Bengtsson C, Björkelund C, Lapidus L, Lissner L
Department of Primary Health Care, University of Gothenburg, Sweden.
BMJ. 1993 Nov 27;307(6916):1385-8. doi: 10.1136/bmj.307.6916.1385.
To examine association of different measures of serum lipid concentration and obesity with mortality in women.
Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years.
Gothenburg, Sweden.
1462 randomly selected women aged 38-60 at start of study.
Total mortality and death from myocardial infarction as predicted by serum cholesterol and triglyceride concentrations, body mass index, and ratio of circumference of waist to circumference of hips.
170 women died during follow up, 26 from myocardial infarction. Serum triglyceride concentration and waist:hip ratio were significantly associated with both end points (relative risk of total mortality for highest quarter of triglyceride concentration v lower three quarters 1.86 (95% confidence interval 1.30 to 2.67); relative risk for waist:hip ratio 1.67 (1.18 to 2.36)). These associations remained after adjustment for background variables. Serum cholesterol concentration and body mass index were initially associated with death from myocardial infarction, but association was lost after adjustment for background variables. Serum triglyceride concentration and waist:hip ratio were independently predictive of both end points (logistic regression coefficient for total mortality for triglyceride 0.514 (SE 0.150), p = 0.0006; coefficient for waist:hip ratio 7.130 (1.92), p = 0.0002) whereas the other two risk factors were not (coefficient for total mortality for cholesterol concentration -0.102 (0.079), p = 0.20; coefficient for body mass index -0.051 (0.027), p = 0.05).
Lipid risk profile appears to be different in men and women given that serum triglyceride concentration was an independent risk factor for mortality while serum cholesterol concentration was not. Consistent with previous observations in men, localisation of adipose tissue was more important than obesity per se as risk factor in women.
研究血清脂质浓度和肥胖的不同测量指标与女性死亡率之间的关联。
1968 - 1969年启动的前瞻性观察性研究，12年后进行随访检查，20年后基于死亡证明进行随访研究。
瑞典哥德堡。
研究开始时随机选取的1462名年龄在38 - 60岁之间的女性。
血清胆固醇和甘油三酯浓度、体重指数以及腰围与臀围之比预测的总死亡率和心肌梗死死亡率。
随访期间170名女性死亡，其中26名死于心肌梗死。血清甘油三酯浓度和腰臀比与两个终点均显著相关（甘油三酯浓度最高四分位数与较低三分位数相比，总死亡率的相对风险为1.86（95%置信区间1.30至2.67）；腰臀比的相对风险为１.67（1.18至2.36））。在对背景变量进行调整后，这些关联依然存在。血清胆固醇浓度和体重指数最初与心肌梗死死亡相关，但在对背景变量进行调整后，这种关联消失。血清甘油三酯浓度和腰臀比可独立预测两个终点（甘油三酯总死亡率的逻辑回归系数为0.514（标准误0.150），p = 0.0006；腰臀比系数为7.130（1.92），p = 0.0002），而其他两个风险因素则不然（胆固醇浓度总死亡率系数为 - 0.102（0.079），p = 0.20；体重指数系数为 - 0.051（0.027），p = 0.05）。
鉴于血清甘油三酯浓度是死亡率的独立危险因素而血清胆固醇浓度不是，男性和女性的脂质风险状况似乎有所不同。与先前对男性的观察结果一致，脂肪组织的分布作为女性的危险因素比肥胖本身更为重要。
