基于CHARLS的体质量调整腰围指数与中老年人群心血管疾病发生风险的纵向关联OA
Longitudinal Association Between Weight Adjusted Waist Index and Cardiovascular Disease Risk in Middle Aged and Elderly Adults Based on the CHARLS
[目的]探讨中国中老年人群体质量调整腰围指数(WWI)的时间变化趋势及其与心血管疾病(CVD)发病风险的关联.[方法]本研究基于中国健康与养老追踪调查(CHARLS),纳入2011、2013、2015年≥45岁、体测数据完整者,使用复杂抽样加权计算WWI均值,采用Mann-Kendall检验分析趋势.在2011年基线中进一步排除曾经或现在罹患心血管疾病和重要协变量缺失研究对象,收集随访至2020年的新发心血管结局事件,根据基线WWI四分位数将研究对象分为Q1~Q4组.建立多变量log-binomial回归模型评估WWI与CVD的关联,限制性立方样条评估非线性,采用敏感性分析验证结果的稳健性.[结果]在2011至2015年期间,加权WWI均值总体稳定(2011:11.17±1.68;2013:11.28±1.35;2015:11.24±1.59;P<0.05).在纵向随访研究期间,共1 784例新发CVD.多变量调整后,WWI每增加1单位,CVD风险增加17%(RR:1.17,95%CI:1.10~1.24).与Q1组相比,Q2,Q3,Q4组CVD风险分别升高23%(RR:1.23,95%CI:1.07~1.40),27%(RR:1.27,95%CI:1.11~1.44),40%(RR:1.40,95%CI:1.22~1.60),风险随WWI升高呈线性递增趋势(P<0.001).亚组分析显示WWI与年龄因素存在交互作用(P<0.05).敏感性分析结果与主要研究结果趋势一致.[结论]中国中老年人群WWI水平在2011至2015年间总体趋势稳定,较高水平的WWI与CVD发病风险增加有关,提示WWI或可作为评估中老年人心血管代谢风险的简易有效指标.
[Objective]To investigate the temporal trend of weight-adjusted-waist index(WWI)and its association with the risk of incident cardiovascular diseases(CVD)among middle-aged and older Chinese adults.[Methods]Based on the China Health and Retirement Longitudinal Study(CHARLS),this research enrolled participants aged 45 and above with complete physical measurement data from the 2011,2013,and 2015 waves.Complex sampling weights were applied to calculate the mean WWI,and the Mann-Kendall test was used to analyze its trend.From the 2011 baseline survey,individuals with a history of cardiovascular disease or missing key covariates were further excluded.New-onset cardiovascular outcome events were collected during follow-up until 2020.Participants were categorized into Q1-Q4 groups based on baseline WWI quartiles.Multivariable log-binomial regression models were constructed to assess the association between WWI and CVD,while restricted cubic splines were employed to evaluate potential nonlinear relationships.Sensitivity analyses were conducted to verify the robustness of the findings.[Results]From 2011 to 2015,the weighted mean WWI among Chinese middle-aged and older adults remained generally stable(2011:11.17±1.68;2013:11.28±1.35;2015:11.24±1.59;P for trend<0.05).During the longitudinal follow-up,1 784 incident CVD cases were documented.After multivariable adjustment,each unit increase in WWI was associated with a 17%increased risk of CVD(RR:1.17,95%CI:1.10-1.24).Compared with the Q1 group,the risk of CVD in the Q2,Q3,and Q4 groups increased by 23%(RR:1.23,95%CI:1.07-1.40),27%(RR:1.27,95%CI:1.11-1.44),and 40%(RR:1.40,95%CI:1.22-1.60),respectively.A significant linear trend was observed between the increasing WWI and elevated CVD risk(P for trend<0.001).Subgroup analysis revealed a stronger association in participants aged 45-60 years(P for interaction<0.05).The results of sensitivity analysis were consistent with the main research results.[Conclusions]The overall trend of WWI level in the middle-aged and elderly population in China is stable from 2011 to 2015.The higher level of WWI is associated with an increased risk of CVD,suggesting that WWI may be used as a simple and effective indicator to evaluate the risk of cardiovascular metabolism in middle-aged and elderly people.
刘翔;杨淑筠;周熙瑞;袁乐乐;孔美偲;柳雁;夏敏
中山大学公共卫生学院,广东 广州 510080中山大学公共卫生学院,广东 广州 510080中山大学公共卫生学院,广东 广州 510080中山大学公共卫生学院,广东 广州 510080中山大学公共卫生学院,广东 广州 510080中山大学公共卫生学院,广东 广州 510080中山大学公共卫生学院,广东 广州 510080
医药卫生
体质量调整腰围指数心血管疾病肥胖中国健康与养老追踪调查纵向研究
weight-adjusted-waist indexcardiovascular diseasesobesityChina Health and Retirement Longitudinal StudyLongitudinal Study
《中山大学学报(医学科学版)》 2026 (1)
64-76,13
国家重点研发计划项目(2022YFC3600600)
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