The effect of metabolic health state transitions and its interaction with body mass index(BMI)on occurrence of cardiovascular disease(CVD)
Objective To investigate the association between metabolic health state change,body mass in-dex(BMI)and cardiovascular disease(CVD).Methods A prospective cohort study was conducted based on the Hotan survey site of"Xinjiang multi-ethnic natural population cohort construction and health fol-low-up study".After 3 years of follow-up,the subjects were divided into 4 groups according to the change of metabolic status:metabolically healthy(MH),metabolically healthy to metabolically unhealthy(MH-MU),metabolically unhealthy(MU)and metabolically unhealthy to metabolically healthy(MU-MH),and the effects of metabolic status on the occurrence of CVD were analyzed by multifactorial Logistic re-gression.Restricted cubic spline was applied to explore the association between BMI as a continuous varia-ble and the risk of CVD,and to analyze the association between metabolic status shift and BMI interaction with CVD.Results A total of 10 232 individuals with a mean age of(52.43±10.29)years were included in this study.There were 349(3.41％)new cases of CVD during the 3-year follow-up period;the CVD rates in the MH,MH-MU,MU and MU-MH groups were 2.48％,4.21％,5.13％and 3.30％,respec-tively.Compared with MH group,the risk of CVD occurrence in MH-MU and MU was OR=1.42(95％CI:1.05～1.93)and OR=1.41(95％CI:1.03～1.92),respectively.Restricted cubic spline analysis showed that baseline BMI was a nonlinear association with CVD incidence(P=0.023).There was an in-teraction between BMI and metabolic state shifts(X2=26.025,P=0.001),which was attributable to the proportion of the interaction effect of 3％[RERI=0.032(95％CI:0.005～0.06),AP=0.031(95％CI:0.007～0.05)],and S=2.157(95％CI:1.194～3.897).Conclusion Maintaining or shifting to a meta-bolically unhealthy state can increase the risk of CVD.The interaction between maintaining or changing to metabolic unhealthy state and overweight and obesity can increase the risk of cardiovascular disease.
metabolic state shiftcardiovascular disease(CVD)body mass index(BMI)interaction
万方数据
维普
