Rexrode K M, Carey V J, Hennekens C H, Walters E E, Colditz G A, Stampfer M J, Willett W C, Manson J E
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass 02215, USA.
JAMA. 1998 Dec 2;280(21):1843-8. doi: 10.1001/jama.280.21.1843.
Obesity is a well-established risk factor for coronary heart disease (CHD), but whether regional fat distribution contributes independently to risk remains unclear.
To compare waist-hip ratio (WHR) and waist circumference in determining risk of CHD in women.
Prospective cohort study among US female registered nurses participating in the Nurses' Health Study conducted between 1986, when the nurses completed a questionnaire, and follow-up in June 1994.
A total of 44702 women aged 40 to 65 years who provided waist and hip circumferences and were free of prior CHD, stroke, or cancer in 1986.
Incidence of CHD (nonfatal myocardial infarction or CHD death).
During 8 years of follow-up 320 CHD events (251 myocardial infarctions and 69 CHD deaths) were documented. Higher WHR and greater waist circumference were independently associated with a significantly increased age-adjusted risk of CHD. After adjusting for body mass index (BMI) (defined as weight in kilograms divided by the square of height in meters) and other cardiac risk factors, women with a WHR of 0.88 or higher had a relative risk (RR) of 3.25 (95% confidence interval [CI], 1.78-5.95) for CHD compared with women with a WHR of less than 0.72. A waist circumference of 96.5 cm (38 in) or more was associated with an RR of 3.06 (95% CI, 1.54-6.10). The WHR and waist circumference were independently strongly associated with increased risk of CHD also among women with a BMI of 25 kg/m2 or less. After adjustment for reported hypertension, diabetes, and high cholesterol level, a WHR of 0.76 or higher or waist circumference of 76.2 cm (30 in) or more was associated with more than a 2-fold higher risk of CHD.
The WHR and waist circumference are independently associated with risk of CHD in women.
肥胖是冠心病（CHD）公认的危险因素，但局部脂肪分布是否独立增加风险仍不清楚。
比较腰臀比（WHR）和腰围在确定女性冠心病风险中的作用。
对参与护士健康研究的美国注册女护士进行前瞻性队列研究，该研究于1986年护士完成问卷调查时开始，并于1994年6月进行随访。
共有44702名年龄在40至65岁之间的女性，她们提供了腰围和臀围数据，且在1986年时没有冠心病、中风或癌症病史。
冠心病（非致命性心肌梗死或冠心病死亡）的发病率。
在8年的随访期间，记录了320例冠心病事件（251例心肌梗死和69例冠心病死亡）。较高的腰臀比和较大的腰围与年龄调整后的冠心病风险显著增加独立相关。在调整体重指数（BMI，定义为体重（千克）除以身高（米）的平方）和其他心脏危险因素后，腰臀比为0.88或更高的女性患冠心病的相对风险（RR）为3.25（95%置信区间[CI]，1.78 - 5.95），而腰臀比小于0.72的女性为参照。腰围96.5厘米（38英寸）或更大与RR为3.06（95%CI，1.54 - 6.10）相关。在体重指数为25kg/m2或更低的女性中，腰臀比和腰围也与冠心病风险增加独立且密切相关。在调整报告的高血压、糖尿病和高胆固醇水平后，腰臀比为0.76或更高或腰围76.2厘米（30英寸）或更大与冠心病风险高出两倍以上相关。
腰臀比和腰围与女性冠心病风险独立相关。
