Del Brutto Oscar H, Mera Robertino M, Recalde Bettsy Y, Pérez Pedro, Ortega-Tola José, Rumbea Denisse A, Sedler Mark J
School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador.
Department of Epidemiology, Gilead Sciences, Inc., Foster City, CA, USA.
J Stroke Cerebrovasc Dis. 2022 Apr;31(4):106200. doi: 10.1016/j.jstrokecerebrovasdis.2021.106200. Epub 2021 Dec 3.
Various anthropometric measurements have been inversely associated with atherosclerosis, giving rise to the concept of an "obesity paradox" However, inconsistent study results make it difficult to determine the best anthropometric measurement with which to assess such inverse relationship. Height has been inversely associated with atherosclerosis and it is unlikely to be associated with unexpected biases. In this study, we aimed to assess the association between height and other anthropometric measurements and intracranial atherosclerotic disease (ICAD).
Community-dwelling older adults enrolled in the Three Villages Study received anthropometric measurements, high-resolution head CT (to evaluate calcium content in carotid siphons) and time-of-flight MRA (to assess stenosis of large intracranial arteries). Logistic regression models were fitted to assess the independent association between each anthropometric measurements and the presence of ICAD, after adjusting for relevant confounders. Estimated adjusted proportions were used to show how increases of different anthropometric measurements impacted ICAD log odds and corresponding odds ratios.
A total of 581 individuals were enrolled. Height was the single variable inversely associated with ICAD at the mean of other anthropometric measurements (OR: 0.954; 95% C.I.: 0.918 - 0.991; p=0.016). Every additional cm of height reduced by 4.6% the probability of having ICAD. The significance of other anthropometric measurements vanished in multivariate models with height as an independent variable.
This study demonstrates a robust inverse association between height and ICAD in Amerindians and opens new avenues of research for a better understanding of the obesity paradox in diverse ethnic groups.
各种人体测量指标与动脉粥样硬化呈负相关，由此产生了“肥胖悖论”的概念。然而，研究结果不一致，难以确定评估这种负相关关系的最佳人体测量指标。身高与动脉粥样硬化呈负相关，且不太可能与意外偏差相关。在本研究中，我们旨在评估身高及其他人体测量指标与颅内动脉粥样硬化疾病（ICAD）之间的关联。
参加三村研究的社区居住老年人接受了人体测量、高分辨率头部CT（以评估颈动脉虹吸部的钙含量）和时间飞跃磁共振血管造影（以评估颅内大动脉狭窄）。在调整相关混杂因素后，采用逻辑回归模型评估各人体测量指标与ICAD存在之间的独立关联。估计的调整比例用于显示不同人体测量指标的增加如何影响ICAD的对数几率和相应的优势比。
共纳入581名个体。在其他人体测量指标均值的情况下，身高是与ICAD呈负相关的单一变量（OR：0.954；95%置信区间：0.918 - 0.991；p = 0.016）。身高每增加1厘米，患ICAD的概率降低4.6%。在以身高为自变量的多变量模型中，其他人体测量指标的显著性消失。
本研究表明美洲印第安人中身高与ICAD之间存在显著的负相关关系，并为更好地理解不同种族群体中的肥胖悖论开辟了新的研究途径。
