Association of total and central obesity with mortality in postmenopausal women with coronary heart disease
Association of total and central obesity with mortality in postmenopausal women with coronary heart disease
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DOI：
10.1093/aje/kwg271
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发表时间：
2003-12-15
影响因子：
5
通讯作者：
Barrett-Connor, E
中科院分区：
文献类型：
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作者：
Kanaya, AM;Vittinghoff, E;Barrett-Connor, E
超重和腹部肥胖增加死亡风险，尽管这种风险可能是由传统的心脏危险因素介导的。作者评估了基线测量、总体体重和腹部肥胖（腰围）的变化以及体重和腰围循环与已知患有心脏病的绝经后妇女总死亡率的相关性。他们使用了1993年至2001年间参与心脏和雌激素/维生素B1替代研究的2,739名美国女性的数据。在6.8年的随访中，498名妇女死亡。在校正的考克斯模型中，包括基线腰围或体重指数（BMI），每一个都与死亡率相关。然而，在进一步调整糖尿病，高血压和脂蛋白后，这些关联消失了。在包括腰围和BMI的模型中，腰围较大（风险比= 1.40/标准差，95%置信区间：1.16，1.68）与风险增加和BMI升高相关（风险比= 0.81/标准差，95%置信区间：0.67，0.97）与总死亡率风险降低相关，独立于心脏危险因素。体重和腰围循环与死亡率无关。结果表明，BMI和腰围都与绝经后心脏病妇女的死亡率相关，但腰围可能比BMI更重要，其影响可能在很大程度上由其他心脏危险因素介导。
Overweight and abdominal obesity increase mortality risk, although the risk may be mediated by traditional cardiac risk factors. The authors assessed the association of baseline measures, change in overall body weight and abdominal obesity (waist circumference), and weight and waist circumference cycling with total mortality among postmenopausal women with known heart disease. They used data from 2,739 US women who participated in the Heart and Estrogen/progestin Replacement Study between 1993 and 2001. Over 6.8 years of follow-up, 498 women died. In adjusted Cox models that included either baseline waist circumference or body mass index (BMI), each was associated with mortality. However, after further adjustment for diabetes, hypertension, and lipoproteins, these associations disappeared. In models including both waist circumference and BMI, larger waist circumference (hazard ratio = 1.40 per standard deviation, 95% confidence interval: 1.16, 1.68) was associated with increased risk and higher BMI (hazard ratio = 0.81 per standard deviation, 95% confidence interval: 0.67, 0.97) was associated with decreased risk of total mortality, independent of cardiac risk factors. Weight and waist circumference cycling were not associated with mortality. Results show that both BMI and waist circumference are associated with mortality among postmenopausal women with established heart disease, but waist circumference may be more important than BMI, and their effects may be largely mediated by other cardiac risk factors.