Blair S N, Shaten J, Brownell K, Collins G, Lissner L
Cooper Institute for Aerobics Research, Dallas, Texas.
Ann Intern Med. 1993 Oct 1;119(7 Pt 2):749-57. doi: 10.7326/0003-4819-119-7_part_2-199310011-00024.
To evaluate the relation between weight variability and death in high-risk, middle-aged men participating in the Multiple Risk Factor Intervention Trial (MRFIT).
Cohort study with 3.8 years of follow-up.
Multicenter, collaborative, primary prevention trial conducted at 22 clinical centers in the United States.
Men (n = 10,529) who were 35 to 57 years old at baseline and who were in the upper 10% to 15% of risk for coronary heart disease because of smoking, high blood pressure, and elevated cholesterol level. Participants were seen at least annually for 6 to 7 years for medical evaluations in study clinical centers.
Death from cardiovascular disease (228 deaths) and from all causes (380 deaths).
The primary measure of weight variability was the intrapersonal standard deviation of weight (ISD), which was calculated from measured weights obtained at clinic visits during a 6- to 7-year period. All-cause death rates per 1000 person-years of follow-up across ISD quartiles were 8.28, 8.25, 10.57, and 11.07 from the first to fourth quartiles, respectively. After adjusting for baseline risk factors associated with weight change, the relative risk for all-cause mortality in the fourth compared with the first quartile was 1.64 (95% CI, 1.21 to 2.23). Cardiovascular death and ISD showed a similar pattern. The association between weight change and death was not observed in the heaviest men.
Greater weight variability was associated with a greater risk for cardiovascular disease and all-cause mortality in some types of high-risk men.
评估参加多重危险因素干预试验（MRFIT）的高危中年男性体重变异性与死亡之间的关系。
随访3.8年的队列研究。
在美国22个临床中心进行的多中心、协作性初级预防试验。
基线时年龄在35至57岁之间、因吸烟、高血压和胆固醇水平升高而处于冠心病风险最高的10%至15%的男性。参与者在研究临床中心至少每年接受6至7年的医学评估。
心血管疾病死亡（228例死亡）和全因死亡（380例死亡）。
体重变异性的主要测量指标是体重的个体内标准差（ISD），它是根据6至7年期间在诊所就诊时测得的体重计算得出的。ISD四分位数中每1000人年随访的全因死亡率从第一四分位数到第四四分位数分别为8.28、8.25、10.57和11.07。在调整了与体重变化相关的基线危险因素后，第四四分位数与第一四分位数相比全因死亡率的相对风险为1.64（95%CI，1.21至2.23）。心血管疾病死亡与ISD呈现相似模式。在体重最重的男性中未观察到体重变化与死亡之间的关联。
在某些类型的高危男性中，更大的体重变异性与心血管疾病和全因死亡率的更高风险相关。
