Associations between body mass index and development of metabolic disorders in fertile women--a nationwide cohort study.
Associations between body mass index and development of metabolic disorders in fertile women--a nationwide cohort study.
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DOI：
10.1161/jaha.113.000672
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发表时间：
2014-04-10
影响因子：
5.4
通讯作者：
Torp-Pedersen C
中科院分区：
文献类型：
--
作者：
Schmiegelow MD;Andersson C;Køber L;Andersen SS;Norgaard ML;Jensen TB;Gislason G;Berger SM;Torp-Pedersen C
代谢紊乱在年轻女性中相对罕见，但可能会随着肥胖而增加。在表面健康的年轻女性中，体重指数 (BMI) 与糖尿病、高血压和血脂异常风险之间的关联尚未得到充分研究，这也是本研究的目的。全国登记册中发现了 2004 年至 2009 年期间生育、无心血管疾病、肾功能不全、妊娠相关代谢紊乱、糖尿病、高血压或血脂异常病史的妇女。女性分为体重不足（BMI<18.5 kg/m2）、正常体重（BMI=18.5至<25 kg/m2）、超重（BMI=25至<30 kg/m2）、肥胖-I（BMI=30至<35 kg/m2）、肥胖-II（BMI=35至<40 kg/m2）和肥胖-III （体重指数≥40公斤/平方米）。我们通过泊松回归模型评估风险（根据年龄、日历年进行调整；参考=正常体重）。该队列由 252 472 名女性组成，中位年龄为 30.4 岁（IQR=27.2;33.7），中位随访时间为 5.5 年（IQR=3.9;6.8）。总共有 2029 名女性患有糖尿病，3133 名女性患有高血压，1549 名女性患有血脂异常。糖尿病的比率（RR）为：体重不足为 0.84（95% 置信区间 [CI]=0.62 至 1.14），超重为 2.63（CI=2.36 至 2.93），I 级肥胖为 4.83（CI=4.27 至 5.47），II 级肥胖为 7.17（CI=6.10 至 8.48）， 6.93（置信区间=5.47 至 8.79），对于肥胖 III 级女性。对于高血压，相应的 RR 为 0.86（CI=0.69 至 1.09）、1.82（CI=1.67 至 1.98）、2.81（CI=2.52 至 3.13）、3.92（CI=3.36 至 4.56）和 5.69（CI=4.71 至 6.89），对于血脂异常， RR 为 1.18（CI=0.85 至 1.65）、2.01（CI=1.75至2.31）、3.11（CI=2.61至3.70）、4.64（CI=3.66至5.87）和3.72（CI=2.53至5.48）。在这项针对有生育能力且表面健康的女性的全国性研究中，孕前 BMI 与分娩后 5.5 年内患糖尿病、高血压和血脂异常的风险增加密切相关。
Metabolic disorders are relatively uncommon in young women, but may increase with obesity. The associations between body mass index (BMI) and risks of diabetes, hypertension, and dyslipidemia in apparently healthy, young women have been insufficiently investigated, and are the aims of this study. Women giving birth during the years 2004–2009, with no history of cardiovascular disease, renal insufficiency, pregnancy‐associated metabolic disorders, diabetes, hypertension, or dyslipidemia were identified in nationwide registers. Women were categorized as underweight (BMI<18.5 kg/m2), normal weight (BMI=18.5 to <25 kg/m2), overweight (BMI=25 to <30 kg/m2), obese‐I (BMI=30 to <35 kg/m2), obese‐II (BMI=35 to <40 kg/m2), and obese‐III (BMI≥40 kg/m2). We assessed risks by Poisson regression models (adjusted for age, calendar year; reference=normal weight). The cohort comprised 252 472 women with a median age of 30.4 years (IQR=27.2;33.7) and a median follow‐up of 5.5 years (IQR=3.9;6.8). In total, 2029 women developed diabetes, 3133 women developed hypertension, and 1549 women developed dyslipidemia. Rate ratios (RRs) of diabetes were: 0.84 (95% confidence interval [CI]=0.62 to 1.14) for underweight, 2.63 (CI=2.36 to 2.93) for overweight, 4.83 (CI=4.27 to 5.47) for obese grade‐I, 7.17 (CI=6.10 to 8.48) for obese grade‐II, and 6.93 (CI=5.47 to 8.79) for obese grade‐III women. For hypertension, corresponding RRs were 0.86 (CI=0.69 to 1.09), 1.82 (CI=1.67 to 1.98), 2.81 (CI=2.52 to 3.13), 3.92 (CI=3.36 to 4.56), and 5.69 (CI=4.71 to 6.89), and for dyslipidemia, RRs were 1.18 (CI=0.85 to 1.65), 2.01 (CI=1.75 to 2.31), 3.11 (CI=2.61 to 3.70), 4.64 (CI=3.66 to 5.87), and 3.72 (CI=2.53 to 5.48). In this nationwide study of fertile, apparently healthy women, pre‐pregnancy BMI was strongly associated with an increased risk of diabetes, hypertension, and dyslipidemia within 5.5 years following childbirth.