Department of Biomedicine & Health Science, Graduate School, The Catholic University of Korea, Seoul, Korea.
Department of Family Medicine, Korea University College of Medicine, Seoul, Korea.
Endocrinol Metab (Seoul). 2020 Dec;35(4):933-942. doi: 10.3803/EnM.2020.871. Epub 2020 Dec 23.
Evidence regarding the association between variabilities in obesity measures and health outcomes is limited. We aimed to examine the association between variabilities in obesity measures and cardiovascular outcomes and all-cause mortality.
We identified 4,244,460 individuals who underwent health examination conducted by the Korean National Health Insurance Service during 2012, with ≥3 anthropometric measurements between 2009 and 2012. Variabilities in body weight (BW) and waist circumference (WC) were assessed using four indices including variability independent of the mean (VIM). We performed multivariable Cox proportional hazards regression analyses.
During follow-up of 4.4 years, 16,095, 18,957, and 30,200 cases of myocardial infarction (MI), stroke, and all-cause mortality were recorded. Compared to individuals with the lowest quartiles, incrementally higher risks of study outcomes and those of stroke and all-cause mortality were observed among individuals in higher quartiles of VIM for BW and VIM for WC, respectively. The multivariable adjusted hazard ratios and 95% confidence intervals comparing the highest versus lowest quartile groups of VIM for BW were 1.17 (1.12 to 1.22) for MI, 1.20 (1.16 to 1.25) for stroke, and 1.66 (1.60 to 1.71) for all-cause mortality; 1.07 (1.03 to 1.12) for stroke and 1.29 (1.25 to 1.33) for all-cause mortality regarding VIM for WC. These associations were similar with respect to the other indices for variability.
This study revealed positive associations between variabilities in BW and WC and cardiovascular outcomes and allcause mortality. Our findings suggest that variabilities in obesity measures are associated with adverse health outcomes in the general population.
关于肥胖测量值的变异性与健康结果之间的关联的证据有限。我们旨在研究肥胖测量值的变异性与心血管结局和全因死亡率之间的关系。
我们确定了 4244460 名在 2012 年期间接受韩国国家健康保险服务进行健康检查的个体，他们在 2009 年至 2012 年期间进行了≥3 次人体测量。使用包括变异独立于均值（VIM）在内的四个指数来评估体重（BW）和腰围（WC）的变异性。我们进行了多变量 Cox 比例风险回归分析。
在 4.4 年的随访期间，记录了 16095 例、18957 例和 30200 例心肌梗死（MI）、中风和全因死亡。与 BW 和 WC 的 VIM 的最低四分位数相比，BW 和 WC 的 VIM 的较高四分位数个体的研究结果、中风和全因死亡率的风险呈递增趋势。与 BW 的 VIM 的最高四分位数组相比，多变量调整后的危险比和 95%置信区间分别为 MI（1.17 [1.12 至 1.22]）、中风（1.20 [1.16 至 1.25]）和全因死亡率（1.66 [1.60 至 1.71]）；1.07 [1.03 至 1.12]）和全因死亡率（1.29 [1.25 至 1.33]）。关于 WC 的 VIM，这些关联与其他变异性指标相似。
本研究揭示了 BW 和 WC 的变异性与心血管结局和全因死亡率之间存在正相关关系。我们的研究结果表明，肥胖测量值的变异性与一般人群的不良健康结果有关。
