中年及老年男性的体重变化与缺血性心脏病风险。哥本哈根男性研究的8年随访

Weight changes and risk of ischaemic heart disease for middle aged and elderly men. An 8-year follow-up in the Copenhagen Male study.

作者信息

Suadicani P, Hein H O, Gyntelberg F

机构信息

Copenhagen Male Study, Rigshospitalet, Denmark.

出版信息

J Cardiovasc Risk. 1997 Feb;4(1):25-32. doi: 10.1177/174182679700400105.

DOI:10.1177/174182679700400105

PMID:9215517

Abstract

BACKGROUND

Weight gain and weight loss are determined by a complex interplay of health, lifestyle and genetic factors. There is controversy concerning whether weight changes are associated with an increased risk of ischaemic heart disease (IHD).

METHODS

The Copenhageri Male Study was initiated in 1970/1971. This paper presents the results of a prospective study using a baseline comprising survivors examined 15 years later in 1985/1986 including 2903 men (aged 53-74 years) without cardiovascular disease. They were classified according to their weight change from 1970/1971 to 1985/1986.

RESULTS

There were no differences among the incidences of IHD during the period 1985/1986-1993 for men who had lost weight (> 5% weight loss), men whose weight had remained constant (within +/-5%) and men who had gained weight (> 5% weight gain); the incidence rates were 7.8, 8.4 and 7.6%, respectively, NS. Adjustment for age and confounders including disease history had no influence on this result. Only for men who had already been overweight at the time of initial study in 1970/1971 (body mass index > 28 kg/m2) was there a slightly increased risk of IHD among those who gained weight. Men in this group who gained weight were characterized by a significantly (P < 0.05) larger tendency to have the Lewis phenotype Le(a-b-), a genetic marker previously shown to be associated with an increased risk of IHD mortality. With respect to death from all causes, only those who lost weight had a significantly increased risk compared with that of the constant weight group; the incidence rates were 25.0 and 12.6%, respectively, age-adjusted P < 0.001. The incidence rate of IHD among those who gained weight was 11.8%, NS.

CONCLUSION

The results suggest that an increase or decrease in weight from middle age to old age is of little clinical importance in the prediction of IHD among men without cardiovascular disease.

摘要

背景

体重增加和体重减轻由健康、生活方式和遗传因素的复杂相互作用决定。体重变化是否与缺血性心脏病（IHD）风险增加相关存在争议。

方法

哥本哈根男性研究始于1970/1971年。本文呈现了一项前瞻性研究的结果，该研究使用了一个基线，包括1985/1986年对15年后的幸存者进行检查，其中有2903名无心血管疾病的男性（年龄在53 - 74岁）。他们根据1970/1971年至1985/1986年期间的体重变化进行分类。

结果

在1985/1986 - 1993年期间，体重减轻（体重减轻>5%）的男性、体重保持不变（在±5%以内）的男性和体重增加（体重增加>5%）的男性，其IHD发病率无差异；发病率分别为7.8%、8.4%和7.6%，无统计学意义。对年龄和包括疾病史在内的混杂因素进行调整对该结果无影响。仅在1970/1971年初始研究时就已超重（体重指数>28 kg/m²）的男性中，体重增加者患IHD的风险略有增加。该组中体重增加的男性的特征是具有明显更高（P<0.05）的Lewis血型Le(a - b - )表型倾向，这是一种先前已证明与IHD死亡风险增加相关的遗传标记。就全因死亡而言，只有体重减轻者与体重保持不变组相比有显著增加的风险；发病率分别为25.0%和12.6%，年龄调整后P<0.001。体重增加者中IHD的发病率为11.8%，无统计学意义。