Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.
Clinical Science Division, R&D Janssen Pharmaceutical K K.
J Atheroscler Thromb. 2022 Feb 1;29(2):252-267. doi: 10.5551/jat.59394. Epub 2021 Jan 17.
We investigated the influence of weight change on concurrent changes in predicted cardiovascular disease (CVD) risk and individual CVD risk factors over time.
A total of 2,140 community-dwellers aged 40-74 years participated in both 2002 and 2007 health examinations. Obesity was defined as body mass index ≥ 25 kg/m. Weight trajectories were classified as: "stable obese" (obese at both examinations), "obese to nonobese" (obese in 2002 but nonobese in 2007), "nonobese to obese" (nonobese in 2002 but obese in 2007), or "stable nonobese" (nonobese at both examinations). We compared changes in the model-predicted risk for CVD and individual CVD risk factors across weight-change categories.
The predicted risk for CVD increased during 5 years in all groups; the increment in the predicted risk for CVD was smallest in the obese to nonobese participants and steepest in the nonobese to obese subjects. Compared with the stable obese participants, the obese to nonobese participants had greater favorable changes in waist circumferences, blood pressure, fasting plasma glucose, serum high-density lipoprotein cholesterol, serum triglycerides, and liver enzymes. For all these parameters, opposite trends were observed when comparing the nonobese to obese participants with the stable nonobese group.
We demonstrated the favorable association of losing weight in obese people and avoiding excessive weight gain in nonobese people with global risk of future CVD and individual CVD risk factors in a real-world setting. The findings could improve behavioral lifestyle interventions that provide information on the health consequences of weight change at health checkups.
我们研究了体重变化对预测心血管疾病(CVD)风险和个体 CVD 风险因素随时间变化的影响。
共有 2140 名 40-74 岁的社区居民参加了 2002 年和 2007 年的两次健康检查。肥胖定义为体重指数≥25kg/m。体重轨迹分为:“稳定肥胖”(两次检查均肥胖)、“肥胖转为非肥胖”(2002 年肥胖但 2007 年非肥胖)、“非肥胖转为肥胖”(2002 年非肥胖但 2007 年肥胖)或“稳定非肥胖”(两次检查均非肥胖)。我们比较了体重变化类别之间 CVD 预测风险和个体 CVD 风险因素的变化。
所有组在 5 年内 CVD 预测风险均增加;肥胖转为非肥胖组 CVD 预测风险的增加最小,而非肥胖转为肥胖组的增加最大。与稳定肥胖组相比,肥胖转为非肥胖组的腰围、血压、空腹血糖、血清高密度脂蛋白胆固醇、血清甘油三酯和肝酶水平有更大的有利变化。对于所有这些参数,与稳定肥胖组相比,非肥胖转为肥胖组的变化趋势相反。
我们在真实环境中证明了肥胖者减肥和非肥胖者避免体重过度增加与未来 CVD 总体风险和个体 CVD 风险因素之间的有利关联。这些发现可以改善行为生活方式干预措施,在健康检查中提供体重变化对健康影响的信息。