Oliveira Bárbara Bruna Rodrigues de, Coelho Carolina Gomes, Barreto Sandhi Maria, Giatti Luana, Araújo Larissa Fortunato
Programa de Pós-graduação em Saúde Pública, Universidade Federal do Ceará, Fortaleza, Brasil.
Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Cad Saude Publica. 2022 Feb 11;38(2):e00346520. doi: 10.1590/0102-311X00346520. eCollection 2022.
Body fat distribution seems to have different effects in cardiovascular diseases (CVD). We aimed to estimate the associations between lower limbs and trunk fat ratio and the 10-year CVD risk, and isolated risk factors in men and women. A total of 10,917 participants from ELSA-Brasil were eligible for this cross-sectional study. Associations between lower limb/trunk fat ratio with the percentage of 10-year CVD risk - according to the Framingham Risk Score - and its risk factors (systolic blood pressure, total cholesterol and HDL-cholesterol, diabetes, and use of antihypertensive medication) were performed using generalized linear models, linear and logistic regressions. All analyses were stratified by gender and adjustments were made by age, self-reported skin color, educational attainment, alcohol consumption, leisure physical activity, hypolipidemic drug use and, for women, menopausal status. In this study, 55.91% were women, with a mean age of 52.68 (SD = 6.57) years. A higher lower limb/trunk fat ratio was related to lower 10-year CVD risk, as well as a reduction in systolic blood pressure, total cholesterol, and antihypertensive drug use, also an increasing HDL-cholesterol in both genders, but this relationship was stronger in women. Besides, a protective relationship to diabetes was observed in women. Higher fat accumulation in the lower body, when compared to the trunk, seems to have a lower risk of CVD and associated risk factors - even in the presence of fat in the abdominal region - with women presenting lower risks than men.
身体脂肪分布在心血管疾病（CVD）中似乎具有不同影响。我们旨在评估下肢与躯干脂肪比率与10年心血管疾病风险以及男性和女性的独立风险因素之间的关联。来自巴西老年健康与生活方式研究（ELSA - Brasil）的10917名参与者符合这项横断面研究的条件。使用广义线性模型、线性回归和逻辑回归分析下肢/躯干脂肪比率与根据弗雷明汉风险评分得出的10年心血管疾病风险百分比及其风险因素（收缩压、总胆固醇和高密度脂蛋白胆固醇、糖尿病以及使用抗高血压药物）之间的关联。所有分析均按性别分层，并对年龄、自我报告的肤色、教育程度、饮酒情况、休闲体育活动、使用降血脂药物情况进行调整，对于女性还对绝经状态进行调整。在本研究中，55.91%为女性，平均年龄为52.68（标准差 = 6.57）岁。较高的下肢/躯干脂肪比率与较低的10年心血管疾病风险相关，同时收缩压、总胆固醇降低以及抗高血压药物使用减少，男女两性的高密度脂蛋白胆固醇均升高，但这种关系在女性中更强。此外，在女性中观察到与糖尿病存在保护性关系。与躯干相比，下半身脂肪堆积较多似乎患心血管疾病及相关风险因素的风险较低——即使腹部存在脂肪——女性的风险低于男性。
