Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.
Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, No.57 Xinhua East Road, Tangshan City, 063001, China.
Nutr Metab Cardiovasc Dis. 2023 Mar;33(3):523-531. doi: 10.1016/j.numecd.2022.11.025. Epub 2022 Dec 23.
The longitudinal trajectories of body mass index (BMI) can reflect the pattern of BMI changes. Lifetime risk quantifies the cumulative risk of developing a disease over the remaining life of a person. We aimed to identify the trajectory of BMI and explore its association with cardiovascular disease (CVD) in the Chinese population.
A total of 68,603 participants with a mean age of 55.46 years were included from the Kailuan cohort in Tangshan, China, who were free of CVD and cancer and with repeated measurements of BMI from 2006 to 2010. A latent mixture model was used to identify BMI trajectories. An improved Kaplan-Meier estimator was used to predict the lifetime risk of CVD according to BMI trajectories. During a median follow-up of 7.0 years, 3325 participants developed CVD. Five BMI trajectories were identified at three index ages (35, 45, and 55) respectively. For index age 35 years, compared with the stable low-normal weight group (22.7% [95% CI, 20.0%-25.4%]), the stable high-normal weight (27.6% [25.6%-29.5%]), stable overweight (29.4% [27.4%-31.4%]), stable-low obesity (32.8% [30.0%-35.5%]), and stable-high obesity (38.9% [33.3%-44.5%]) groups had a higher lifetime risk of CVD (P < 0.05). We observed similar patterns for stroke and myocardial infarction. Similarly, the lifetime risk of CVD was higher in the long-term overweight and obese groups at 45 and 55 index ages.
Long-term overweight and obesity were associated with an increased lifetime risk of CVD. Our findings could assist in predicting the population burden of CVD.
体重指数（BMI）的纵向轨迹可以反映 BMI 变化的模式。终生风险量化了一个人在剩余生命中患上某种疾病的累积风险。我们旨在确定 BMI 的轨迹，并探讨其与中国人群心血管疾病（CVD）的关系。
本研究共纳入了 68603 名来自中国唐山开滦队列的参与者，他们在研究开始时没有 CVD 和癌症，并且在 2006 年至 2010 年期间重复测量了 BMI。使用潜在混合模型来识别 BMI 轨迹。使用改良的 Kaplan-Meier 估计器根据 BMI 轨迹预测 CVD 的终生风险。在中位随访 7.0 年期间，有 3325 名参与者发生了 CVD。在三个索引年龄（35、45 和 55 岁）分别确定了五个 BMI 轨迹。对于 35 岁的索引年龄，与稳定的低正常体重组（22.7%[95%CI，20.0%-25.4%]）相比，稳定的高正常体重组（27.6%[25.6%-29.5%]）、稳定超重组（29.4%[27.4%-31.4%]）、稳定低肥胖组（32.8%[30.0%-35.5%]）和稳定高肥胖组（38.9%[33.3%-44.5%]）的 CVD 终生风险更高（P<0.05）。我们观察到类似的中风和心肌梗死模式。同样，在 45 和 55 岁的指数年龄时，长期超重和肥胖组的 CVD 终生风险也更高。
长期超重和肥胖与 CVD 的终生风险增加有关。我们的研究结果可以帮助预测 CVD 的人群负担。
