Obesity attenuates gender differences in cardiovascular mortality

Cardiovascular Diabetology

Original Investigation

Altan Onat¹  Pekka Jousilahti²  Jaakko Tuomilehto³  Tiina Laatikainen⁴  Olga Vaccaro⁵  Peter M Nilsson⁶  Adam G Tabák⁷  Coen DA Stehouwer⁸  John S Yudkin⁹  Björn Zethelius^1,10  Stefan Söderberg^1,11  Xin Song^1,12  Qing Qiao^1,13  Ilhan Satman^1,14  Rachel Dankner^1,15 

[1] Department of Cardiology, Cerrahpaşa Medical Faculty, Istanbul, Turkey;Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland;Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland;Center for Vascular Prevention, Danube University Krems, Krems, Austria;King Abdulaziz University, Jeddah, Saudi Arabia;Instituto de Investigacion Sanitaria del Hospital Universario LaPaz (IdiPAZ), Madrid, Spain;Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland;Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland;Hospital District of North Karelia, Joensuu, Finland;Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy;Department of Clinical Sciences, Lund University, Malmö, Sweden;Center of Emergency Medicine, Skåne University Hospital, Malmö, Sweden;Department of Epidemiology and Public Health, University College London, London, UK;1st Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary;Department of Internal Medicine and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands;Department of Medicine, University College London, London, UK;Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden;Medical Products Agency, Uppsala, Sweden;Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden;Baker IDI Heart and Diabetes Institute, Melbourne, Australia;Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland;Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland;Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland;Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland;R&D AstraZeneca AB, Mölndal, Sweden;Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey;Unit for Cardiovascular Epidemiology, The Gertner Institute, Sheba Medical Center, Tel Hashomer, Israel;Division of Epidemiology and Prevention, School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;

关键词: Obesity;    Gender;    Cardiovascular disease mortality;   

DOI  :  10.1186/s12933-014-0144-5

 received in 2014-07-14, accepted in 2014-10-06,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundTo estimate cardiovascular disease (CVD) mortality in relation to obesity and gender.MethodsData 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.ResultsMen 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/m2). 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.ConclusionsMen 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.

【 授权许可】

CC BY   
© Song et al.; licensee BioMed Central Ltd. 2014