Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China.
J Int Med Res. 2020 Jul;48(7):300060520932820. doi: 10.1177/0300060520932820.
To investigate the association of body mass index (BMI) with multivessel coronary artery disease in patients with myocardial infarction.
This study was performed in 1566 patients with myocardial infarction in the Department of Cardiology, Affiliated Hospital of Jining Medical University, China. Independent and dependent variables were BMI measured at baseline and multivessel coronary artery disease, respectively. The covariates examined in this study were age, systolic blood pressure, diastolic blood pressure, heart rate, creatinine, uric acid, bilirubin, cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, left ventricular ejection fraction, sex, heart failure, atrial fibrillation, chronic obstructive pulmonary disease, stroke, hypertension, diabetes mellitus, and smoking.
A nonlinear relationship was detected between BMI and multivessel coronary artery disease, and this was an inverted U-shaped curve and the cutoff point was 26.3 kg/m. The effect sizes and confidence intervals on the left and right sides of the inflection point were 1.10 (1.01-1.20) and 0.85 (0.74-0.97), respectively.
There is an obesity paradox for BMI > 26.3 kg/m. Future studies should examine the relationship between BMI and prognosis in patients with myocardial infarction, which may be important for improving the prognosis through control of BMI.
探讨体质量指数（BMI）与心肌梗死后多支冠状动脉病变的相关性。
本研究在中国济宁医学院附属医院心内科对 1566 例心肌梗死患者进行了研究。独立和依赖变量分别为基线时测量的 BMI 和多支冠状动脉病变。本研究中检查的协变量为年龄、收缩压、舒张压、心率、肌酐、尿酸、胆红素、胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、左心室射血分数、性别、心力衰竭、心房颤动、慢性阻塞性肺疾病、中风、高血压、糖尿病和吸烟。
BMI 与多支冠状动脉病变之间存在非线性关系，呈倒 U 型曲线，拐点为 26.3kg/m。拐点左右两侧的效应大小和置信区间分别为 1.10（1.01-1.20）和 0.85（0.74-0.97）。
BMI＞26.3kg/m 时存在肥胖悖论。未来的研究应该探讨 BMI 与心肌梗死后患者预后之间的关系，这对于通过控制 BMI 来改善预后可能很重要。
