Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine.
Department of Public Health and Hygiene, Yamagata University School of Medicine.
J Atheroscler Thromb. 2023 Jul 1;30(7):754-766. doi: 10.5551/jat.63753. Epub 2022 Sep 7.
Aortic diseases (ADs), including aortic dissection, aortic aneurysm, and aortic rupture, are fatal, with extremely high mortality rates. A body shape index (ABSI), an anthropometric measure calculated as waist circumference adjusted by height and weight, improves the predictive capacity for mortality. However, whether ABSI is a risk factor for AD-related mortality in the general population remains unclear.
We used a nationwide database of 630,842 individuals (aged 40-75 years) who participated in the annual "Specific Health Check and Guidance in Japan" between 2008 and 2010.
During the follow-up period of 3.8 years, 159 AD-related deaths occurred, including 105 aortic dissections and 54 aortic aneurysm ruptures. The subjects were divided into three groups based on ABSI tertiles. Kaplan-Meier analysis demonstrated that the 3 tertile (with the highest ABSI) had the greatest risk among the three groups. Multivariate Cox proportional hazard regression analysis demonstrated that ABSI was significantly associated with AD-related death after adjusting for confounding risk factors. Neither waist circumference nor body mass index consistently predicted AD-related death in the multivariate model. The prediction capacity was significantly improved by the addition of ABSI to the confounding risk factors.
We demonstrated for the first time that ABSI, a surrogate marker for abdominal visceral fat tissue, was associated with AD-related deaths in the general population, suggesting the importance of central adiposity in the development of AD.
主动脉疾病（AD）包括主动脉夹层、主动脉瘤和主动脉破裂，这些疾病是致命的，死亡率极高。身体形态指数（ABSI）是一种通过身高和体重调整的腰围指标，可提高对死亡率的预测能力。然而，ABSI 是否是一般人群中 AD 相关死亡率的危险因素尚不清楚。
我们使用了一个全国性的数据库，该数据库包含了 630842 名年龄在 40-75 岁之间的个体（参加了 2008 年至 2010 年期间的“日本特定健康检查和指导”年度检查）。
在 3.8 年的随访期间，发生了 159 例 AD 相关死亡事件，其中包括 105 例主动脉夹层和 54 例主动脉瘤破裂。根据 ABSI 三分位将受试者分为三组。Kaplan-Meier 分析表明，三组中第三组（ABSI 最高）的风险最大。多变量 Cox 比例风险回归分析表明，在调整混杂风险因素后，ABSI 与 AD 相关死亡显著相关。在多变量模型中，腰围和体重指数均不能始终预测 AD 相关死亡。在混杂风险因素中加入 ABSI 后，预测能力显著提高。
我们首次证明，ABSI，一种腹部内脏脂肪组织的替代标志物，与一般人群中 AD 相关的死亡有关，提示中心性肥胖在 AD 发生中的重要性。
