Prospective Cohort Study of Central Adiposity and Risk of Death in Middle Aged and Elderly Chinese.
Prospective Cohort Study of Central Adiposity and Risk of Death in Middle Aged and Elderly Chinese.
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DOI：
10.1371/journal.pone.0138429
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Zheng W
中科院分区：
文献类型：
--
作者：
Warren Andersen S;Shu XO;Gao YT;Zhang X;Cai H;Yang G;Li HL;Xiang YB;Zheng W
亚洲人有中心性肥胖的高患病率，尽管普遍肥胖的低患病率。我们评估了中心性肥胖指标、腰臀比（WHR）与中国中老年人总死亡率和死因特异性死亡率之间的关系。数据来自两项前瞻性人群队列研究：上海男性健康研究涉及53，425名男性（参与率= 74.0%），基线年龄为40-74岁，上海女性健康研究涉及63，017名女性（参与率= 92.7%），基线年龄为40-70岁。在基线访谈时获取有关生活方式因素和人体测量的信息。通过调查和与上海相关登记中心的年度联系获得生命状态和死亡原因，直至2011年12月31日。在上海男性健康研究和上海女性健康研究的中位随访时间分别为7.5年和13.2年后，分别有2,058人和3,167人死亡。在校正BMI和其他潜在混杂因素的模型中，WHR与全因死亡率相关;风险比（95%置信区间）从1（参考），1.10（0.95，1.27），1.21（1.04，1.41），1.11（0.96，1.30），男性为1.42（1.22，1.65），女性为1（参考），1.10（0.96，1.27），1.11（0.97，1.27），1.20（1.05，1.37），至1.48（1.30，1.69）。腰臀比与心血管疾病有更强的相关性，观察到腰臀比最高与最低五分位数的多变量校正HR为1.5至1.7。癌症和其他原因死亡也存在剂量反应相关性。分层分析表明，正常体重（BMI <25）与死亡率的关联性强于超重（BMI ≥25）个体。在随访时间、合并症、年龄、吸烟和体力活动定义的亚组中观察到与死亡率的正相关性。在中国成年人中，即使是低BMI的个体，更大的中心性肥胖也与死亡率增加相关。医生和公众应该意识到中枢性肥胖对健康的独立影响。
Asians have high prevalence of central obesity despite the low prevalence of general obesity. We evaluated associations between the central obesity measure, waist-hip ratio (WHR) with total and cause-specific mortality in middle-aged and elderly Chinese participants. Data arise from two prospective population-based cohort studies: the Shanghai Men’s Health Study involves 53,425 men (participation rate = 74.0%), age 40–74 at baseline, and the Shanghai Women’s Health Study involves 63,017 women (participation rate = 92.7%), age 40–70 at baseline. Information on lifestyle factors and anthropometric measurements were taken at baseline interview. Vital status and causes of death were obtained via surveys and annual linkages to relevant Shanghai registries through December 31, 2011. After median follow-up time of 7.5 years for the Shanghai Men’s Health Study and 13.2 years for the Shanghai Women’s Health Study, there were 2,058 and 3,167 deaths, respectively. In models adjusted for BMI and other potential confounders, WHR was associated with all-cause mortality; hazard ratios (HRs) (95% confidence intervals) across the first to fifth quintile increased from 1 (Reference), 1.10 (0.95,1.27), 1.21 (1.04,1.41), 1.11 (0.96,1.30), to 1.42 (1.22,1.65) in men and from 1 (Reference), 1.10 (0.96,1.27), 1.11 (0.97,1.27), 1.20 (1.05,1.37), to 1.48 (1.30,1.69) in women. WHR had a stronger association with cardiovascular disease, with multivariate-adjusted HRs of 1.5 to 1.7 observed for the highest versus lowest quintile of WHR. Dose-response associations were also seen for cancer and other-cause deaths. Stratified analyses suggested a stronger association with mortality among normal weight (BMI <25) than over-weight (BMI ≥25) individuals. Positive associations with mortality were observed in subgroups defined by follow-up duration, comorbidity, age, smoking, and physical activity. Greater central adiposity is associated with increased mortality in Chinese adults, even among individuals with low BMI. Physicians and the public should be aware of central adiposity’s independent effects on health.