中心肥胖与全因死亡风险:72 项前瞻性队列研究的系统回顾和剂量反应荟萃分析。

IF 105.7 1区 医学 Q1 Medicine BMJ : British Medical Journal Pub Date : 2020-09-23 DOI:10.1136/bmj.m3324
Ahmad Jayedi, Sepideh Soltani, Mahdieh Sadat Zargar, Tauseef Ahmad Khan, Sakineh Shab-Bidar
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引用次数: 0

摘要

目的量化中心性肥胖指数(包括腰围、臀围、大腿围、腰臀比、腰高比、腰大比、体脂指数和A体型指数)与普通人群全因死亡风险的关系,并阐明剂量-反应关系的形态:数据来源:PubMed 和 Scopus:数据来源:PubMed 和 Scopus(从开始到 2019 年 7 月),以及所有相关文章和综述的参考文献列表:前瞻性队列研究,报告至少三类中心脂肪指数的全因死亡率风险估计值。数据综合:进行随机效应剂量反应荟萃分析,以评估线性趋势估计值。采用单阶段线性混合效应荟萃分析来估计剂量反应曲线:在筛选出的 98 745 项研究中,对 1950 项研究的全文进行了资格审查。最终分析包括 72 项前瞻性队列研究,共有 2 528 297 名参与者。汇总的危险比如下:腰围(10 厘米,增加 3.94 英寸):1.11(95% 置信区间 1.08 至 1.13,I2=88%,n=50);臀围(10 厘米,增加 3.94 英寸):0.90(0.81 至 0.99,I2=95%,n=9);大腿围(5 厘米,增加 1.97 英寸):0.82(0.75 至 0.89,I2=54%,n=3);腰臀比(增加 0.1 个单位):1.20(1.15 至 1.25,I2=90%,n=31);腰围与身高比(增加 0.1 个单位):1.24(1.12 至 1.36,I2=94%,n=11);腰围与大腿之比(增加 0.1 个单位):1.21(1.03 至 1.39,I2=97%,n=2);身体肥胖指数(增加 10%):1.17(1.00 至 1.33,I2=75%,n=4);A 身体形态指数(增加 0.005 个单位):1.15(1.10 至 1.20,I2=87%,n=9)。在考虑体重指数后,正相关仍然存在。腰围和腰围身高比与男性和女性全因死亡风险之间存在近似 "J "形的关联。腰臀比和 A 身体形态指数呈单调的正相关。体型肥胖指数呈 U 型关系:结论:腰围、腰臀比、腰高比、腰高比、体型肥胖指数和 A 型体型指数等中心肥胖指数与总体肥胖无关,它们与较高的全因死亡风险呈显著正相关。臀围和大腿围越大,风险越低。研究结果表明,中心脂肪测量值可与体重指数一起作为确定过早死亡风险的补充方法。
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Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies.

Objective: To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and to clarify the shape of the dose-response relations.

Design: Systematic review and meta-analysis.

Data sources: PubMed and Scopus from inception to July 2019, and the reference lists of all related articles and reviews.

Eligibility criteria for selecting studies: Prospective cohort studies reporting the risk estimates of all cause mortality across at least three categories of indices of central fatness. Studies that reported continuous estimation of the associations were also included.

Data synthesis: A random effects dose-response meta-analysis was conducted to assess linear trend estimations. A one stage linear mixed effects meta-analysis was used for estimating dose-response curves.

Results: Of 98 745 studies screened, 1950 full texts were fully reviewed for eligibility. The final analyses consisted of 72 prospective cohort studies with 2 528 297 participants. The summary hazard ratios were as follows: waist circumference (10 cm, 3.94 inch increase): 1.11 (95% confidence interval 1.08 to 1.13, I2=88%, n=50); hip circumference (10 cm, 3.94 inch increase): 0.90 (0.81 to 0.99, I2=95%, n=9); thigh circumference (5 cm, 1.97 inch increase): 0.82 (0.75 to 0.89, I2=54%, n=3); waist-to-hip ratio (0.1 unit increase): 1.20 (1.15 to 1.25, I2=90%, n=31); waist-to-height ratio (0.1 unit increase): 1.24 (1.12 to 1.36, I2=94%, n=11); waist-to-thigh ratio (0.1 unit increase): 1.21 (1.03 to 1.39, I2=97%, n=2); body adiposity index (10% increase): 1.17 (1.00 to 1.33, I2=75%, n=4); and A body shape index (0.005 unit increase): 1.15 (1.10 to 1.20, I2=87%, n=9). Positive associations persisted after accounting for body mass index. A nearly J shaped association was found between waist circumference and waist-to-height ratio and the risk of all cause mortality in men and women. A positive monotonic association was observed for waist-to-hip ratio and A body shape index. The association was U shaped for body adiposity index.

Conclusions: Indices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.

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BMJ : British Medical Journal
BMJ : British Medical Journal Medicine-General Medicine
CiteScore
19.90
自引率
1.80%
发文量
2997
审稿时长
2-4 weeks
期刊介绍: The BMJ (British Medical Journal) is an international peer-reviewed medical journal with a "continuous publication" model, where articles are published on bmj.com before appearing in the print journal. The website is updated daily with the latest original research, education, news, and comment articles, along with podcasts, videos, and blogs. The BMJ's editorial team is primarily located in London, with additional editors in Europe, the US, and India.
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