也与 HDL-胆固醇和 TAG 相关。HbA1c 与当前 BMI 无关。我们发现，这些关系在哥斯达黎加和美国之间对于 HbA1c 和 HDL-胆固醇是一致的。
结论
心血管风险生物标志物的当前水平不仅是当前 BMI 水平的产物，也是最大终生 BMI 的产物，特别是对于 HbA1c 和 HDL-胆固醇水平。在整个生命过程中管理获得的最大 BMI 可能对维持最健康的心血管风险水平最为关键。
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