Eight-year change in body mass index and subsequent risk of cardiovascular disease among healthy non-smoking men
Eight-year change in body mass index and subsequent risk of cardiovascular disease among healthy non-smoking men
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DOI：
10.1016/j.ypmed.2007.06.022
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发表时间：
2007-12-01
影响因子：
5.1
通讯作者：
Gaziano, J. Michael
中科院分区：
文献类型：
--
作者：
Bowman, Thomas S.;Kurth, Tobias;Gaziano, J. Michael
目标。确定8年以上中年男性BMI变化与随后心血管疾病（CVD）风险的关系。《内科医生健康研究》中13230名健康男性（年龄51.6±8.7岁）的前瞻性队列研究。BMI是在1982年和8年后收集的，8年后开始随访。随后的心血管疾病事件被收集并确认至2005年3月31日。Cox比例风险模型评估了8年BMI和CVD风险，8年BMI变化和CVD风险，以及在考虑8年BMI后BMI变化是否增加了预后信息。1308个主要的心血管疾病事件发生在13.5年。第8年时较高的BMI与心血管疾病的风险增加有关。与稳定的BMI （+/- 0.5 kg/m(2)）相比，0.5-2.0 kg/m(2)增加的多变量校正RR为1.00（0.86-1.16）。BMI = 2.0 kg/m(2)增加的多变量调整后的RR为1.39(1.16-1.68)，而BMI进一步调整后的RR降至1.00（0.81-1.23）。BMI下降的多变量RR为1.23(1.07-1.42)，8年BMI调整不影响。较高的BMI和不断上升的BMI都与心血管疾病的风险增加有关，然而，一旦考虑到当前的BMI，不断增加的BMI并没有增加预后信息。相反，BMI下降与心血管疾病风险增加相关，与当前BMI无关。(c) 2007爱思唯尔公司版权所有。
Objective. To determine how change in BMI over 8 years is associated with risk of subsequent cardiovascular disease (CVD) among middle aged men.Methods. Prospective cohort study among 13,230 healthy men (aged 51.6 +/- 8.7 years) in the Physicians' Health Study. BMI was collected at baseline in 1982 and after 8 years, at which time follow-up began. Subsequent CVD events were collected and confirmed through March 31, 2005. Cox proportional hazards models evaluated BMI at 8 years and risk of CVD, 8-year change in BMI and risk of CVD, and whether change in BMI added prognostic information after the consideration of BMI at 8 years.Results. 1308 major CVD events occurred over 13.5 years. A higher BMI at year 8 was associated with an increased risk of CVD. Compared to a stable BMI (+/- 0.5 kg/m(2)), a 0.5-2.0 kg/m(2) increase had a multivariable-adjusted RR of 1.00 (0.86-1.16). A >= 2.0 kg/m(2) increase had a multivariable-adjusted RR of 1.39 (1.16-1.68), however further adjustment for BMI reduced the RR to 1.00 (0.81-1.23). A decrease in BMI had a multivariable RR of 1.23 (1.07-1.42) which was unaffected by adjustment for BMI at 8 years.Conclusion. A higher BMI and a rising BMI were both associated with an increased risk of CVD, however an increasing BMI did not add prognostic information once current BMI was considered. In contrast, a declining BMI was associated with an increased risk of CVD independent of current BMI. (c) 2007 Elsevier Inc. All rights reserved.