| 周脉耕,陈铮鸣,胡以松,杨玲,王骏,MargaretSmith,葛辉,谢俊卿,杨功焕.中国22万男性人群体重指数与缺血性心脏病关系的15年前瞻陛研究[J].Chinese journal of Epidemiology,2010,31(4):424-429 |
| 中国22万男性人群体重指数与缺血性心脏病关系的15年前瞻陛研究 |
| Body mass index and mortality from isehaemic heart disease in China:a 15-year prospective study on 220000 adult men |
| Received:December 24, 2009 |
| DOI：10.3760/cma.j.issn.0254-6450.2010.04.015 |
| KeyWord: 体重指数|缺血性心脏病|队列研究|流行病学 |
| English Key Word: Body mass index|Ischaemic heart disease|Cohort study|Epidamiology |
| FundProject: |
| Author Name | Affiliation | E-mail | | Zhou Maigeng | Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Chen Zhengming | Clinical Laboratory and Epidemiology Research Center, Oxford University, UK | | | Hu Yisong | Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Yang Ling | Clinical Laboratory and Epidemiology Research Center, Oxford University, UK | | | Wang Jun | Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Margaret Smith | Clinical Laboratory and Epidemiology Research Center, Oxford University, UK | | | Ge Hui | Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Xie Junqing | Chinese Center for Disease Control and Prevention, Beijing 102206, China | | | Yang Gonghuan | Chinese Center for Disease Control and Prevention, Beijing 102206, China | yanggh@chinacdc.cn |
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| Abstract: |
| 目的 探讨中国人群尤其是低体重人群中体重指数(BMI)与缺血性心脏病(IHD)死亡之间的关系。方法 数据来源于1990-1991年已随访15年共涉及中国220000名40～79岁男性对象的前瞻性队列研究。利用Cox比例风险模型, 在调整年龄、吸烟史及其他潜在混杂因素后, 计算BMI与IHD死亡间的相对危险度(艘)。结果 基线BMI平均值为21.7kg/m2。15年随访期间, 共有2763例对象死于IHD(占总死亡的6.8%)。在排除了基线调查时已报告患有心脑血管疾病史的对象后, BMI与IHD死亡率之间呈“J”形关系。当BMI>20kg/m2时, BMI与IHD死亡风险呈正相关。BMI值每升高5kg/m2, IHD死亡率相应增高2l%(95%CI:9%～35%, P=0.0004)。而当BMI<20kg/m2时。IHD死亡风险反而随着BMI的下降呈上升的趋势。在BMI值为20～21.9、18～19.9、<18 kg/m2范围时, 其对应的艘值分别为1.00、1.11和1.14。在排除了前3年随访中死亡的病例或将分析局限于从不吸烟者中, BMI与IHD死亡风险的关系仍呈现相同趋势。结论对于处在所谓正常BMI范围值内(20～25kg/m2)的人群, BMI与IHD死亡风险呈正相关, 但当BMI低于这一范围, 两者的关联极有可能为负相关。 |
| English Abstract: |
| Objective To assess the relationship between body mass index (BMI) and ischaemic heart disease (IHD) mortality, especially in populations with low mean BMI levels. Methods We examined the data from a population-based, prospective cohort study of 220000 Chinese men aged 40-79, who were enrolled in 1990-199l, and followed up ever since to l/1/2006. Relative risks of the deaths from IHD by the baseline BMI were calculated, after controlling age, smoking, and the other potential confounding factors. Results The mean baseline BMI was 21.7kg/m2, and 2763 IHD deaths were recorded during the 15-year follow-up (6.8% of all deaths) program. Among men without prior vascular diseases at baseline, there was a J-shaped association between BMI and IHD mortality. When baseline BMI was above 20kg/m2, there was a strongly positive association of BMI with IHD risk, with each 5kg/m2 higher in BMI associated with 2l%(95%CI:9%-35%, P=0.0004) higher IHD mortality. Below this BMI range, the association appeared to be reverse, with the risk ratios as 1.00, 1.1l, and 1.14, respectively, for men with BMI 20-21.9, 18-19.9, and <18kg/m2. The excess IHD risk observed at low BMI levels persisted after restricting analysis to never smokers or excluding the first 3 years of follow-up. Conclusion Lower BMI was associated with lower IHD risk among people in the SO-called‘normal range’of BMI values (20-25kg/m2). However, below that range, the association might well be reversed. |
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