腰臀比与心肌梗死患者全因死亡的关系  

Relationship between Waist-to-hip Ratio and All-cause Death in Post-myocardial Infarction Patients

作　　者：徐利娜 缪从良 赵丹丹 付宇 蔡静宜 林涌迪 吴佳妮 吴寿岭[3] 洪江 XU Lina;MIAO Congliang;ZHAO Dandan;FU Yu;CAI Jingyi;LIN Yongdi;WU Jiani;WU Shouling;HONG Jiang(Department of Critical Care Medicine,Shanghai General Hospital of Nanjing Medical University,Shanghai 201600,China;Department of Emergency and Critical Care Medicine,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201600,China;Department of Cardiology,Kailuan General Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]南京医科大学附属上海一院临床医学院重症医学科,上海201600 [2]上海交通大学医学院附属第一人民医院急诊危重病科,上海201600 [3]开滦总医院心内科,河北唐山063000

出　　处：《中国分子心脏病学杂志》2024年第5期6313-6318,共6页Molecular Cardiology of China

基　　金：国家自然科学基金面上项目(82070335);科技部主动健康与老龄化科学应对重点专项基金(2020YFC2004703)。

摘　　要：目的分析腰臀比与心肌梗死患者全因死亡的关系。方法纳入开滦研究中首次体检时有心肌梗死史或在2006—2018年的随访中新发心肌梗死的参与者,并排除腰围和臀围数值缺失或为极端值的参与者,以及有恶性肿瘤史的参与者。将参与者按腰臀比四分位数进行分组。采用多因素Cox回归模型分析腰臀比四分位数分组及腰臀比连续变量(每增加1个标准差)与心肌梗死患者全因死亡的关系。结果共纳入4474名心肌梗死参与者。在8.29(4.52,12.09)年的随访中,1271名(28.4%)参与者死亡。在校正年龄、性别和体重指数等混杂因素后,腰臀比每增加1个标准差,心肌梗死患者全因死亡的风险增加11%[95%置信区间(95%CI):1.04~1.17]。与腰臀比第一分位组相比,腰臀比第四分位组的校正风险比为1.20(95%CI:1.02~1.40)。限制性立方样条曲线显示腰臀比与心肌梗死患者全因死亡存在线性关系(非线性P>0.05)。结论腰臀比是心肌梗死患者全因死亡的独立危险因素,且腰臀比与全因死亡风险呈剂量-反应关系。Objective To evaluate the relationship between waist-to-hip ratio(WHR)and all-cause death in patients with myocardial infarction(MI).Methods Patients with a history of MI at the first physical examination or new-onset MI during follow-up from 2006 to 2018 in Kailuan Study were included.Patients with missing or extreme values of waist and hip circumference and those with a history of malignancy were excluded.Patients were divided into four groups according to quartiles of WHR.The cox proportional hazard regression model was used to analyze the effect of quartiles of WHR and each 1 standard deviation increase in WHR on the risk of developing all-cause mortality in post-MI patients.Results A total of 4474 patients were included in the analysis.During a median follow-up of 8.29 years(interquartile spacing:4.52-12.09 years),1271(28.4%)of patients died.Adjusting for confounders such as age,sex,and body mass index,the risk of all-cause mortality in patients with MI increased by 11%(95%confidence interval[95%CI]:1.04-1.17)for every 1 standard deviation increase in WHR.The adjusted hazard ratio was 1.20(95%CI:1.02-1.40)in the fourth quartile of the WHR compared with the first quartile of the WHR.Restricted cubic spline curves showed a linear relationship between WHR and all-cause mortality in patients with MI(P for nonlinearity>0.05).ConclusionWHR is an independent risk factor for all-cause death in post-MI patients,and WHR demonstrates a dose-response relationship with all-cause death risk.

关 键 词：腰臀比 全因死亡 心肌梗死 二级预防 

分 类 号：R542.22[医药卫生—心血管疾病]