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Mối liên hệ đặc thù theo giới giữa các loại hình BMI tuổi thiếu niên với tỷ lệ tử vong do tim mạch và không do tim mạch ở độ tuổi trung niên
Tóm tắt
Hầu hết các nghiên cứu liên kết hậu quả lâu dài của tình trạng gầy và béo phì ở tuổi thiếu niên chủ yếu tập trung vào nam giới. Nghiên cứu này nhằm đánh giá mối liên hệ theo giới tính giữa chỉ số BMI ở tuổi thiếu niên với tỷ lệ tử vong do bệnh tim mạch và không do bệnh tim mạch ở tuổi trưởng thành trẻ và trung niên. Một nghiên cứu đoàn hệ quốc gia. 927,868 phụ nữ, 1,366,271 nam giới. Dữ liệu kiểm tra y tế ở tuổi 17, bao gồm BMI, đã được liên kết với cơ sở dữ liệu quốc gia về tử vong. Tử vong do nguyên nhân tim mạch (CVD) và không phải CVD. Trong 17,346,230 năm phụ nữ và 28,367,431 năm nam giới theo dõi, đã ghi nhận 451 và 3208 ca tử vong do CVD, lần lượt, và 6235 và 22,223 ca tử vong không do CVD, lần lượt. So với BMI thấp-norm (18.5–22.0 kg/m2), phụ nữ gầy có nguy cơ tử vong do CVD đã được điều chỉnh thấp hơn (tỷ lệ nguy cơ Cox (HR) = 0.68; 95% CI 0.46–0.98) trái ngược với nam giới gầy (HR = 0.99; 0.88–1.13). Nhóm nam giới này có nguy cơ cao hơn cho tỷ lệ tử vong không do CVD (HR = 1.04; 1.00–1.09), không giống như phụ nữ gầy (HR = 1.01; 0.93–1.10). Các kết quả vẫn tồn tại khi mẫu nghiên cứu được giới hạn cho những người có sức khỏe không bị suy giảm, và càng nổi bật hơn cho nhóm béo phì với ≥ 30 năm theo dõi. Cả hai giới đều thể hiện các ước lượng rủi ro cao hơn ở khoảng BMI cao-norm (22.0 ≤ BMI < 25.0 kg/m2) mà không có tương tác nào giữa giới tính và BMI (p = 0.62). Các mô hình spline điều chỉnh cho thấy giá trị BMI thấp hơn để có nguy cơ tử vong tối thiểu ở phụ nữ (16.8 và 18.2 kg/m2) so với nam giới (18.8 và 20.0 kg/m2), đối với tử vong do CVD và không do CVD, tương ứng. Phụ nữ tuổi thiếu niên gầy có kết quả tốt về tim mạch trong cuộc sống trưởng thành. Ngược lại, mẫu hình rủi ro giữa hai giới là tương tự nhau. Giá trị BMI tối ưu cho phụ nữ và nam giới liên quan đến kết quả CVD trong tương lai nằm trong hoặc dưới khoảng BMI thấp-norm hiện được chấp nhận.
Từ khóa
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