Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Sci Rep. 2022 Jan 7;12(1):147. doi: 10.1038/s41598-021-02409-6.
Body-mass index (BMI), waist circumference, and waist-hip ratio are commonly used anthropometric indices of adiposity. However, over the past 10 years, several new anthropometric indices were developed, that more accurately correlated with body fat distribution and total fat mass. They include relative fat mass (RFM), body-roundness index (BRI), weight-adjusted-waist index and body-shape index (BSI). In the current study, we included 8295 adults from the PREVEND (Prevention of Renal and Vascular End-Stage Disease) observational cohort (the Netherlands), and sought to examine associations of novel as well as established adiposity indices with incident heart failure (HF). The mean age of study population was 50 ± 13 years, and approximately 50% (n = 4134) were women. Over a 11 year period, 363 HF events occurred, resulting in an overall incidence rate of 3.88 per 1000 person-years. We found that all indices of adiposity (except BSI) were significantly associated with incident HF in the total population (P < 0.001); these associations were not modified by sex (P interaction > 0.1). Amongst adiposity indices, the strongest association was observed with RFM [hazard ratio (HR) 1.67 per 1 SD increase; 95% confidence interval (CI) 1.37-2.04]. This trend persisted across multiple age groups and BMI categories, and across HF subtypes [HR: 1.76, 95% CI 1.26-2.45 for HF with preserved ejection fraction; HR 1.61, 95% CI 1.25-2.06 for HF with reduced ejection fraction]. We also found that all adiposity indices (except BSI) improved the fit of a clinical HF model; improvements were, however, most evident after adding RFM and BRI (reduction in Akaike information criteria: 24.4 and 26.5 respectively). In conclusion, we report that amongst multiple anthropometric indicators of adiposity, RFM displayed the strongest association with HF risk in Dutch community dwellers. Future studies should examine the value of including RFM in HF risk prediction models.
体重指数（BMI）、腰围和腰臀比是常用的肥胖人体测量学指标。然而，在过去的 10 年中，已经开发了几种新的人体测量学指标，这些指标可以更准确地与体脂肪分布和总脂肪量相关联。它们包括相对脂肪量（RFM）、身体圆润度指数（BRI）、体重调整腰围指数和体型指数（BSI）。在目前的研究中，我们纳入了 PREVEND（预防肾脏和血管终末期疾病）观察性队列（荷兰）中的 8295 名成年人，并试图研究新的和已建立的肥胖指标与心力衰竭（HF）事件的相关性。研究人群的平均年龄为 50±13 岁，约 50%（n=4134）为女性。在 11 年的时间里，发生了 363 例 HF 事件，总发病率为 3.88/1000 人年。我们发现，所有肥胖指标（BSI 除外）在总人群中与 HF 事件显著相关（P<0.001）；这些相关性不受性别影响（P 交互作用>0.1）。在肥胖指标中，与 RFM 的相关性最强[每增加 1 个标准差的风险比（HR）为 1.67；95%置信区间（CI）为 1.37-2.04]。这种趋势在多个年龄组和 BMI 类别中持续存在，并且在 HF 亚型中也存在[HR：HF 射血分数保留的 HR 为 1.76，95%CI 为 1.26-2.45；HF 射血分数降低的 HR 为 1.61，95%CI 为 1.25-2.06]。我们还发现，所有肥胖指标（BSI 除外）都改善了临床 HF 模型的拟合度；然而，在添加 RFM 和 BRI 后，改善最为明显（Akaike 信息准则减少：分别为 24.4 和 26.5）。总之，我们报告称，在多种肥胖人体测量学指标中，RFM 与荷兰社区居民的 HF 风险相关性最强。未来的研究应该研究在 HF 风险预测模型中纳入 RFM 的价值。
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