Cohort study of effect of being overweight and change in weight on risk of coronary heart disease in old age
Cohort study of effect of being overweight and change in weight on risk of coronary heart disease in old age
复制标题
DOI：
10.1136/bmj.314.7097.1791
复制
发表时间：
1997-06-21
影响因子：
105.7
通讯作者：
Feldman, JJ
中科院分区：
文献类型：
--
作者：
Harris, TB;Launer, LJ;Feldman, JJ
目的：评价中老年晚期超重与晚年冠心病的相关风险，并评估体重变化是否能改变这种风险。设计：对全国健康与营养检查调查流行病学随访研究对象进行纵向研究。研究对象：1982-84年间无冠心病的621名男性和960名女性（平均年龄77岁）。主要结局指标：冠心病发生率。结果：中年晚期体重指数大于等于27与晚年冠心病风险增加相关（相对风险= 1.7(95%可信区间1.3 ~ 2.1)），而老年期体重指数大于等于27与晚年冠心病风险增加无关（1.1(0.8 ~ 1.5)）。这种风险差异主要是由于中年和老年之间的体重减轻。排除体重减轻10%或更多的人，老年体重增加的风险增加（1.4(1.0至1.9)）。与体重稳定的较瘦的人相比，体重减轻的较瘦的老年人和体重增加的较胖的人患冠心病的风险更高。结论：中年晚期体重过重是晚年冠心病的危险因素。一旦那些体重大幅减轻的人被排除在外，老年时体重较重与风险增加有关。如果忽视体重史，体重对老年人冠心病风险的影响可能会被低估。
Objective: To evaluate risk of late life coronary heart disease associated with being overweight in late middle or old age and to assess whether weight change modifies this risk.Design: Longitudinal study of subjects in the epidemiological follow up study of the national health and nutrition examination survey I.Setting: United States.Subjects: 621 men and 960 women free of coronary heart disease in 1982-84 (mean age 77 years).Main outcome measure: Incidence of coronary heart disease.Results: Body mass index of 27 or more in late middle age nas associated with increased risk of coronary heart disease in late life (relative risk = 1.7 (95% confidence interval 1.3 to 2.1)) while body mass index of 27 or more in old age was not (1.1 (0.8 to 1.5)). This difference in risk was due largely to weight loss between middle and old age. Exclusion of those with weight loss of 10% or more increased risk associated with heavier weight in old age (1.4 (1.0 to 1.9)). Thinner older people who lost weight and heavier people who had gained weight showed increased risk of coronary heart disease compared with thinner people with stable weight.Conclusions: Heavier weight in late middle age was a risk factor for coronary heart disease in late life. Heavier weight in old age was associated with an increased risk once those with substantial weight loss were excluded. The contribution of weight to risk of coronary heart disease in older people may be underestimated if weight history is neglected.