Association of Multiple Anthropometrics of Overweight and Obesity With Incident Heart Failure The Atherosclerosis Risk in Communities Study
Association of Multiple Anthropometrics of Overweight and Obesity With Incident Heart Failure The Atherosclerosis Risk in Communities Study
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DOI：
10.1161/circheartfailure.108.813782
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发表时间：
2009-01-01
影响因子：
9.7
通讯作者：
Heiss, Gerardo
中科院分区：
文献类型：
--
作者：
Loehr, Laura R.;Rosamond, Wayne D.;Heiss, Gerardo
方法和结果-社区动脉粥样硬化风险研究是一项正在进行的以45至64岁的人群为基础的队列研究，这些人群来自4个美国社区，对事件、住院或致死性HE的中位数随访时间为16年。在基线（1987-1989年）测量体重指数（BMI）。排除后，样本量为14 641。BMI被归类为≥ 30 kg/m（2）。腰围和腰臀比被分为性别特异性三分位数。首次出现国际疾病分类第9版临床修订版HF代码，出院（428.0 - 428.9; n = 145 1）或死亡证明（428.0 - 428.9或I50.0-I50.9; n=77）均被视为HF事件。考克斯模型根据饮酒、吸烟、年龄、中心和教育水平进行调整。所有3项人体测量指标中，最高类别（肥胖）与最低类别相比的调整后风险比均远高于1.0（腰臀比第三与第一三分位数的风险比：白色女性2.27 [1.71，3.02];黑人女性3.24 [2.25，4.65];白色男性2.46 [1.95，3.09];黑人男性为2.63 [1.90，3.65]）。超重的危险比较低的幅度，建议身体大小和HF. Conclusions之间的分级反应肥胖和超重，3个不同的人体测量学测量，与事件HF在社区队列的动脉粥样硬化风险。目前的研究不支持腰臀比和腰围相对于BMI在预测HE事件（循环心力衰竭）方面的优势。2009;2：18-24.）
Background-The association of central adiposity with incident heart failure (HF) has yet to be studied in a large population-based study.Methods and Results-The Atherosclerosis Risk in Communities study is an ongoing biracial population-based cohort of those aged 45 to 64 years from 4 US communities with 16 years' median follow-up for incident, hospitalized, or fatal HE Waist-hip ratio, waist circumference, and body mass index (BMI) were measured at baseline (1987-1989). After exclusions, the sample size was 14 641. BMI was categorized as = 30 kg/m(2). Waist circumference and waist-hip ratio were divided into gender-specific tertiles. A first occurrence of International Classification of Diseases, 9th Revision, Clinical Modification, codes of HF, either hospital discharge (428.0 to 428.9; n = 145 1) or on a death certificate (428.0 to 428.9 or I50.0 to I50.9; n=77) was considered an HF event. Cox models were adjusted for alcohol use, smoking, age, center, and educational level. The adjusted hazard ratios for the highest category (obese) compared with the lowest were well above 1.0 for all 3 anthropometric measures (hazard ratio for 3rd versus 1st tertile of waist-hip ratio: 2.27 [1.71, 3.02] for white women; 3.24 [2.25, 4.65] for black women; 2.46 [1.95, 3.09] for white men; and 2.63 [1.90, 3.65] for black men). Hazard ratios for overweight were lower in magnitude, suggesting a graded response between body size and HF.Conclusions-Obesity and overweight, as measured by 3 different anthropometrics, were associated with incident HF in the Atherosclerosis Risk in Communities cohort. The current study does not support the superiority of waist-hip ratio and waist circumference over BMI for the prediction of incident HE (Circ Heart Fail. 2009;2:18-24.)