Zhang Bin, Zhu Changguo, Ma Lanhua, Shen Bai, Zhang Gaoxing
Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Cardiovascular Disease and Clinical Experimental Center, Jiangmen Central Hospital, Jiangmen, Guangdong, China.
Front Cardiovasc Med. 2025 Jun 24;12:1590979. doi: 10.3389/fcvm.2025.1590979. eCollection 2025.
Cardiovascular disease (CVD) represent a primary factor contributing to death worldwide. Conventional indicators of obesity, waist circumference, waist-to-hip ratio, body mass index (BMI), have limitations in differentiating between fat and muscle mass. Relative fat mass (RFM), a novel metric based on waist to height ratio, has been proposed as a more accurate measure of total body fat percentage. This research examines the relationship between RFM and CVD, utilizing data sourced from the National Health and Nutrition Examination Survey (NHANES).
This cross sectional study utilized data sourced from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Participants with unavailable data on waist circumference, height, CVD complications, or total cholesterol were excluded. A total of 45,000 participants were included and divided into quartiles based on RFM values. Multivariate logistic regression models were used to assess the association between RFM and CVD. Moreover, analyses including subgroup evaluations, smooth curve modeling, and testing for interactions were conducted.
The prevalence of CVD was 10.42% (4,691) among the 45,000 participants. Fully adjusted models showed a significant positive association between RFM and CVD (OR = 1.04; 95% CI = 1.03-1.05; < 0.001). Participants in the highest RFM quartile(Q4) had a 2.11 fold increased risk of CVD compared to those in the lowest quartile (OR = 2.11; 95% CI = 1.76-2.53; < 0.001). Subgroup analyses indicated that the association was stronger in individuals aged <60 years, nonHispanic Whites, and those with BMI < 30 kg/m.
Elevated RFM is associated with an higher proportion of patients with CVD, suggesting that RFM may be a valuable indicator for CVD prevention and management. Future prospective studies are warranted to further explore the causal relationship between RFM and CVD.
心血管疾病（CVD）是全球范围内导致死亡的主要因素。肥胖的传统指标，如腰围、腰臀比、体重指数（BMI），在区分脂肪和肌肉量方面存在局限性。相对脂肪量（RFM）是一种基于腰高比的新指标，已被提议作为更准确测量全身脂肪百分比的方法。本研究利用来自美国国家健康与营养检查调查（NHANES）的数据，探讨RFM与CVD之间的关系。
这项横断面研究使用了1999年至2018年美国国家健康与营养检查调查（NHANES）的数据。排除腰围、身高、CVD并发症或总胆固醇数据缺失的参与者。共纳入45000名参与者，并根据RFM值分为四分位数。使用多变量逻辑回归模型评估RFM与CVD之间的关联。此外，还进行了包括亚组评估、平滑曲线建模和交互作用检验在内的分析。
45000名参与者中CVD的患病率为10.42%（4691人）。完全调整模型显示RFM与CVD之间存在显著正相关（OR = 1.04；95%CI = 1.03 - 1.05；P < 0.001）。与最低四分位数的参与者相比，RFM最高四分位数（Q4）的参与者患CVD的风险增加了2.11倍（OR = 2.11；95%CI = 1.76 - 2.53；P < 0.001）。亚组分析表明，在年龄<60岁的个体、非西班牙裔白人以及BMI < 30 kg/m的个体中，这种关联更强。
RFM升高与较高比例的CVD患者相关，这表明RFM可能是CVD预防和管理的一个有价值指标。未来有必要进行前瞻性研究，以进一步探索RFM与CVD之间的因果关系。
