Abdominal adiposity and coronary heart disease in women
Abdominal adiposity and coronary heart disease in women
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DOI：
10.1001/jama.280.21.1843
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发表时间：
1998-12-02
影响因子：
120.7
通讯作者：
Manson, JAE
中科院分区：
文献类型：
--
作者：
Rexrode, KM;Carey, VJ;Manson, JAE
背景：肥胖是冠心病(CHD)的一个公认的风险因素，但区域脂肪分布是否对风险独立起作用仍不清楚。目的：比较腰臀比(WHR)和腰围在确定女性冠心病风险方面的作用。设计和设置。-在参加护士健康研究的美国注册护士中进行前瞻性队列研究，研究从1986年护士完成问卷开始，到1994年6月进行。参与者。-共有44 702名年龄在40岁至65岁之间的女性，她们提供腰围和臀围，没有冠心病、中风、主要观察指标：CHD(非致命性心肌梗死或CHD死亡)发生率。结果：在8年的随访期内，共记录到320例CHD事件(251例心肌梗塞和69例死亡)。腰围比高和腰围大独立地与年龄调整后的冠心病风险显著增加有关。在调整了体重指数(BMI)(定义为体重(公斤)除以身高(米)的平方)和其他心脏风险因素后，腰臀比为0.88或更高的女性与腰围比小于0.72的女性相比，患冠心病的相对风险(RR)为3.25(95%可信区间[CI]，1.78-5.95)。腰围大于或等于96.5厘米(38英寸)与RR为3.06(95%可信区间，1.54-6.10)相关。腰围和腰围独立地与冠心病风险的增加密切相关，在BMI为25 kg/m(2)或更小的女性中也是如此。在对报告的高血压、糖尿病和高胆固醇水平进行调整后，腰围比为0.76或更高，或腰围为76.2厘米(30英寸)或更高，患冠心病的风险增加2倍以上。结论-腰围比和腰围与女性患冠心病的风险独立相关。
Context.-Obesity is a well-established risk factor for coronary heart disease (CHD), but whether regional fat distribution contributes independently to risk remains unclear.Objective.-To compare waist-hip ratio (WHR) and waist circumference in determining risk of CHD in women.Design and Setting.-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.Participants.-A total of 44 702 women aged 40 to 65 years who provided waist and hip circumferences and were free of prior CHD, stroke, or cancer in 1986.Main Outcome Measures.-Incidence of CHD (nonfatal myocardial infarction or CHD death).Results.-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/m(2) 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.Conclusions.-The WHR and waist circumference are independently associated with risk of CHD in women.