Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, United States of America.
Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
PLoS One. 2021 Mar 1;16(3):e0247821. doi: 10.1371/journal.pone.0247821. eCollection 2021.
To determine how baseline weight status contributes to differences in postmenopausal weight gain among non-Hispanic Blacks (NHBs) and non-Hispanic Whites (NHWs).
Data were included from 70,750 NHW and NHB postmenopausal women from the Women's Health Initiative Observational Study (WHI OS). Body Mass Index (BMI) at baseline was used to classify women as having normal weight, overweight, obese class I, obese class II or obese class III. Cox proportional hazards was used to estimate the hazard of a 10% or more increase in weight from baseline.
In both crude and adjusted models, NHBs were more likely to experience ≥10% weight gain than NHWs within the same category of baseline weight status. Moreover, NHBs who were normal weight at baseline were most likely to experience ≥10% weight gain in both crude and adjusted models. Age-stratified results were consistent with overall findings. In all age categories, NHBs who were normal weight at baseline were most likely to experience ≥10% weight gain. Based on the results of adjusted models, the joint influence of NHB race/ethnicity and weight status on risk of postmenopausal weight gain was both sub-additive and sub-multiplicative.
NHBs are more likely to experience postmenopausal weight gain than NHWs, and the disparity in risk is most pronounced among those who are normal weight at baseline. To address the disparity in postmenopausal obesity, future studies should focus on identifying and modifying factors that promote weight gain among normal weight NHBs.
确定基线体重状况如何导致非西班牙裔黑人(NHB)和非西班牙裔白人(NHW)之间绝经后体重增加的差异。
纳入了来自妇女健康倡议观察研究(WHI OS)的 70750 名 NHW 和 NHB 绝经后女性的数据。基线时的体重指数(BMI)用于将女性分为正常体重、超重、肥胖 I 级、肥胖 II 级或肥胖 III 级。使用 Cox 比例风险来估计从基线开始体重增加 10%或更多的风险。
在未经调整和调整后的模型中,NHB 比 NHW 在相同的基线体重状况类别中更有可能经历≥10%的体重增加。此外,在未经调整和调整后的模型中,基线正常体重的 NHB 最有可能经历≥10%的体重增加。年龄分层结果与总体发现一致。在所有年龄类别中,基线正常体重的 NHB 最有可能经历≥10%的体重增加。基于调整后模型的结果,NHB 种族/民族和体重状况对绝经后体重增加风险的联合影响是次加性和次乘性的。
与 NHW 相比,NHB 更有可能经历绝经后体重增加,而且这种风险的差异在基线正常体重的人群中最为明显。为了解决绝经后肥胖的差异,未来的研究应重点确定和改变促进正常体重 NHB 体重增加的因素。