Song X et al.; DECODE Study Group. Obesity attenuates gender differencesin cardiovascular mortality. Cardiovasc Diabetol. 2014 Oct 19;13:144. PubMed PMID: 25928355; PubMed Central PMCID:PMC4212094.

Cardiovasc Diabetol. 2014 Oct 19;13:144. doi: 10.1186/s12933-014-0144-5.

Obesity attenuates gender differences in cardiovascular mortality.

Song X(1,)(2), Tabák AG(3,)(4), Zethelius B(5,)(6), Yudkin JS(7), Söderberg S(8,)(9), Laatikainen T(10,)(11,)(12), Stehouwer CD(13), Dankner R(14,)(15), Jousilahti P(16), Onat A(17), Nilsson PM(18,)(19), Satman I(20), Vaccaro O(21), Tuomilehto J(22,)(23,)(24,)(25), Qiao Q(26,)(27,)(28); DECODE Study Group.

Author information:
(1)Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland. xin.song@helsinki.fi.
(2)Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.xin.song@helsinki.fi.
(3)Department of Epidemiology and Public Health, University College London, London, UK. a.tabak@ucl.ac.uk.
(4)1st Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary. a.tabak@ucl.ac.uk.
(5)Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden. bjorn.zethelius@pubcare.uu.se.
(6)Medical Products Agency, Uppsala, Sweden. bjorn.zethelius@pubcare.uu.se.
(7)Department of Medicine, University College London, London, UK. j.yudkin@ucl.ac.uk.
(8)Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. stefan.soderberg@medicin.umu.se.
(9)Baker IDI Heart and Diabetes Institute, Melbourne, Australia. stefan.soderberg@medicin.umu.se.
(10)Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland. tiina.laatikainen@thl.fi.
(11)Institute of Public Health andClinical Nutrition, University of Eastern Finland, Kuopio, Finland. tiina.laatikainen@thl.fi.
(12)Hospital District of North Karelia, Joensuu, Finland. tiina.laatikainen@thl.fi.
(13)Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands. cda.stehouwer@mumc.nl.
(14)Unit for Cardiovascular Epidemiology, The Gertner Institute, Sheba Medical Center, Tel Hashomer, Israel. RachelD@gertner.health.gov.il.
(15)Division of Epidemiology and Prevention, School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. RachelD@gertner.health.gov.il.
(16)Department ofChronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland. pekka.jousilahti@thl.fi.
(17)Department of Cardiology, Cerrahpaşa Medical Faculty, Istanbul, Turkey. alt_onat@yahoo.com.tr.
(18)Department of Clinical Sciences, Lund University, Malmö, Sweden. peter.nilsson@med.lu.se.
(19)Center of Emergency Medicine, Skåne University Hospital, Malmö, Sweden. peter.nilsson@med.lu.se.
(20)Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey. satmandiabet@gmail.com.
(21)Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. ovaccaro@unina.it.
(22)Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland. jaakko.tuomilehto@thl.fi.
(23)Center for Vascular Prevention, Danube University Krems, Krems, Austria. jaakko.tuomilehto@thl.fi.
(24)King Abdulaziz University, Jeddah, Saudi Arabia. jaakko.tuomilehto@thl.fi.
(25)Instituto de Investigacion Sanitaria del Hospital Universario LaPaz (IdiPAZ), Madrid, Spain. jaakko.tuomilehto@thl.fi.
(26)Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland. qing.qiao@helsinki.fi.
(27)Department of Chronic Disease Prevention, National Institute for Health andWelfare, Helsinki, Finland. qing.qiao@helsinki.fi.
(28)R&D AstraZeneca AB, Mölndal, Sweden. qing.qiao@helsinki.fi.

BACKGROUND: To estimate cardiovascular disease (CVD) mortality in relation to obesity and gender.

METHODS: Data from 11 prospective cohorts from four European countries including 23 629 men and 21 965 women, aged 24 to 99 years, with a median follow-up of 7.9 years were analyzed. Hazards ratios (HR) for CVD mortality in relation to baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were estimated using Cox proportional hazards models with age as the timescale.

RESULTS: Men had higher CVD mortality than women in all four BMI categories (<25.0, 25.0-29.9, 30.0-34.9 and ≥35.0 kg/m(2)). Compared with the lowest BMI category in women, multivariable adjusted HRs (95% confidence intervals) for higher BMI categories are 1.0 (0.8-1.4), 1.6 (1.1-2.1) and 2.8 (2.0-3.8) in women and 2.8 (2.2-3.6), 3.1 (2.5-3.9), 3.8 (2.9-4.9) and 5.4 (3.8-7.7) in men, respectively. Similar findings were observed for abdominal obesity defined by WC, WHR or WHtR. The gender difference was slightly smaller in obese than in non-obese individuals; but the interaction was statistically significant only between gender and WC (p = 0.02), and WHtR (p = 0.01). None of the interaction terms was significant among non-diabetic individuals.

CONCLUSIONS: Men had higher CVD mortality than women across categories of anthropometric measures of obesity. The gender difference was attenuated in obese individuals, which warrants further investigation.

PMCID: PMC4212094
PMID: 25928355  [PubMed - indexed for MEDLINE]

האתר מעודכן נכון לתאריך:  22/05/2017 14:00:17
עבור לתוכן העמוד