Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China; School of Medicine, South China University of Technology, Guangzhou, China.
Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China; Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Nutr Metab Cardiovasc Dis. 2024 Nov;34(11):2562-2569. doi: 10.1016/j.numecd.2024.04.001. Epub 2024 Apr 5.
Obesity and metabolic abnormalities were associated with an increased risk of cardiovascular disease. However, it is unclear how metabolic weight phenotypes relate to cardiovascular diseases in postmenopausal women. This study aimed to explore the relationships in postmenopausal women.
We included 15,575 postmenopausal women aged 35-75 years (median age, 60.6) without cardiovascular disease at baseline from a subcohort of the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project. Metabolically unhealthy phenotype was defined as having ≥2 risk factors of metabolic syndrome: blood pressure ≥130/85 mm Hg or current use of antihypertensive drugs, fasting glucose ≥5.6 mmol/L or current use of antidiabetic agents, triglycerides ≥1.7 mmol/L, and high-density lipoprotein cholesterol <1.3 mmol/L. Cox regression analysis was used to evaluate the risks of cardiovascular diseases. Over a median follow-up period of 3.55 (interquartile range, 2.59-4.44) years, a total of 1354 cardiovascular events occurred. Compared to metabolically healthy normal weight, the multivariate-adjusted hazard ratios and their 95% confidence intervals were 1.41 (1.16-1.72) for metabolically unhealthy normal weight, 1.42 (1.16-1.73) for metabolically healthy overweight/obesity, and 1.75 (1.48-2.08) for metabolically unhealthy overweight/obesity. Subdividing overweight/obesity into separate groups revealed higher total cardiovascular disease risk only in metabolically unhealthy individuals across body mass index categories.
In postmenopausal women, both metabolically healthy overweight/obesity and metabolically unhealthy normal weight were associated with a higher risk of cardiovascular disease compared to metabolically healthy normal weight, and the greatest risk was observed in the metabolically unhealthy overweight/obesity category.
肥胖和代谢异常与心血管疾病风险增加相关。然而，代谢体重表型与绝经后女性心血管疾病的关系尚不清楚。本研究旨在探讨绝经后女性中的这种关系。
我们纳入了来自中国以患者为中心的心血管事件评估百万人大样本项目子队列的 15575 名年龄在 35-75 岁（中位年龄 60.6 岁）、基线时无心血管疾病的绝经后女性。代谢不健康表型定义为存在代谢综合征的≥2 个危险因素：血压≥130/85mmHg 或正在使用降压药物、空腹血糖≥5.6mmol/L 或正在使用降糖药物、三酰甘油≥1.7mmol/L 以及高密度脂蛋白胆固醇<1.3mmol/L。采用 Cox 回归分析评估心血管疾病风险。在中位随访 3.55 年（四分位距 2.59-4.44 年）期间，共发生 1354 例心血管事件。与代谢健康正常体重者相比，校正多因素后的风险比及其 95%置信区间分别为代谢不健康正常体重者 1.41（1.16-1.72）、代谢健康超重/肥胖者 1.42（1.16-1.73）和代谢不健康超重/肥胖者 1.75（1.48-2.08）。将超重/肥胖进一步分为单独的组别后，仅在代谢不健康的个体中，无论体重指数类别如何，超重/肥胖者的全因心血管疾病风险均更高。
在绝经后女性中，与代谢健康正常体重者相比，代谢健康超重/肥胖和代谢不健康正常体重者均与心血管疾病风险增加相关，且代谢不健康超重/肥胖者的风险最大。
