IHD INCIDENCE AND INDICES OF BODY-FAT DISTRIBUTION

IHD 发病率和身体脂肪分布指数

• 批准号: 3358100
• 负责人: HENRY S KAHN
• 金额: $ 46.61万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-05-01 至 1994-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3358100
• 关键词: body physical characteristic; cardiovascular disorder epidemiology; case history; disease /disorder proneness /risk; female; hospital patient care; human subject; interview; lifestyle; male; myocardial ischemia /hypoxia; obesity; postmortem; statistics /biometry

Reports from Sweden, Hawaii and France have each demonstrated that abdominal obesity, i.e., central, upper-body, or "apple", can be predictive of ischemic heart disease (IHD). These prospective cohort studies employed different simple indicates of body-fat distribution such as waist-to-hip circumference ratio or subscapular skinfold. Their similar results, however, suggest that increased abdominal obesity confers approximately a two-fold increased risk of IHD among middle-aged men. The effect among females may be stronger. This proposal approaches the epidemiologic relationship between IHD incidence and simple indices of fat distribution using the case-control method instead of a more costly prospective cohort. Two parallel, case- control protocols are proposed. A hospital based investigation will study 450 early survivors of a first IHD event (cases), 450 matched neighborhood controls and 450 hospital controls (suspected of IHD, but with negative work-up). A morgue-based study will involve 354 non-survivors of a first IHD event, 354 matched neighborhood controls and 354 controls who died from an acute process and were free of IHD. These two studies will permit the testing of alternative fat-distribution indices which may be stronger risk factors for IHD incidence than the waist-to-hip ratio of the subscapular skinfold. The proposed anthropometric data sets will include 6 girths, 7 skinfolds, abdominal sagittal diameter, height and weight. Principal component and canonical correlations analyses will assist the researchers to identify combinations of these measures which efficiently distinguish cases from controls. The analyses for both protocols will consider males and females separately. Possible confounders of the association between fat-distribution indices and IHD (e.g., race, age, tobacco use, alcohol use, diabetes) will be considered and, if required, adjusted for in multivariate analysis. These protocols will provide a previously unavailable combination, in one America data set, of well documented IHD outcomes and a variety of fat- distribution measurements. Any improved indices identified in these studies will have potential utility for future prospective investigations, for intergroup comparisons of IHD risk, for patient assessment and perhaps for the rapid evaluation of protective interventions (e.g., diet, exercise programs) against cardiovascular disease.

来自瑞典、夏威夷和法国的报告都表明， 腹部肥胖，即，中央，上身，或“苹果”，可以预测 缺血性心脏病（IHD） 这些前瞻性队列研究采用 不同的身体脂肪分布的简单指标，如腰臀比， 周长比或肩胛下皮褶。 类似的结果， 然而，这表明腹部肥胖的增加大约会导致 中年男性患缺血性心脏病的风险增加两倍。 其中的影响 女性可能更强大。 本研究旨在探讨IHD与糖尿病的流行病学关系， 使用病例对照法的脂肪分布发生率和简单指数 而不是更昂贵的前瞻性队列。 两个平行的，情况- 提出了控制协议。 一项基于医院的调查将研究 450例首次IHD事件的早期幸存者（病例），450例匹配的邻居 对照组和450名医院对照组（疑似IHD，但阴性） 后处理）。 一项基于停尸房的研究将涉及354名第一次死亡的非幸存者。 IHD事件，354名匹配的邻居对照和354名对照死于 急性过程，无IHD。 这两项研究将允许测试替代脂肪分布 这些指标可能是IHD发病率的更强危险因素， 肩胛下皮褶的腰臀比建议的人体测量 数据集将包括6个腰围，7个皮褶，腹部矢状径， 身高和体重 主成分和典型相关分析将有助于 研究人员确定这些措施的组合， 区分病例和对照。 两个方案的分析将 分别考虑男性和女性。可能的混杂因素 脂肪分布指数和IHD之间的关联（例如，种族，年龄， 烟草使用，酒精使用，糖尿病）将被考虑，如果需要， 在多变量分析中调整。 这些协议将提供一个以前不可用的组合，在一个 美国数据集，有充分记录的IHD结果和各种脂肪- 分布测量。 这些指标中确定的任何改进指标 这些研究对于未来的前瞻性研究具有潜在的实用性， 用于IHD风险的组间比较，用于患者评估， 为了快速评估保护性干预（例如，饮食、锻炼 预防心血管疾病。