Waist circumference as compared with body-mass index in predicting mortality from specific causes.
Waist circumference as compared with body-mass index in predicting mortality from specific causes.
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DOI：
10.1371/journal.pone.0018582
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发表时间：
2011-04-26
期刊：
影响因子：
3.7
通讯作者：
Schatzkin A
中科院分区：
文献类型：
--
作者：
Leitzmann MF;Moore SC;Koster A;Harris TB;Park Y;Hollenbeck A;Schatzkin A
腰围是否提供了体重指数所不能提供的关于预测死因特异性死亡的有临床意义的信息尚不确定。我们前瞻性地研究了腰围（WC）和体重指数（BMI）与225，712名美国女性和男性的死因相关性。考克斯回归用于估计相对风险和95%置信区间（CI）。使用SAS 9.1版进行统计分析。在1996年至2005年的随访期间，我们记录了20,977例死亡。WC增加可持续预测任何原因以及主要死亡原因导致的死亡风险，包括癌症、心血管疾病和非癌症/非心血管疾病导致的死亡，与BMI、年龄、性别、人种/种族、吸烟状况和饮酒量无关。当WC和BMI在模型中相互调整时，WC与任何癌症死亡风险增加1.37倍和心血管疾病死亡风险增加1.82倍相关，比较最高与最低WC类别。重要的是，WC而不是BMI与肺癌和慢性呼吸道疾病的死亡率呈统计学显著正相关。最高与最低WC类别的参与者死于肺癌的相对风险为1.77（95%CI，1.41至2.23），死于慢性呼吸道疾病的相对风险为2.77（95%CI，1.95至3.95）。相比之下，BMI最高与最低类别的受试者死于肺癌的相对风险为0.94（95% CI，0.75 - 1.17），死于慢性呼吸道疾病的相对风险为1.18（95% CI，0.89 - 1.56）。通过WC测量的腹部脂肪增加与主要特定原因导致的死亡风险增加有关，包括肺癌和慢性呼吸道疾病死亡，与BMI无关。
Whether waist circumference provides clinically meaningful information not delivered by body-mass index regarding prediction of cause-specific death is uncertain. We prospectively examined waist circumference (WC) and body-mass index (BMI) in relation to cause-specific death in 225,712 U.S. women and men. Cox regression was used to estimate relative risks and 95% confidence intervals (CI). Statistical analyses were conducted using SAS version 9.1. During follow-up from 1996 through 2005, we documented 20,977 deaths. Increased WC consistently predicted risk of death due to any cause as well as major causes of death, including deaths from cancer, cardiovascular disease, and non-cancer/non-cardiovascular diseases, independent of BMI, age, sex, race/ethnicity, smoking status, and alcohol intake. When WC and BMI were mutually adjusted in a model, WC was related to 1.37 fold increased risk of death from any cancer and 1.82 fold increase risk of death from cardiovascular disease, comparing the highest versus lowest WC categories. Importantly, WC, but not BMI showed statistically significant positive associations with deaths from lung cancer and chronic respiratory disease. Participants in the highest versus lowest WC category had a relative risk of death from lung cancer of 1.77 (95% CI, 1.41 to 2.23) and of death from chronic respiratory disease of 2.77 (95% CI, 1.95 to 3.95). In contrast, subjects in the highest versus lowest BMI category had a relative risk of death from lung cancer of 0.94 (95% CI, 0.75 to 1.17) and of death from chronic respiratory disease of 1.18 (95% CI, 0.89 to 1.56). Increased abdominal fat measured by WC was related to a higher risk of deaths from major specific causes, including deaths from lung cancer and chronic respiratory disease, independent of BMI.
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