Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America.
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
PLoS One. 2018 Dec 3;13(12):e0207223. doi: 10.1371/journal.pone.0207223. eCollection 2018.
We previously reported in a cross-sectional analysis an adverse relationship between weight cycling and HDL-cholesterol but not angiographic obstructive coronary artery disease (CAD) among women undergoing coronary angiography for suspected ischemia in the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE). We now examine the relationship between weight cycling and prospective adverse cardiovascular outcome in this group.
795 women enrolled between 1996-2001 in the WISE undergoing coronary angiography for evaluation of suspected ischemia and followed for a median of 6.0 years (interquartile range = 3.4 years). Adverse outcome was defined as a composite of all-cause death, cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke, and hospitalization for heart failure. Weight cycling was defined as the intentional loss of at least 10 lbs. (4.5 kgs.) at least three times during the women's lifetime.
Women (n = 224) who reported a history of weight cycling were younger; more often white and better educated compared those without this history. At baseline, women with a weight cycling history had lower HDL-C values, higher body mass index, larger waist circumferences and higher values for fasting blood sugar, but no difference in obstructive CAD prevalence or severity. There was an inverse relationship between weight cycling and adverse composite cardiovascular outcome, whereby fewer of women with a history of weight cycling experienced an adverse outcome as compared to non-cyclers (21% vs 29%, respectively, p = 0.03).
Despite an adverse association with HDL-cholesterol in women undergoing coronary angiography for suspected ischemia, weight cycling was associated with a lower adverse outcome rate in women with suspected ischemia.
我们之前在一项横断面分析中报告，在 NHLBI 赞助的女性缺血综合征评估（WISE）中，接受冠状动脉造影检查以疑似缺血的女性中，体重循环与高密度脂蛋白胆固醇呈负相关，但与影像学阻塞性冠状动脉疾病（CAD）无关。我们现在在这组人群中检查体重循环与前瞻性不良心血管结局之间的关系。
1996 年至 2001 年间，WISE 共纳入 795 例女性，因疑似缺血接受冠状动脉造影检查，并进行中位数为 6.0 年（四分位距=3.4 年）的随访。不良结局定义为全因死亡、心血管死亡率、非致死性心肌梗死、非致死性卒中和心力衰竭住院的复合终点。体重循环定义为女性一生中至少三次意图减轻至少 10 磅（4.5 公斤）。
报告有体重循环史的女性更年轻；更多为白人，受教育程度更高。与无此病史的女性相比，基线时体重循环史女性的高密度脂蛋白胆固醇值较低，体重指数较高，腰围较大，空腹血糖值较高，但影像学阻塞性 CAD 的患病率或严重程度无差异。体重循环与不良复合心血管结局呈负相关，有体重循环史的女性发生不良结局的比例低于非循环者（分别为 21%和 29%，p=0.03）。
尽管在接受冠状动脉造影检查以疑似缺血的女性中，体重循环与高密度脂蛋白胆固醇呈负相关，但在疑似缺血的女性中，体重循环与较低的不良结局率相关。
