Montoya Castillo Mariana, Martínez Quiroz Wilson de Jesús, Suarez-Ortegón Milton Fabian, Higuita-Gutiérrez Luis Felipe
Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín 050012, Colombia.
Dirección de Gestión Clínica y Promoción y Prevención, Metrosalud, Medellín 050010, Colombia.
J Clin Med. 2025 Apr 1;14(7):2411. doi: 10.3390/jcm14072411.
Few studies have compared the associations of different adiposity markers with cardiometabolic risk factors in individuals without diabetes or cardiovascular disease (CVD), particularly in South America. Moreover, the associations with more severe cardiometabolic risk, defined by the simultaneous presence of altered glycemia, blood pressure, and dyslipidemia, remain unknown. We examined whether the waist-to-height ratio (W-HtR), waist circumference (WC), and BMI were independently associated with cardiometabolic risk in a chronic disease prevention program in Medellín, Colombia. A cross-sectional study was conducted in 29,236 adults (age: 19-121 years) without diabetes or CVD. Exposures included increased W-HtR (>0.5), increased WC (≥80 cm for women, ≥90 cm for men), and overweight/obesity. The outcomes were dyslipidemia, elevated glycemia, high blood pressure, and full cardiometabolic risk (FCMR), defined as the presence of all three factors. Logistic regressions adjusted for sociodemographic and lifestyle covariates and additional adiposity markers were used. Cubic spline analyses examined the shape of associations. Most individuals were over 40 years old (97.6%), only 40 were ≥100 years, and 16.5% ( = 4821) had FCMR. Increased W-HtR tripled the odds of FCMR compared with normal W-HtR (OR: 3.04, 95%CI: 2.45-3.77, < 0.001). Increased WC doubled the odds of FCMR ( < 0.001). W-HtR remained the strongest predictor after adjusting for WC (OR: 1.99, 95%CI: 1.59-2.50) and BMI (OR: 2.48, 95%CI: 1.99-3.08). Cubic spline analyses showed a linear association between W-HtR and FCMR, whereas the BMI-FCMR association plateaued at approximately 30 kg/m. In this cross-sectional study of a large middle-to-older-aged cohort, W-HtR was the strongest adiposity marker correlated with cardiometabolic risk.
很少有研究比较过不同肥胖指标与无糖尿病或心血管疾病(CVD)个体的心血管代谢危险因素之间的关联,尤其是在南美洲。此外,同时存在血糖、血压和血脂异常所定义的更严重心血管代谢风险的相关情况仍不清楚。我们在哥伦比亚麦德林的一项慢性病预防项目中,研究了腰高比(W-HtR)、腰围(WC)和体重指数(BMI)是否与心血管代谢风险独立相关。对29236名无糖尿病或CVD的成年人(年龄:19 - 121岁)进行了一项横断面研究。暴露因素包括腰高比升高(>0.5)、腰围增加(女性≥80厘米,男性≥90厘米)以及超重/肥胖。结局指标为血脂异常、血糖升高、高血压以及完全心血管代谢风险(FCMR,定义为所有三个因素均存在)。使用了经社会人口学和生活方式协变量以及其他肥胖指标调整的逻辑回归分析。三次样条分析研究了关联的形状。大多数个体年龄超过40岁(97.6%),只有40人年龄≥100岁,16.5%(n = 4821)有完全心血管代谢风险。与正常腰高比相比,腰高比升高使完全心血管代谢风险的几率增加两倍(比值比:3.04,95%置信区间:2.45 - 3.77,P < 0.001)。腰围增加使完全心血管代谢风险的几率增加一倍(P < 0.001)。在调整腰围(比值比:1.99,95%置信区间:1.59 - 2.50)和体重指数(比值比:2.48,95%置信区间:1.99 - 3.08)后,腰高比仍然是最强的预测指标。三次样条分析显示腰高比与完全心血管代谢风险之间呈线性关联,而体重指数与完全心血管代谢风险的关联在约30 kg/m²时趋于平稳。在这项针对大量中老年队列的横断面研究中,腰高比是与心血管代谢风险相关的最强肥胖指标。