Overweight Without Central Obesity, Cardiovascular Risk, and All-Cause Mortality
Overweight Without Central Obesity, Cardiovascular Risk, and All-Cause Mortality
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无中心性肥胖的超重、心血管风险和全因死亡率
DOI：
10.1016/j.mayocp.2018.01.027
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发表时间：
2018-06-01
影响因子：
8.9
通讯作者：
Dong, Yugang
中科院分区：
文献类型：
--
作者：
He, Xin;Liu, Chen;Dong, Yugang
目的：评估非中心性肥胖超重与死亡风险的关系。研究对象和方法：参加了1988年10月18日至1994年10月15日第三次全国健康与营养检查调查的14,299人。根据他们的体重指数和腰围，参与者被分为7个人体测量组。Logistic回归模型用于评估心血管危险因素(高血压、糖尿病或高胆固醇血症)和10年心血管危险与人体测量组的关系。COX比例风险模型用于评估全因死亡的风险，竞争风险回归模型用于计算心血管和非心血管疾病的死亡率。结果：与体重指数和腰围正常的男性相比，无中心性肥胖的超重男性更有可能拥有所有3种心血管危险因素和心血管风险，而该人体测量学组的女性更有可能患有高胆固醇血症。在比例风险模型中，在有心血管危险因素的人群(风险比，0.71；95%CI，0.56-0.89；P=.004)和普通人群(风险比，0.72；95%CI，0.60-0.87；P=.001)中，超重而不是中心性肥胖的男性与较低的全因死亡率相关，而女性之间的这些比较结果并不显著(P>；.05)。在相互竞争的风险分析中，没有中心性肥胖的超重男性非心血管死亡的风险较低，但没有心血管死亡。结论：尽管超重没有中心性肥胖与男性的心血管危险因素和心血管风险高相关，但这一人体测量组的男性死亡风险较低。(C)2018年梅奥医学教育和研究基金会
Objective: To assess the association of overweight without central obesity with risks of mortality.Patients and Methods: We included 14,299 participants in the Third National Health and Nutrition Examination Survey (from October 18, 1988, through October 15, 1994). According to their body mass index and waist circumference, participants were categorized into 7 anthropometric groups. Logistic regression models were used to assess the relation of cardiovascular risk factors (hypertension, diabetes, or hypercholesterolemia) and 10-year cardiovascular risk to anthropometric groups. Cox proportional hazards models were used to assess the risk of all-cause mortality, and competing-risks regression models were used for calculating cardiovascular and noncardiovascular mortality.Results: Compared with those with normal body mass index and waist circumference, overweight men without central obesity were more likely to have all 3 cardiovascular risk factors and a high cardiovascular risk, whereas women in this anthropometric group were more likely to have hypercholesterolemia. In proportional hazards models, overweight without central obesity was associated with lower all-cause mortality among men in the population with cardiovascular risk factors (hazard ratio, 0.71; 95% CI, 0.56-0.89; P=.004) and the general population (hazard ratio, 0.72; 95% CI, 0.60-0.87; P=.001), whereas results of these comparisons among women were not significant (P>.05). In competing risk analyses, overweight men without central obesity had a lower risk of noncardiovascular mortality, but not cardiovascular mortality.Conclusion: Although overweight without central obesity was associated with cardiovascular risk factors and a high cardiovascular risk among men, men in this anthropometric group had a lower mortality risk. (C) 2018 Mayo Foundation for Medical Education and Research