Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Obes Res Clin Pract. 2022 Jan-Feb;16(1):63-71. doi: 10.1016/j.orcp.2021.12.004. Epub 2021 Dec 28.
The contribution of anthropometric measures to predict mortality in normal-weight subjects is unclear. We aimed to study the association of central obesity measures, e.g., waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), with the risk of all-cause and CVD mortality.
In a prospective population-based Tehran Lipid and Glucose Study, 8287 participants aged ≥30 y, followed for a median of 18 years. The association of WC, WHR and WHtR with the risk for mortality was estimated using multivariate Cox proportional hazard models in different BMI groups.
We documented 821 deaths, of which 251 were related to CVD mortality. Normal weight individuals with central obesity were significantly at increased risk of all-cause (HR: 1.5; 95% CI: 1.10, 2.1) and CVD mortality (HR: 1.6; 95% CI: 0.92, 2.9) compared with normal-weight individuals without central obesity; the risk remained significant only in women. Also, normal-weight women (not men) with high WHR were at increased risk of all-cause (HR: 1.7; 95% CI: 1.0, 2.8) and CVD mortality (HR: 5.9; 95% CI: 1.5, 23.2). High WHtR increased the risk of all-cause (HR: 1.5; 95% CI: 1.2, 1.8) and CVD mortality (HR: 1.8; 95% CI: 1.2, 2.7) which remained significant in normal-weight men and women. All central obesity indicators were significantly associated with all-cause and CVD mortality in subjects aged under 65.
Even in normal-weight individuals, WC and WHR in women and WHtR in both sexes are predictors of all-cause and CVD mortality. WHtR shows a stronger association, especially in the population aged under 65.
目前尚不清楚人体测量学指标对预测正常体重人群死亡率的作用。本研究旨在探讨中心性肥胖指标（如腰围[WC]、腰臀比[WHR]和腰高比[WHtR]）与全因和心血管疾病（CVD）死亡率风险之间的关系。
在一项前瞻性人群为基础的德黑兰血脂和血糖研究中，我们对 8287 名年龄≥30 岁的参与者进行了随访，中位随访时间为 18 年。我们使用多变量 Cox 比例风险模型在不同 BMI 组中评估了 WC、WHR 和 WHtR 与死亡率风险的相关性。
我们记录了 821 例死亡，其中 251 例与 CVD 死亡率相关。与无中心性肥胖的正常体重个体相比，具有中心性肥胖的正常体重个体发生全因（HR：1.5；95%CI：1.10，2.1）和 CVD 死亡率（HR：1.6；95%CI：0.92，2.9）的风险显著增加；这种相关性仅在女性中仍然显著。此外，正常体重女性（而非男性）中 WHtR 较高者发生全因（HR：1.7；95%CI：1.0，2.8）和 CVD 死亡率（HR：5.9；95%CI：1.5，23.2）的风险增加。WHtR 升高与全因（HR：1.5；95%CI：1.2，1.8）和 CVD 死亡率（HR：1.8；95%CI：1.2，2.7）风险增加相关，这种相关性在正常体重的男性和女性中仍然显著。所有中心性肥胖指标在年龄<65 岁的人群中与全因和 CVD 死亡率均显著相关。
即使在正常体重人群中，女性的 WC 和 WHR 以及男性和女性的 WHtR 也是全因和 CVD 死亡率的预测指标。WHtR 与全因和 CVD 死亡率的相关性更强，尤其是在年龄<65 岁的人群中。
