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正常体重中心性肥胖的现状与转变及心血管疾病风险:一项基于中国人群的队列研究

Status and transition of normal-weight central obesity and the risk of cardiovascular diseases: A population-based cohort study in China.

作者信息

Ren Ziyang, Sun Weidi, Wang Shuhui, Ying Jiayao, Liu Wen, Fan Lijun, Zhao Yang, Wu Chenkai, Song Peige

机构信息

School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.

School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Nutr Metab Cardiovasc Dis. 2022 Dec;32(12):2794-2802. doi: 10.1016/j.numecd.2022.07.023. Epub 2022 Aug 9.

Abstract

BACKGROUND AND AIMS

Cardiovascular disease (CVD) has become a growing public health concern. Normal weight central obesity (NWCO) has emerged as a potential risk factor for cardiometabolic dysregulation. To date, the association between NWCO and new-onset CVDs remains unclear. We aimed to evaluate the associations of NWCO and its longitudinal transitions with cardiovascular risks in middle-aged and older Chinese.

METHODS AND RESULTS

Data were from the China Health and Retirement Longitudinal Study 2011-2018. NWCO was defined as the combination of a body mass index (BMI) of <24.0 kg/m and a waist circumference (WC) of >85 cm in males or >80 cm in females. CVDs included heart diseases and stroke. Cause-specific hazard models and subdistribution hazard models with all-cause death as the competing event were applied. In 2011, 9856 participants without prior CVDs were included, of whom 1814 developed CVDs during a 7-year follow-up. Compared to normal weight and non-central obesity (NWNCO), NWCO was significantly associated with new-onset CVDs, with cause-specific hazard ratios (cHRs) and 95% confidence intervals (CIs) of 1.21 (1.04-1.41) for heart diseases and 1.40 (1.11-1.76) for stroke. From 2011 to 2013, 571 NWNCO participants developed NWCO who subsequently demonstrated a 45% higher risk of CVDs than those with maintained NWNCO.

CONCLUSION

NWCO and transition from NWNCO to NWCO are associated with higher risks of CVDs. Identification and prevention of NWCO may be useful in the management of CVDs.

摘要

背景与目的

心血管疾病(CVD)已成为日益严重的公共卫生问题。正常体重中心性肥胖(NWCO)已成为心脏代谢失调的潜在危险因素。迄今为止,NWCO与新发心血管疾病之间的关联仍不明确。我们旨在评估NWCO及其纵向转变与中国中老年人心血管风险之间的关联。

方法与结果

数据来自2011 - 2018年中国健康与养老追踪调查。NWCO定义为男性体重指数(BMI)<24.0 kg/m²且腰围(WC)>85 cm,或女性BMI<24.0 kg/m²且腰围>80 cm。心血管疾病包括心脏病和中风。应用以全因死亡为竞争事件的病因特异性风险模型和亚分布风险模型。2011年纳入9856名无既往心血管疾病的参与者,其中1814人在7年随访期间发生了心血管疾病。与正常体重且非中心性肥胖(NWNCO)相比,NWCO与新发心血管疾病显著相关,心脏病的病因特异性风险比(cHRs)及95%置信区间(CIs)为1.21(1.04 - 1.41),中风为1.40(1.11 - 1.76)。2011年至2013年,571名NWNCO参与者转变为NWCO,随后这些人发生心血管疾病的风险比维持NWNCO的人高45%。

结论

NWCO以及从NWNCO转变为NWCO与心血管疾病的较高风险相关。识别和预防NWCO可能有助于心血管疾病的管理。

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