Adiposity and incidence of heart failure hospitalization and mortality: a population-based prospective study.
Adiposity and incidence of heart failure hospitalization and mortality: a population-based prospective study.
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DOI：
10.1161/circheartfailure.108.794099
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发表时间：
2009-05
期刊：
影响因子：
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通讯作者：
Mittleman MA
中科院分区：
文献类型：
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作者：
Levitan EB;Yang AZ;Wolk A;Mittleman MA
肥胖与心力衰竭（HF）的发病率相关。我们按年龄以及体重指数（BMI）和腰围（WC）的联合关联情况，研究了BMI与HF关联的强度。
年龄在48 - 83岁的女性（n = 36873）和年龄在45 - 79岁的男性（n = 43487）自行报告了身高、体重和腰围。1998年1月1日至2004年12月31日期间因HF住院或死亡的情况（女性n = 382，男性n = 718）通过行政登记确定。根据Cox比例风险模型，BMI每增加一个四分位间距，女性在60岁时的风险比（HR）为1.39（95%置信区间[CI] 1.15 - 1.68），在75岁时为1.13（95% CI 1.02 - 1.27）。男性在60岁时HR为1.54（95% CI 1.37 - 1.73），在75岁时为1.25（95% CI 1.16 - 1.35）。在BMI为25和30 kg/m²的女性中，腰围每增加10 cm，HF发生率分别增加15%（95% CI 2% - 31%）和18%（95% CI 4% - 33%）；对于腰围为70和100 cm的女性，BMI每增加1 kg/m²，HR分别为1.00（95% CI 0.96 - 1.04）和1.01（95% CI 0.98 - 1.04）。在男性中，对于BMI为25和30 kg/m²的情况，腰围每增加10 cm，HF发生率分别增加16%和18%；无论腰围如何，BMI每增加1 kg/m²，HF发生率增加4%。
BMI与HF事件之间关联的强度随年龄增长而下降。在女性中，在所有BMI水平下，较高的腰围都与HF相关。在男性中，BMI和腰围都是预测因素。
Obesity is associated with heart failure (HF) incidence. We examined the strength of the association of body mass index (BMI) with HF by age and joint associations of BMI and waist circumference (WC). Women aged 48–83 (n = 36,873) and men aged 45–79 (n = 43,487) self-reported height, weight, and WC. HF hospitalization or death (n = 382 women, 718 men) between January 1, 1998 and December 31, 2004 was determined through administrative registers. Hazard ratios (HR), from Cox proportional-hazards models, for an interquartile range higher BMI were 1.39 (95% confidence interval [CI] 1.15–1.68) at age 60 and 1.13 (95% CI 1.02–1.27) at 75 in women. In men, HR were 1.54 (95% CI 1.37–1.73) at 60 and 1.25 (95% CI 1.16–1.35) at 75. A 10 cm higher WC was associated with 15% (95% CI 2%–31%) and 18% (95% CI 4%–33%) higher HF rates among women with BMI 25 and 30 kg/m2, respectively; HR for 1 kg/m2 higher BMI were 1.00 (95% CI 0.96–1.04) and 1.01 (95% CI 0.98–1.04) for WC 70 and 100 cm, respectively. In men, a 10 cm higher WC was associated with 16% and 18% higher rates for BMI 25 and 30 kg/m2, respectively; a 1 kg/m2 higher BMI was associated with 4% higher HF rates regardless of WC. Strength of the association between BMI and HF events declined with age. In women, higher WC was associated with HF at all levels of BMI. Both BMI and WC were predictors among men.