Association Between Weight Change Since 20 Years of Age With Mortality From Myocardial Infarction and Chronic Heart Failure in the Japan Collaborative Cohort (JACC) Study
Association Between Weight Change Since 20 Years of Age With Mortality From Myocardial Infarction and Chronic Heart Failure in the Japan Collaborative Cohort (JACC) Study
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DOI：
10.1253/circj.cj-13-1057
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发表时间：
2014-03-01
影响因子：
3.3
通讯作者：
Tamakoshi, Akiko
中科院分区：
文献类型：
--
作者：
Cui, Renzhe;Iso, Hiroyasu;Tamakoshi, Akiko
背景资料：体重增加是冠状动脉疾病的一个重要危险因素，但体重变化对心力衰竭（HF）死亡率的影响的证据有限。方法和结果：共有61,571名年龄在40-79岁的受试者被选中。参与者已入组日本协作队列（JACC）研究，可获得20岁时的体重数据。死亡的根本原因是根据国际疾病分类确定的。在队列的中位19.3年随访期间，有640例心肌梗死（MI）死亡和605例HF死亡。体重增加的男性和女性有更高的MI死亡风险，而体重减轻的男性和女性有更高的HF死亡风险。与体重无变化的受试者相比（+/- 5.0 kg内），多变量风险比（人力资源;体重变化≥ 10.0 kg时MI的95%置信区间[Cl]）为1.51男性为1.11-2.06，女性为1.80（1.23-2.64），而HF的HR分别为0.76（0.51-1.13）和0.94（0.66-1.33）。体重变化≥-10.0 kg时MI的相应HR为0.86男子为0.57-1.31，女性为0.54-1.53，HF为1.33（0.93-1.89）和1.48（1.04-2.12）。高BMI和体重增加与MI死亡风险增加相关，而低BMI和体重减轻与HF死亡风险增加相关。
Background: Weight gain is an important risk factor of coronary artery disease, but there is limited evidence for an effect of weight change on heart failure (HF) mortality.Methods and Results: A total of 61,571 subjects aged 40-79 years were selected. Participants were already enrolled in the Japan Collaborative Cohort (JACC) study, for whom data regarding weight at the age of 20 years of age were available. The underlying causes of death were determined based on the International Classification of Diseases. During the median 19.3-year follow-up of the cohort, there were 640 deaths from myocardial infarction (MI) and 605 deaths from HF. Men and women who had gained weight had a higher risk of mortality from MI, whereas those who had lost weight had a higher risk of mortality from HF. Compared to subjects with no weight change (within +/- 5.0 kg), the multivariate hazard ratios (HR; 95% confidence interval [Cl]) of MI for weight change of +10.0 kg or more were 1.51 (1.11-2.06) for men and 1.80 (1.23-2.64) for women, whereas HRs of HF were 0.76 (0.51-1.13) and 0.94 (0.66-1.33), respectively. The corresponding HRs of MI for weight change of -10.0 kg or more were 0.86 (0.57-1.31) for men and 0.90 (0.54-1.53) for women, whereas those of HF were 1.33 (0.93-1.89) and 1.48 (1.04-2.12), respectively.Conclusions: High BMI and weight gain are associated with increased risk of mortality from MI, whereas low BMI and weight loss are associated with increased risk of mortality from HF.