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自 20 岁以来体重变化与心血管疾病死亡率的关系:一项前瞻性队列研究。

Weight Change Since Age 20 and the Risk of Cardiovascular Disease Mortality: A Prospective Cohort Study.

机构信息

Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.

Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.

出版信息

J Atheroscler Thromb. 2022 Oct 1;29(10):1511-1521. doi: 10.5551/jat.63191. Epub 2021 Nov 20.

Abstract

AIM

Weight change could have many health outcomes. This study aimed to investigate the association between weight change and mortality risk due to total cardiovascular disease (CVD), ischemic heart disease (IHD), and stroke among Japanese.

METHODS

We used Suita Study data from 4,746 people aged 30-79 years in this prospective cohort study. Weight change was defined as the difference between baseline weight and weight at age 20. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of total CVD, IHD, and stroke mortality for 1) participants with a weight change (>10, 5 to 10, -5 to -10, and <-10 kg) compared to those with stable weight (-4.9 to 4.9 kg) and 2) participants who moved from one body mass index category (underweight, normal weight, or overweight) to another compared to those with normal weight at age 20 and baseline.

RESULTS

Within a median follow-up period of 19.9 years, the numbers of total CVD, IHD, and stroke mortality were 268, 132, and 79, respectively. Weight loss of >10 kg was associated with the increased risk of total CVD mortality 2.07 (1.29, 3.32) and stroke mortality 3.02 (1.40, 6.52). Moving from normal weight at age 20 to underweight at baseline was associated with the increased risk of total CVD, IHD, and stroke mortality: 1.76 (1.12, 2.77), 2.10 (1.13, 3.92), and 2.25 (1.05, 4.83), respectively.

CONCLUSION

Weight loss, especially when moving from normal to underweight, was associated with the increased risk of CVD mortality.

摘要

目的

体重变化可能对健康产生诸多影响。本研究旨在探究日本人的体重变化与全因心血管疾病(CVD)、缺血性心脏病(IHD)和中风死亡风险之间的相关性。

方法

我们在这项前瞻性队列研究中使用了来自 Suita 研究的 4746 名 30-79 岁人群的数据。体重变化定义为基线体重与 20 岁时体重的差值。我们使用 Cox 比例风险模型计算了体重变化(>10、5-10、-5--10 和<-10kg)参与者与体重稳定(-4.9-4.9kg)参与者之间的全因 CVD、IHD 和中风死亡率的风险比(HR)和 95%置信区间(CI),以及从一个 BMI 类别(消瘦、正常体重或超重)变为另一个 BMI 类别(消瘦、正常体重或超重)的参与者与 20 岁和基线时体重正常的参与者之间的全因 CVD、IHD 和中风死亡率的 HR 和 95%CI。

结果

在中位随访期 19.9 年内,全因 CVD、IHD 和中风死亡率分别为 268、132 和 79。体重减轻>10kg 与全因 CVD 死亡率的增加相关(HR 2.07,95%CI 1.29-3.32)和中风死亡率的增加相关(HR 3.02,95%CI 1.40-6.52)。从 20 岁时的正常体重变为基线时的消瘦与全因 CVD、IHD 和中风死亡率的增加相关:1.76(1.12-2.77)、2.10(1.13-3.92)和 2.25(1.05-4.83)。

结论

体重减轻,尤其是从正常体重变为消瘦,与 CVD 死亡率的增加相关。

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