Association of changes in waist circumference with cardiovascular disease and all-cause mortality among the elderly Chinese population: a retrospective cohort study

摘要

BACKGROUND To examine the association of baseline waist circumference(WC)and changes in WC with cardiovascular disease(CVD)and all-cause mortality among elderly people.METHODS A total of 30,041 eligible participants were included from a retrospective cohort in China.The same questionnaire,anthropometric and laboratory measurements were performed at baseline(2010)and the first follow-up(2013).The percent change in WC between baseline and the first follow-up was calculated to evaluate three years change of WC.We collected the occurrence of CVD and all-cause death from the first follow-up to December 31,2018.Restricted cubic splines and Cox proportionalhazards regression models were used to evaluate the relationship between baseline WC/changes in WC and mortality.RESULTS The dose-response relationships between baseline WC and CVD mortality were U-or J-shaped.In low WC group,compared with stable group,the fully adjusted hazard ratio(aHR)for CVD mortality was 1.60(95%CI:1.24−2.06)in WC gain group among men.In normal WC group,the CVD mortality risk increased with WC gain(men:aHR=1.86,95%CI:1.36−2.56;women:aHR=1.83,95%CI:1.29−2.58).In moderate-high WC group,the CVD mortality risk increased with WC gain(men:aHR=1.76,95%CI:1.08−2.88;women:aHR=1.46,95%CI:1.04−2.05)and risk decreased with WC loss(men:aHR=0.54,95%CI:0.30−0.98;women:aHR=0.59,95%CI:0.37−0.96).CONCLUSIONS For the elderly population,WC gain may increase CVD mortality risk regardless of baseline WC,whereas WC reduction could decrease the risk only in the moderate-high WC group.