Waist-to-hip ratio and body mass index as risk factors for cardiovascular events in CKD
Waist-to-hip ratio and body mass index as risk factors for cardiovascular events in CKD
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DOI：
10.1053/j.ajkd.2008.04.002
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发表时间：
2008-07-01
影响因子：
13.2
通讯作者：
Sarnak, Mark J.
中科院分区：
文献类型：
--
作者：
Elsayed, Essam F.;Tighiouart, Hocine;Sarnak, Mark J.
背景：肥胖作为慢性肾脏疾病（CKD）患者心血管疾病的危险因素的作用尚不清楚。腰臀比（WHR）受肌肉和骨量的影响比体重指数（BMI）要小。我们比较了WHIR和BMI作为CKD患者心脏事件（心肌梗死和致命性冠状动脉疾病）的危险因素。研究设计：队列研究。环境和参与者：CKD患者，定义为肾小球滤过率基线估计为15至60 mL/min/1.73 m(2)，来自两项社区研究：社区动脉粥样硬化风险研究和心血管健康研究。预测指标：腰重比、腰围和体重指数。结果和测量：心肌梗死和致死性冠心病。结果：1,669名CKD患者的平均年龄为70.3岁，其中56%为女性。男性的平均（SD） whr为0.97 +/- 0.08，女性为0.90 +/- 0.07；平均（SD） BMI为27.2±4.6 kg/m(2)。在平均9.3年的随访期间，发生了334起心脏事件。在多变量调整的Cox模型中，与最低WHR组相比，最高WHR组（n = 386）与心脏事件风险增加相关（风险比为1.36；95%可信区间为1.01至1.83）。肥胖，定义为BMI大于30 kg/m(2) (n = 381)，与正常BMI的参与者相比，与心脏事件无关（风险比0.86；95%可信区间0.62至1.20）(
Background: The role of obesity as a risk factor for cardiovascular disease in patients with chronic kidney disease (CKD) is poorly understood. Waist-to-hip ratio (WHR) is less influenced by muscle and bone mass than body mass index (BMI). We compared WHIR and BMI as risk factors for cardiac events (myocardial infarction and fatal coronary disease) in persons with CKD.Study Design: Cohort study.Setting & Participants: Persons with CKD, defined as baseline estimated glomerular filtration rate of 15 to 60 mL/min/1.73 m(2), drawn from 2 community studies: the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study.Predictor: WHR, waist circumference, and BMI.Outcomes & Measurements: Myocardial infarction and fatal coronary heart disease.Results: Of 1,669 participants with CKD, mean age was 70.3 years and 56% were women. Mean (SD) WHRs were 0.97 +/- 0.08 in men and 0.90 +/- 0.07 in women; mean (SD) BMI was 27.2 +/- 4.6 kg/m(2). During a mean of 9.3 years of follow-up, there were 334 cardiac events. In multivariable-adjusted Cox models, the highest WHR group (n = 386) was associated with an increased risk of cardiac events compared with the lowest WHR group (hazard ratio, 1.36; 95% confidence interval, 1.01 to 1.83). Obesity, defined as BMI greater than 30 kg/m(2) (n = 381), was not associated with cardiac events (hazard ratio, 0.86; 95% confidence interval, 0.62 to 1.20) in comparison to participants with normal BMI (