阻塞性冠状动脉疾病患者超重和肥胖与冠状动脉风险因素和多血管疾病的关系--一项全国范围的登记研究

Maria Hang Xuan Pham , Daniel Mølager Christensen , Andreas Torp Kristensen , Charlotte Middelfart , Caroline Sindet-Pedersen , Gunnar Gislason , Niels Thue Olsen
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摘要

背景肥胖症的发病率越来越高,预计会加重冠状动脉疾病的负担。本研究调查了当代人群中首次诊断为阻塞性冠状动脉疾病的患者中超重和肥胖的发生率。我们探讨了体重指数(BMI)与年龄、传统风险因素以及是否存在多血管疾病之间的关系。方法和结果通过丹麦全国范围的登记,我们确定了2012-2018年间首次诊断为阻塞性冠状动脉疾病的49733名患者。我们通过多变量逻辑回归研究了体重指数与冠状动脉风险因素之间的关系。平均年龄为 65.8 ± 11.8 岁,平均体重指数为 27.5 kg/m2 ± 7.2,73.2% 为男性。66.3%的患者体重指数≥25 kg/m2,1.3%体重不足。随着年龄的增长,体重指数≥25 kg/m2的患者比例下降,50岁患者的比例为69%,而≥80岁患者的比例为46.2%(P< 0.001)。在所有年龄组中,男性、曾吸烟者和高血压患者的体重指数≥25 kg/m2的几率较高。在多变量逻辑回归中,BMI ≥25 kg/m2 与是否存在多血管疾病无关(p = 0.74)。年轻患者的体重指数较高,而且更有可能是吸烟者。超重或肥胖与糖尿病和高血压的存在有独立关联。体重指数≥25 kg/m2与是否存在多血管疾病没有独立关联。
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Association of overweight and obesity with coronary risk factors and the presence of multivessel disease in patients with obstructive coronary artery disease – A nationwide registry study

Background

The growing prevalence of obesity is expected to increase the burden of coronary artery disease. This study examined the prevalence of overweight and obesity in patients with a first-time diagnosis of obstructive coronary artery disease in a contemporary population. The association of body-mass-index (BMI) with age, traditional risk factors, and the presence of multivessel disease were explored.

Methods and results

Using the Danish Nationwide registries, we identified 49,733 patients with a first-time diagnosis of obstructive coronary artery disease in the period 2012–2018. We investigated the association between BMI and coronary risk factors by multivariate logistic regression. Mean age was 65.8 ± 11.8 years, mean BMI was 27.5 kg/m2 ± 7.2, and 73.2 % were men. 66.3 % had a BMI ≥25 kg/m2 and 1.3 % were underweight. The prevalence of patients with BMI ≥25 kg/m2 decreased with increasing age and was 69 % in patients <50 year vs. 46.2 % in patients ≥80 years (p < 0.001). In all age groups, higher odds of BMI ≥25 kg/m2 were observed in males, former smokers, and patients with hypertension. In multivariate logistic regression, BMI ≥25 kg/m2 was not associated with presence of multivessel disease (p = 0.74).

Conclusion

In this large, nationwide study, 66.3 % of patients with first time diagnosis of obstructive coronary disease had BMI ≥25 kg/m2. Young patients had higher BMI and were more likely to be current smokers. Overweight or obesity was independently associated with the presence of diabetes and hypertension. BMI ≥25 kg/m2 was not independently associated with the presence of multivessel disease.

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