The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: A population-based comparison

被引：650

作者：

Kahn H.S. ^{[1
]}

机构：

[1] National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA 30341-3717

来源：

BMC Cardiovascular Disorders | / 5卷 / 1期

关键词：

Waist Circumference; Uric Acid Concentration; Standardize Beta Coefficient; Waist Size; Lipid Accumulation Product;

D O I：

10.1186/1471-2261-5-26

中图分类号：

学科分类号：

摘要：

Background: Body mass index (BMI, kg/m2) may not be the best marker for estimating the risk of obesity-related disease. Consistent with physiologic observations, an alternative index uses waist circumference (WC) and fasting triglycerides (TG) concentration to describe lipid overaccumulation. Methods: The WC (estimated population minimum 65 cm for men and 58 cm for women) and TG concentration from the third National Health and Nutrition Examination Survey (N = 9,180, statistically weighted to represent 100.05 million US adults) were used to compute a "lipid accumulation product" [LAP = (WC-65) × TG for men and (WC-58) × TG for women] and to describe the population distribution of LAP. LAP and BMI were compared as categorical variables and as log-transformed continuous variables for their ability to identify adverse levels of 11 cardiovascular risk factors. Results: Nearly half of the represented population was discordant for their quartile assignments to LAP and BMI. When 23.54 million with ordinal LAP quartile > BMI quartile were compared with 25.36 million with ordinal BMI quartile > LAP quartile (regression models adjusted for raceethnicity and sex) the former had more adverse risk levels than the latter (p < 0.002) for seven lipid variables, uric acid concentration, heart rate, systolic and diastolic blood pressure. Further adjustment for age did not materially alter these comparisons except for blood pressures (p > 0.1). As continuous variables, LAP provided a consistently more adverse beta coefficient (slope) than BMI for nine cardiovascular risk variables (p < 0.01), but not for blood pressures (p > 0.2). Conclusion: LAP (describing lipid overaccumulation) performed better than BMI (describing weight overaccumulation) for identifying US adults at cardiovascular risk. Compared to BMI, LAP might better predict the incidence of cardiovascular disease, but this hypothesis needs prospective testing. ©2005 Kahn; licensee BioMed Central Ltd.

引用

页数：10

共 44 条

[1]

McGee D.L., Body mass index and mortality: A meta-analysis based on person-level data from twenty-six observational studies, Ann. Epidemiol., 15, pp. 87-97, (2005)

[2]

Frayn K.N., Karpe F., Fielding B.A., MacDonald I.A., Coppack S.W., Integrative physiology of human adipose tissue, Int. J. Obes. Relat. Metab. Disord., 27, pp. 875-888, (2003)

[3]

Havel P.J., Update on adipocyte hormones: Regulation of energy balance and carbohydrate/lipid metabolism, Diabetes, 53, (2004)

[4]

Lamarche B., Abdominal obesity and its metabolic complications: Implications for the risk of ischaemic heart disease, Coron. Artery Dis., 9, pp. 473-481, (1998)

[5]

Van Pelt R.E., Evans E.M., Schechtman K.B., Ehsani A.A., Kohrt W.M., Contributions of total and regional fat mass to risk for cardiovascular disease in older women, Am. J. Physiol. Endocrinol. Metab., 282, (2002)

[6]

Tanko L.B., Bagger Y.Z., Alexandersen P., Larsen P.J., Christiansen C., Central and peripheral fat mass have contrasting effect on the progression of aortic calcification in postmenopausal women, Eur. Heart J., 24, pp. 1531-1537, (2003)

[7]

Ferreira I., Snijder M.B., Twisk J.W.R., van Mechelen W., Kemper H.C.G., Seidell J.C., Stehouwer C.D.A., Central fat mass versus peripheral fat and lean mass: Opposite (adverse versus favorable) associations with arterial stiffness? The Amsterdam Growth and Health Longitudinal Study, J. Clin. Endocrinol. Metab., 89, pp. 2632-2639, (2004)

[8]

Karelis A.D., St Pierre D.H., Conus F., Rabasa-Lhoret R., Poehlman E.T., Metabolic and body composition factors in subgroups of obesity: What do we know?, J. Clin. Endocrinol. Metab., 89, pp. 2569-2575, (2004)

[9]

Frayn K.N., Adipose tissue as a buffer for daily lipid flux, Diabetologia, 45, pp. 1201-1210, (2002)

[10]

Schaffer J.E., Lipotoxicity: When tissues overeat, Curr. Opin. Lipidol., 14, pp. 281-287, (2003)

← 1 2 3 4 5 →