Associations of general and abdominal obesity with multiple health outcomes in older women -: The Iowa women's health study
Associations of general and abdominal obesity with multiple health outcomes in older women -: The Iowa women's health study
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DOI：
10.1001/archinte.160.14.2117
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发表时间：
2000-07-24
影响因子：
--
通讯作者：
Prineas, R
中科院分区：
文献类型：
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作者：
Folsom, AR;Kushi, LH;Prineas, R
背景资料：最新的肥胖症健康风险临床指南使用体重指数（BMI;计算方法为体重（千克）除以身高（米）的平方）和腰围，但腰臀比可以提供独立的信息。评估BMI、腰围和腰臀比与多个疾病终点的联合相关性，我们对31702名爱荷华州妇女进行了一项前瞻性队列研究，年龄在55 - 69岁之间，无癌症、心脏病和糖尿病，于1986年通过随机抽样和邮寄调查收集。研究终点为11 - 12年的总死亡率、病因特异性死亡率、部位特异性癌症发病率、自我报告的糖尿病、高血压和髋部骨折。腰臀比是预测总死亡率的最佳人体测量学指标，五分位数5vs 1的多变量校正相对危险度为1.2（95%置信区间，1.1-1.4），而BMI为0.91（95%置信区间，0.8-1.0），腰围为1.1（95%置信区间，1.0-1.3）。腰臀比也与冠心病、其他心血管疾病、癌症和其他原因的死亡率呈正相关。腰臀比与癌症发病率的相关性不如BMI或腰围。所有人体测量学指标与糖尿病和高血压的发病率相关。例如，同时在最高的五分之一的BMI和腰臀比的妇女有糖尿病的相对风险为29（95%的置信区间，18-46）与妇女在最低的组合quintile.Conclusion：腰臀比提供了额外的预后信息超出BMI和腰围。
Background: Recent clinical guidelines on the health risks of obesity use body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and waist circumference, but the waist-hip ratio may provide independent information.Methods: To assess the joint and relative associations of BMI, waist circumference, and waist-hip ratio with multiple disease end points, we conducted a prospective cohort study of 31 702 Iowa women, aged 55 to 69 years and free of cancer, heart disease, and diabetes, assembled by random sampling and mail survey in 1986. Study end points were total and cause-specific mortality and incidence of site-specific cancers and self-reported diabetes, hypertension,and hip fracture over 11 to 12 years.Results: The waist-hip ratio was the best anthropometric predictor of total mortality, with the multivariable-adjusted relative risk for quintile 5 vs 1 of 1.2 (95% confidence interval, 1.1-1.4), compared with 0.91 (95% confidence interval, 0.8-1.0) for BMI and 1.1 (95% confidence interval, 1.0-1.3) for waist circumference. The waist-hip ratio was also associated positively with mortality from coronary heart disease, other cardiovascular diseases, cancer, and other causes. The waist-hip ratio was associated less consistently than BMI or waist circumference with cancer incidence. All anthropometric indexes were associated with incidence of diabetes and hypertension. For example, women simultaneously in the highest quintiles of BMI and waist-hip ratio had a relative risk of diabetes of 29 (95% confidence interval, 18-46) vs women in the lowest combined quintiles.Conclusion: The waist-hip ratio offers additional prognostic information beyond BMI and waist circumference.