Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Endocrinol (Lausanne). 2024 May 13;15:1345781. doi: 10.3389/fendo.2024.1345781. eCollection 2024.
We aimed to investigate the effect of BMI variability on CVD and mortality and to explore the mediation effects of the main cardiovascular risk factors contributing to this association.
Participants aged 40-65 years were pooled from three cohort studies(ARIC [Atherosclerosis Risk in Communities], MESA [Multi-ethnic Study of Atherosclerosis], and TLGS [Tehran Lipid and Glucose Study]. We employed root mean squared error of the fractional mixed model to calculate BMI variability in the measurement period. In the event assessment period, the hazard ratios for CVD and mortality were estimated using Cox proportional hazard regression models. In the next step, the mediation and interaction effects of fasting plasma glucose, total cholesterol, and systolic blood pressure were determined.
A total of 19073 participants were included in this pooled analysis. During a median of 20.7 years of follow-up, 3900 (20.44%) CVD and 6480 (33.97%) all-cause mortality events were recorded. After adjusting for potential confounders, BMI variability was linked to the 1.3 (1.2-1.4) and 1.7 (1.6-1.8) increased risk of CVD and mortality, respectively. Fasting plasma glucose mediated approximately 24% and 8% of the effect of BMI variability on CVD and mortality, respectively. However, systolic blood pressure and total cholesterol did not have mediation effects in this association.
High BMI variability is independently associated with the development of CVD and mortality. This association is partly mediated through fasting plasma glucose. Modern cardiometabolic therapies that lower fasting glucose may reduce the risk of future CVD and mortality in individuals with high BMI variability.
本研究旨在探讨 BMI 变异性对心血管疾病（CVD）和死亡率的影响，并探讨导致这种相关性的主要心血管风险因素的中介作用。
参与者年龄为 40-65 岁，来自三个队列研究（ARIC [社区动脉粥样硬化风险]、MESA [多民族动脉粥样硬化研究]和 TLGS [德黑兰血脂和血糖研究]）。我们采用分数混合模型均方根误差来计算测量期间的 BMI 变异性。在事件评估期间，使用 Cox 比例风险回归模型估计 CVD 和死亡率的风险比。在下一步中，确定空腹血糖、总胆固醇和收缩压的中介和交互作用。
共有 19073 名参与者纳入本荟萃分析。在中位数为 20.7 年的随访期间，记录到 3900 例（20.44%）CVD 和 6480 例（33.97%）全因死亡事件。在调整了潜在混杂因素后，BMI 变异性与 CVD 和死亡率的风险比分别增加了 1.3（1.2-1.4）和 1.7（1.6-1.8）。空腹血糖介导了 BMI 变异性对 CVD 和死亡率影响的约 24%和 8%。然而，收缩压和总胆固醇在这种相关性中没有中介作用。
高 BMI 变异性与 CVD 和死亡率的发生独立相关。这种相关性部分通过空腹血糖介导。降低空腹血糖的现代心脏代谢治疗可能会降低 BMI 变异性高的个体未来发生 CVD 和死亡率的风险。
