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Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study.
J Am Heart Assoc 2018; 7(4)JA

Abstract

BACKGROUND

This study aimed to determine the association between different weight histories, including cumulative excess weight, cumulative excess waist circumference (WC), duration of general and central adiposity, current and maximum body mass index, and current and maximum WC, and incident coronary heart disease (CHD) and stroke.

METHODS AND RESULTS

The study population consisted of 4398 adults aged ≥40 years without CHD or stroke at baseline. Associations between different weight histories and CHD and stroke were determined by multivariable time-varying Cox regression models after adjustment for age, sex, and time-varying confounders. Further adjustment was also done for mediators (eg, diabetes mellitus, hypercholesterolemia, and hypertension). During median follow-up of 13.9 years, 718 incident CHD and 158 stroke events were documented. Multivariable adjusted hazard ratios (HRs) were calculated in the sex and confounder adjusted model for CHD per 1-SD increase in cumulative excess weight (HR: 1.02; 95% confidence interval [CI], 0.96-1.07), cumulative excess WC (HR: 1.14; 95% CI, 1.04-1.24), duration of general adiposity (HR: 1.00; 95% CI, 0.92-1.08), duration of central adiposity (HR: 1.01; 95% CI, 0.93-1.09), current body mass index (HR: 1.03; 95% CI, 0.99-1.07), current WC (HR: 1.21; 95% CI, 1.11-1.32), maximum body mass index (HR: 1.01; 95% CI, 0.95-1.07), and maximum WC (HR: 1.17; 95% CI, 1.07-1.28). After further adjustment for mediators, current and maximum WC still showed a significant risk (HR: 1.13 [95% CI, 1.03-1.23] and 1.09 [95% CI, 1.00-1.20], respectively). Moreover, in the sex and confounder adjusted model, cumulative excess WC and maximum WC were associated with higher risk of stroke (hazard ratio: 1.21 [95% CI, 0.99-1.48] and 1.25 [95% CI, 1.02-1.55], respectively).

CONCLUSIONS

Exposure to cumulative excess weight and cumulative excess WC confers little additional risk beyond their current and maximum values. Even current and maximum WC were associated with incident CHD in the presence of obesity mediators, and the latter was a significant predictor of stroke in the presence of confounders.

Authors+Show Affiliations

Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran fzhadaegh@endocrine.ac.ir.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29440011

Citation

Kabootari, Maryam, et al. "Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study." Journal of the American Heart Association, vol. 7, no. 4, 2018.
Kabootari M, Asgari S, Mansournia MA, et al. Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study. J Am Heart Assoc. 2018;7(4).
Kabootari, M., Asgari, S., Mansournia, M. A., Khalili, D., Valizadeh, M., Azizi, F., & Hadaegh, F. (2018). Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study. Journal of the American Heart Association, 7(4), doi:10.1161/JAHA.117.006924.
Kabootari M, et al. Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study. J Am Heart Assoc. 2018 02 10;7(4) PubMed PMID: 29440011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study. AU - Kabootari,Maryam, AU - Asgari,Samaneh, AU - Mansournia,Mohammad Ali, AU - Khalili,Davood, AU - Valizadeh,Majid, AU - Azizi,Fereidoun, AU - Hadaegh,Farzad, Y1 - 2018/02/10/ PY - 2018/2/15/entrez PY - 2018/2/15/pubmed PY - 2019/10/23/medline KW - body mass index KW - coronary heart disease KW - stroke KW - waist circumference JF - Journal of the American Heart Association JO - J Am Heart Assoc VL - 7 IS - 4 N2 - BACKGROUND: This study aimed to determine the association between different weight histories, including cumulative excess weight, cumulative excess waist circumference (WC), duration of general and central adiposity, current and maximum body mass index, and current and maximum WC, and incident coronary heart disease (CHD) and stroke. METHODS AND RESULTS: The study population consisted of 4398 adults aged ≥40 years without CHD or stroke at baseline. Associations between different weight histories and CHD and stroke were determined by multivariable time-varying Cox regression models after adjustment for age, sex, and time-varying confounders. Further adjustment was also done for mediators (eg, diabetes mellitus, hypercholesterolemia, and hypertension). During median follow-up of 13.9 years, 718 incident CHD and 158 stroke events were documented. Multivariable adjusted hazard ratios (HRs) were calculated in the sex and confounder adjusted model for CHD per 1-SD increase in cumulative excess weight (HR: 1.02; 95% confidence interval [CI], 0.96-1.07), cumulative excess WC (HR: 1.14; 95% CI, 1.04-1.24), duration of general adiposity (HR: 1.00; 95% CI, 0.92-1.08), duration of central adiposity (HR: 1.01; 95% CI, 0.93-1.09), current body mass index (HR: 1.03; 95% CI, 0.99-1.07), current WC (HR: 1.21; 95% CI, 1.11-1.32), maximum body mass index (HR: 1.01; 95% CI, 0.95-1.07), and maximum WC (HR: 1.17; 95% CI, 1.07-1.28). After further adjustment for mediators, current and maximum WC still showed a significant risk (HR: 1.13 [95% CI, 1.03-1.23] and 1.09 [95% CI, 1.00-1.20], respectively). Moreover, in the sex and confounder adjusted model, cumulative excess WC and maximum WC were associated with higher risk of stroke (hazard ratio: 1.21 [95% CI, 0.99-1.48] and 1.25 [95% CI, 1.02-1.55], respectively). CONCLUSIONS: Exposure to cumulative excess weight and cumulative excess WC confers little additional risk beyond their current and maximum values. Even current and maximum WC were associated with incident CHD in the presence of obesity mediators, and the latter was a significant predictor of stroke in the presence of confounders. SN - 2047-9980 UR - https://www.unboundmedicine.com/medline/citation/29440011/Different_Weight_Histories_and_Risk_of_Incident_Coronary_Heart_Disease_and_Stroke:_Tehran_Lipid_and_Glucose_Study_ L2 - http://www.ahajournals.org/doi/full/10.1161/JAHA.117.006924?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -