中国成人BMI和腹型肥胖与急性心肌梗死发病关系的前瞻性研究

目的  了解中国成人BMI和腹型肥胖与急性心肌梗死(acute myocardial infarction, AMI)的发病关系。方法  从2010年中国慢性病及危险因素监测中抽取11个省(市)，再从中选择60个监测点作为随访点，并于2016―2017年进行随访调查，共随访到27 604人，数据清理后共26 794名调查对象纳入分析。采用Cox比例风险回归模型分析BMI和腹型肥胖与AMI发病的关系。结果  26 794名调查对象，平均随访6.0年，随访期间共观察到256例AMI事件。在调整相关混杂因素后，与腰围(waist circumference, WC)正常、BMI < 24 kg/m²组相比，腹型肥胖、BMI < 24 kg/m²组AMI的发病风险增加85%(HR=1.85, 95% CI: 1.14~3.01)，腹型肥胖、BMI≥24 kg/m²组AMI的发病风险增加56%(HR=1.56, 95% CI: 1.11~2.18)，而WC正常、BMI≥24 kg/m²组与AMI的发病风险无相关(HR=0.85, 95% CI: 0.49~1.47)。结论  无论BMI值为多少，腹型肥胖都是AMI发病的重要危险因素。

Relationship between BMI,abdominal obesity and the incidence of acute myocardial infarction in Chinese adults: a prospective study

  Objective  To investigate the relationship between BMI, abdominal obesity and the incidence of acute myocardial infarction (AMI) in Chinese adults.  Methods  Eleven Provinces/Cities were selected from 2010 China Chronic Disease Risk Factor Surveillance, and 60 surveillance sites were selected as follow-up spots. A total of 27 604 participants were followed up from 2016 to 2017. Finally, a total of 26 794 subjects were included in the analysis. The Cox proportional hazard regression model was used to analyze the relationship between BMI, abdominal obesity and the incidence of AMI.  Results  A total of 26 794 subjects were follow-up for an average of 6.0 years. During the follow-up period, of 256 cases of AMI were observed. After adjusting for relevant confounders, compared with normal waist circumference (WC) and BMI < 24 kg/m2 group, the risk of AMI in abdominal obesity and BMI < 24 kg/m2 group increased by 85% (HR=1.85, 95% CI: 1.14-3.01), and the risk of AMI in abdominal obesity group and BMI≥24 kg/m2 group increased by 56% (HR=1.56, 95% CI: 1.11-2.18). However, there was no significant correlation between the risk of AMI and the subjects with normal WC and BMI≥24 kg/m2 (HR=0.85, 95% CI: 0.49-1.47).  Conclusion  Abdominal obesity is an important risk factor for AMI regardless of BMI.