Obesity and 33-year follow-up for coronary heart disease and cancer mortality
Obesity and 33-year follow-up for coronary heart disease and cancer mortality
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DOI：
10.1097/00001648-199707000-00005
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发表时间：
1997-07-01
期刊：
影响因子：
5.4
通讯作者：
Swan, GE
中科院分区：
文献类型：
--
作者：
Carmelli, D;Zhang, HP;Swan, GE
我们采用树结构生存分析（TSSA），一种计算机密集型分类方法，前瞻性地确定了3,155名最初没有这些疾病的中年男性的体重指数和腰小腿围比与冠心病和癌症死亡率的关系。应用于冠心病死亡率，TSSA确定了7个亚组，这些亚组在危险因素和相关生存率方面存在差异。在这7个亚组中，一小组年龄较大、肥胖、血压正常的男性（N = 71）在33年的随访中经历了异常高的冠心病死亡风险（34%），与年龄相似、肥胖程度较低且血压水平较高的男性的较大亚组（N = 387）经历的36%的风险相似。我们还观察到，在随访期间，血压水平较低的年轻中心型肥胖男性的冠心病死亡总风险高于年龄相仿、肥胖程度较低的男性（10.3%比5.3%）。当应用于所有部位的癌症死亡率时，TSSA确定了五个亚组，这些亚组在生存分布和风险因素方面存在差异。一个年轻的、中心性肥胖的和曾经吸烟的男性亚组比他们不那么肥胖的同龄人经历了更高的癌症死亡风险（14%比846）。这些分析的结果证明了树形结构分析对将受试者分为高风险和低风险生存亚组的有用性。
We used tree-structured survival analysis (TSSA), a computer intensive method of classification, to determine prospectively the relation of the body mass index and the waist-to-calf circumference ratio to coronary heart disease and cancer mor tality in 3,155 middle aged men initially free of these diseases. Applied to coronary heart disease mortality, TSSA identified seven subgroups that differed in profile of risk factors and associated survival. Among the seven subgroups, a small subgroup of older, obese, normotensive men (N = 71) experienced an exceptionally high risk of coronary heart disease deaths over the 33 years of follow-up (34%), similar to the risk of 36% experienced by a larger subgroup (N = 387) of men of similar ages who were less obese and had higher blood pressure Levels. We also observed a higher overall risk of coronary heart disease deaths during follow-up (10.3% us 5.3%) in younger centrally obese men who had low blood pressure levels compared with their counterparts of similar age who were less obese. When applied to mortality from cancer of all sites, TSSA identified five subgroups that differed in survival distributions and profile of risk factors. A subgroup of younger, centrally obese, and ever-smoker men experienced a higher risk of cancer deaths than their counterparts who were less obese (14% vs 846). Results from these analyses demonstrate the usefulness of a tree structured analysis for classification of subjects into high and low risk survival subgroups.