动态肥胖与心血管疾病风险之间的关系:久山研究

IF 8.9 1区 医学 Journal of Cachexia, Sarcopenia and Muscle Pub Date : 2024-10-08 DOI:10.1002/jcsm.13564
Yu Setoyama, Takanori Honda, Takahiro Tajimi, Satoko Sakata, Emi Oishi, Yoshihiko Furuta, Mao Shibata, Jun Hata, Takanari Kitazono, Yasuharu Nakashima, Toshiharu Ninomiya
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Handgrip strength was classified as low, medium, or high by age‐ and sex‐specific tertiles. Body mass index (BMI) levels were categorized as lean (&lt;18.5 kg/m<jats:sup>2</jats:sup>), normal (18.5–24.9 kg/m<jats:sup>2</jats:sup>), or obese (≥25.0 kg/m<jats:sup>2</jats:sup>). Dynapenic obesity was defined as having both low handgrip strength and obesity. The outcomes were defined as the first‐ever development of CVD (defined as stroke or coronary heart disease). The hazard ratios (HRs) and their 95% confidence intervals (CIs) for the development of CVD were estimated using a Cox proportional hazards model, in which participants with high handgrip strength and normal BMI were used as a reference group. Mediation analyses used serum high‐sensitivity C‐reactive protein (hs‐CRP) and homeostatic model assessment for insulin resistance (HOMA‐IR) as mediators.ResultsDuring the follow‐up period, 482 participants developed CVD events (324 cases of stroke and 209 of coronary heart disease). 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引用次数: 0

摘要

背景动态性肥胖是一种以高脂肪水平合并肌肉功能障碍为特征的疾病。虽然高脂肪和肌肉损失/功能障碍被认为会协同增加心血管疾病(CVD)的风险,但很少有研究探讨动态肥胖和肌肉疏松性肥胖与心血管疾病之间的关系。我们的目的是利用日本一项基于人群的前瞻性纵向研究的数据,调查动态肥胖与心血管疾病事件之间的关系。方法我们对 2490 名 40-79 岁(42.5% 为男性,平均年龄为 57.7 ± 10.6 岁)、无心血管疾病史的日本社区居民进行了中位数为 24 年的随访。手握力按年龄和性别分为低、中、高三级。体重指数(BMI)水平分为瘦(18.5 kg/m2)、正常(18.5-24.9 kg/m2)或肥胖(≥25.0 kg/m2)。动力性肥胖的定义是同时具有低握力和肥胖。结果定义为首次发生心血管疾病(定义为中风或冠心病)。心血管疾病发病的危险比(HRs)及其95%置信区间(CIs)是用Cox比例危险模型估算的,其中将手握力量大且体重指数正常的参与者作为参照组。结果在随访期间,482 名参与者发生了心血管疾病事件(324 例中风和 209 例冠心病)。与参照组相比,经多变量调整后,动态肥胖参与者的心血管疾病风险显著增加(HR 1.49,95% CI 1.03-2.17)。按年龄组进行的分析表明,65 岁以下的动态性肥胖参与者患心血管疾病的风险进一步增加(HR 1.66,95% CI 1.04-2.65)。在对年龄小于 65 岁的参与者进行的中介分析中,血清 hs-CRP 被证明是一个重要的中介因素,可解释动态肥胖与心血管疾病之间 13.8% 的关系,而 HOMA-IR 可解释这种关系的 12.2%。这种关联在 65 岁以上的人群中更为明显。炎症以及葡萄糖代谢可能是导致这种关联的部分原因。我们的研究结果表明,预防肌肉功能障碍以及适当控制体重,尤其是在中年时期,对于预防心血管疾病的发生非常重要。
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Association between dynapenic obesity and risk of cardiovascular disease: The Hisayama study
BackgroundDynapenic obesity is a condition characterized by high adiposity levels combined with muscle dysfunction. Although high adiposity and muscle loss/dysfunction are thought to synergistically increase the risk of cardiovascular disease (CVD), few studies have addressed the association between dynapenic and sarcopenic obesity and CVD. We aimed to investigate the association of dynapenic obesity with incident CVD events using the data from a population‐based prospective longitudinal study in Japan.MethodsA total of 2490 community‐dwelling Japanese aged 40–79 years (42.5% males, mean age 57.7 ± 10.6 years) without a history of CVD were followed up for a median of 24 years. Handgrip strength was classified as low, medium, or high by age‐ and sex‐specific tertiles. Body mass index (BMI) levels were categorized as lean (<18.5 kg/m2), normal (18.5–24.9 kg/m2), or obese (≥25.0 kg/m2). Dynapenic obesity was defined as having both low handgrip strength and obesity. The outcomes were defined as the first‐ever development of CVD (defined as stroke or coronary heart disease). The hazard ratios (HRs) and their 95% confidence intervals (CIs) for the development of CVD were estimated using a Cox proportional hazards model, in which participants with high handgrip strength and normal BMI were used as a reference group. Mediation analyses used serum high‐sensitivity C‐reactive protein (hs‐CRP) and homeostatic model assessment for insulin resistance (HOMA‐IR) as mediators.ResultsDuring the follow‐up period, 482 participants developed CVD events (324 cases of stroke and 209 of coronary heart disease). The multivariable‐adjusted risk of CVD increased significantly among participants with dynapenic obesity compared with the reference group (HR 1.49, 95% CI 1.03–2.17). An analysis by age groups showed a further increase in the risk of CVD among participants with dynapenic obesity aged less than 65 years (HR 1.66, 95% CI 1.04–2.65). In mediation analyses for participants aged less than 65 years, serum hs‐CRP was shown to be a significant mediator explaining 13.8% of the association between dynapenic obesity and the development of CVD, while HOMA‐IR explained 12.2% of this relationship.ConclusionsDynapenic obesity was a significant risk factor for the development of CVD in a general Japanese population. This association was more pronounced among those aged <65 years. Inflammation, and possibly glucose metabolism, might partly mediate this association. Our findings suggest that preventing muscle dysfunction as well as appropriate weight control, especially in middle‐age, are important for preventing the development of CVD.
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来源期刊
Journal of Cachexia, Sarcopenia and Muscle
Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine
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期刊介绍: The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.
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