腰臀比和其他肥胖指标作为2型糖尿病患者心血管疾病风险预测指标的比较:ADVANCE的一项前瞻性队列研究

Sébastien Czernichow, Andre-Pascal Kengne, Rachel R Huxley, George David Batty, Bastiaan de Galan, Diederick Grobbee, Avinesh Pillai, Sophia Zoungas, Michel Marre, Mark Woodward, Bruce Neal, John Chalmers
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引用次数: 135

摘要

目的:本研究的目的是比较体重指数(BMI)、腰围(WC)和腰臀比(WHR)与2型糖尿病患者心血管疾病风险的相关性和识别能力。方法与结果:对11,140名男性和女性进行了平均4.8年的随访。采用Cox比例风险模型计算基线BMI (SD: 5 kg/m2)、WC (SD: 13 cm)和WHR (SD: 0.08)与心血管疾病风险增加的一个标准差(SD)的风险比和95%置信区间(95% CI)。调整后,WC的心血管事件风险比(95% CI)为1.10(1.03-1.18),冠状动脉事件风险比为1.13(1.03-1.24),心血管死亡风险比为1.08(0.98-1.19)。估计WHR分别为1.12(1.05-1.19)、1.17(1.08-1.28)和1.19(1.09-1.31)。BMI与这些结果没有任何关系。尽管受试者工作特征曲线不能区分人体测量变量(P值0.24),但相对综合判别改善统计数据显示,除脑血管事件外,使用WHR的模型对心血管事件的判别能力有所增强。结论:关联强度和判别统计表明,WHR是2型糖尿病患者心血管事件和死亡率的最佳预测因子,BMI最差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of waist-to-hip ratio and other obesity indices as predictors of cardiovascular disease risk in people with type-2 diabetes: a prospective cohort study from ADVANCE.

Aims: The aim of this study was to compare the strength of associations and discrimination capability of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with cardiovascular disease risk in individuals with type-2 diabetes.

Methods and results: Eleven thousand, one hundred and forty men and women were followed for a mean of 4.8 years. The Cox proportional hazard models were used to compute the hazard ratios and 95% confidence intervals (95% CI) for one standard deviation (SD) increase in baseline BMI (SD: 5 kg/m2), WC (SD: 13 cm) and WHR (SD: 0.08) with cardiovascular disease risk. After adjustment, hazard ratio (95% CI) for WC were 1.10 (1.03–1.18) for cardiovascular events, 1.13 (1.03–1.24) for coronary events, and 1.08 (0.98–1.19) for cardiovascular deaths. Estimates for WHR were 1.12 (1.05–1.19), 1.17 (1.08–1.28) and 1.19 (1.09–1.31). BMI was not related to any of these outcomes. Although the receiver operating characteristic curve could not differentiate between anthropometric variables (P values 0.24), the relative integrated discrimination improvement statistic showed an enhancement in the discrimination capabilities of models using WHR for cardiovascular outcomes, except for cerebrovascular events.

Conclusion: Strengths of associations and discrimination statistics suggested that WHR was the best predictor of cardiovascular events and mortality in patients with type-2 diabetes and BMI the worst.

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