身体形态指数与心血管代谢多种疾病之间的矛盾关联：英国老龄化纵向研究的结果

A paradoxical association between A Body Shape Index and cardiometabolic multimorbidity: Findings from the English longitudinal study of ageing.

作者信息

Kunutsor Setor K, Bhattacharjee Atanu, Jae Sae Young, Laukkanen Jari A

机构信息

Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R2H 2A6, Canada; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4WP, UK.

Population Health and Genomics, School of Medicine, University of Dundee, Dundee DD1 4HN, UK.

出版信息

Nutr Metab Cardiovasc Dis. 2025 May 30:104167. doi: 10.1016/j.numecd.2025.104167.

DOI:10.1016/j.numecd.2025.104167

PMID:40615310

Abstract

BACKGROUND AND AIMS

A Body Shape Index (ABSI) is a novel metric designed to more accurately reflect abdominal adiposity and visceral fat distribution - factors more strongly associated with cardiometabolic risk than body mass index (BMI) and waist circumference (WC). The association between ABSI and cardiometabolic multimorbidity (CMM) is unclear. This study aimed to assess the prospective association between ABSI and CMM risk, and to directly compare this association with those of other adiposity measures (BMI, WC, height, and weight) on CMM risk within the same population.

METHODS AND RESULTS

We analyzed data from 3408 participants (mean age: 63 years; 44.7 % male) who were free from hypertension, coronary heart disease, diabetes, and stroke at wave 4 of the English Longitudinal Study of Ageing. ABSI was calculated as WC/(BMIheight). CMM was defined as the presence of at least two chronic conditions (hypertension, cardiovascular disease, diabetes, and stroke) at wave 10. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs). Over a 15-year follow-up period, 201 participants developed CMM. Spline analysis showed a U-shaped trend between ABSI and CMM risk. Compared with the middle tertile, the multivariable adjusted ORs (95 % CIs) for CMM were 1.57 (1.10-2.25) for the lowest tertile and .97 (.64-1.48) for the highest tertile. Increased levels of BMI, WC, height, and weight were each associated with an elevated CMM risk.

CONCLUSION

There was a U-shaped relationship between ABSI and CMM risk, with low ABSI being associated with an increased CMM risk.

摘要

背景与目的

体型指数（ABSI）是一种新型指标，旨在更准确地反映腹部肥胖和内脏脂肪分布，相较于体重指数（BMI）和腰围（WC），这些因素与心脏代谢风险的关联更为密切。ABSI与心脏代谢多发病（CMM）之间的关联尚不清楚。本研究旨在评估ABSI与CMM风险之间的前瞻性关联，并在同一人群中直接比较这种关联与其他肥胖指标（BMI、WC、身高和体重）对CMM风险的影响。

方法与结果

我们分析了英国老龄化纵向研究第4波中3408名参与者（平均年龄：63岁；44.7%为男性）的数据，这些参与者当时没有高血压、冠心病、糖尿病和中风。ABSI计算公式为WC/（BMI×身高）。CMM定义为在第10波时存在至少两种慢性病（高血压、心血管疾病、糖尿病和中风）。使用多变量逻辑回归模型来估计比值比（OR）和95%置信区间（CI）。在15年的随访期内，201名参与者发展为CMM。样条分析显示ABSI与CMM风险之间呈U形趋势。与中间三分位数相比，多变量调整后的CMM的OR（95%CI）在最低三分位数为1.57（1.10 - 2.25），在最高三分位数为0.97（0.64 - 1.48）。BMI、WC、身高和体重水平的升高均与CMM风险升高相关。