Independent relevance of adiposity measures to coronary heart disease risk among 0.5 million adults in UK Biobank

作者：Eirini Trichia, Deborah E. Malden, Danyao Jin, Neil Wright, Hannah Taylor, Fredrik Karpe, Paul Sherliker, Federico Murgia, Jemma C. Hopewell, Ben Lacey, Jonathan Emberson, Derrick Bennett, Sarah Lewington · 发表于：International Journal of Epidemiology · 年份：2023 · DOI：10.1093/ije/dyad143 · 被引用次数：8 · 研究领域：Genetic Associations and Epidemiology、Diabetes, Cardiovascular Risks, and Lipoproteins、Cardiovascular Disease and Adiposity

BACKGROUND: Evidence on body fat distribution shows opposing effects of waist circumference (WC) and hip circumference (HC) for coronary heart disease (CHD). We aimed to investigate the causality and the shape of such associations. METHODS: UK Biobank is a prospective cohort study of 0.5 million adults aged 40-69 years recruited between 2006 and 2010. Adjusted hazard ratios (HRs) for the associations of measured and genetically predicted body mass index (BMI), WC, HC and waist-to-hip ratio with incident CHD were obtained from Cox models. Mendelian randomization (MR) was used to assess causality. The analysis included 456 495 participants (26 225 first-ever CHD events) without prior CHD. RESULTS: All measures of adiposity demonstrated strong, positive and approximately log-linear associations with CHD risk over a median follow-up of 12.7 years. For HC, however, the association became inverse given the BMI and WC (HR per usual SD 0.95, 95% CI 0.93-0.97). Associations for BMI and WC remained independently positive after adjustment for other adiposity measures and were similar (1.14, 1.13-1.16 and 1.18, 1.15-1.20, respectively), with WC displaying stronger associations among women. Blood pressure, plasma lipids and dysglycaemia accounted for much of the observed excess risk. MR results were generally consistent with the observational, implying causality. CONCLUSIONS: Body fat distribution measures displayed similar associations with CHD risk as BMI except for HC, which was invers...