Body mass index in late adolescence and its association with coronary heart disease and stroke in middle age among Swedish men
Body mass index in late adolescence and its association with coronary heart disease and stroke in middle age among Swedish men
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DOI：
10.1038/sj.ijo.0803480
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发表时间：
2007-05-01
影响因子：
4.9
通讯作者：
Lundberg, I.
中科院分区：
文献类型：
--
作者：
Falkstedt, D.;Hemmingsson, T.;Lundberg, I.
背景和目的：青少年身体质量指数（BMI）可能是预测未来冠心病（CHD）风险的一个特别重要的指标。在童年或中年时期测量的关联似乎较弱或不存在。我们调查了瑞典中年男性在青春期测量的BMI与冠心病和中风之间的关系，并控制了以前研究中未包括的潜在混杂因素。方法：收集1949-1951年出生、1969/70年服兵役的49321名瑞典男性的BMI、吸烟和血压（舒张压和收缩压）数据。儿童和成年期社会经济指标的普查数据与该队列相关联。从1991年到2004年，研究人员对这些男性进行了关于冠心病和中风死亡率和住院率的国家登记。结果：6个以上BMI水平(BMI = 18.5，危险比（HR） 1.0, BMI 18.5 ~ 20.99（参考类），BMI 21 ~ 22.99, HR = 1.2；Bmi 23-24.99, hr = 1.5；Bmi 25 ~ 29.99, hr = 2.5；Bmi = 30, hr = 4.3)。BMI和中风之间也有分级关联，尽管关联性较弱。心血管危险因素（吸烟、舒张压和收缩压、父母早期心血管疾病死亡率）的调整在一定程度上降低了相对风险，而儿童和成年期社会经济指标的调整影响较小。结论：研究结果强烈提示，在55岁之前的男性中，青春期晚期的BMI是冠心病和中风的重要预测因子，与吸烟、高血压和父母早期心血管疾病死亡无关。
Background and objectives: Body mass index (BMI) in adolescence may be of particular importance as a predictor of future risk of coronary heart disease (CHD). Associations measured either in childhood or in middle age have appeared to be weaker or non-existent. We investigated the association between BMI measured in adolescence and CHD, and also stroke, among middle aged Swedish men and controlled for potential confounders not included in previous studies.Methods: Data on BMI, smoking and blood pressure (diastolic and systolic) was collected from 49 321 Swedish males, born during 1949-1951, at conscription for military service in 1969/70. Census data on socioeconomic indicators in childhood and adulthood was linked to the cohort. The men were followed from 1991 through 2004 in national registers with regard to mortality and hospitalization from CHD and stroke.Results: A graded increase of CHD was seen in over six levels of BMI (BMI = 18.5, hazard ratio (HR) 1.0, BMI 18.5-20.99 (reference category), BMI 21-22.99, HR = 1.2; BMI 23-24.99, HR = 1.5; BMI 25-29.99, HR = 2.5; BMI >= 30, HR = 4.3). A graded association between BMI and stroke was also found, although weaker. Adjustments for cardiovascular risk factors (smoking, diastolic and systolic blood pressure, and early cardiovascular mortality in parents) attenuated the relative risks to some extent, whereas adjustments for socioeconomic indicators in childhood and adulthood had minor effects.Conclusion: The results strongly suggest that BMI in late adolescence is an important predictor of both CHD and stroke among men before age 55 years, independent of smoking, hypertension and early cardiovascular mortality in parents.