Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China.
Institute of Biomedicine, Anhui Medical University, Hefei, China.
J Clin Endocrinol Metab. 2021 Jan 23;106(2):e812-e823. doi: 10.1210/clinem/dgaa823.
The effect of weight change patterns on cardiovascular diseases (CVD) remains uncertain.
We aim to examine the relation of weight change patterns and absolute weight change from young adulthood to midlife with incident CVD.
Retrospective cohort study.
National Health and Nutrition Examination Survey 1999-2016.
A total of 20 715 US adults aged 40 through 79 with recalled weight at young adulthood (25 years) and midlife (10 years before baseline).
CVD status was determined by self-report of a prior diagnosis, and age at diagnosis was used to establish time of CVD onset. CVD events was defined as the first occurrence of a congestive heart failure, coronary heart disease, angina pectoris, heart attack, or stroke.
After 9.76 years of follow-up, compared with participants who remained at normal weight, those in maximum overweight, changing from nonobese to obese, changing from obese to nonobese, maintaining obesity between young and middle adulthood had a 39% (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.19-1.62), 93% (HR, 1.93; 95% CI, 1.64-2.28), 125% (HR, 2.25; 95% CI, 1.29-3.94), and 132% (HR, 2.32; 95% CI, 1.68-3.20) higher risk of CVD, respectively. In addition, compared with weight change within 2.5 kg, weight gain ≥ 10.0 kg was associated with higher risk of CVD.
Both nonobese to obese, obese to nonobese, and stable obese from young to middle adulthood were associated with increased risks of CVD. The findings emphasize the importance of maintaining normal weight throughout the adulthood for preventing CVD in later life.
体重变化模式对心血管疾病（CVD）的影响尚不确定。
本研究旨在探讨从青年到中年的体重变化模式和绝对体重变化与心血管疾病发病的关系。
回顾性队列研究。
1999-2016 年全国健康和营养调查。
共有 20715 名年龄在 40 至 79 岁的美国成年人，他们在年轻时（25 岁）和中年（基线前 10 年）回忆起自己的体重。
心血管疾病状态通过自我报告的既往诊断确定，年龄用于确定心血管疾病发病时间。心血管疾病事件定义为充血性心力衰竭、冠心病、心绞痛、心脏病发作或中风的首次发生。
在 9.76 年的随访后，与保持正常体重的参与者相比，那些超重最多（从非肥胖变为肥胖）、从肥胖变为非肥胖、从非肥胖变为肥胖、在青年和中年时期一直肥胖的参与者发生心血管疾病的风险分别增加了 39%（风险比[HR]，1.39；95%置信区间[CI]，1.19-1.62）、93%（HR，1.93；95% CI，1.64-2.28）、125%（HR，2.25；95% CI，1.29-3.94）和 132%（HR，2.32；95% CI，1.68-3.20）。此外，与体重变化 2.5 公斤以内相比，体重增加≥10.0 公斤与心血管疾病风险增加相关。
从青年到中年，非肥胖变为肥胖、肥胖变为非肥胖以及稳定肥胖均与心血管疾病风险增加相关。这些发现强调了在成年期保持正常体重对于预防晚年心血管疾病的重要性。
