Abstract 14464: Prospective Study Of Waist Circumference Trajectories And Incident Cardiovascular Disease
Introduction: Single measurement of waist circumference (WC) predicts the incident cardiovascular disease (CVD); however, long term patterns of WC and their association with the incidence of CVD are poorly characterized. The objective of this study was to identify WC trajectories and to determine their association with the incidence of CVD (stroke and myocardial infraction). We also conducted a secondary analysis by the restricting analysis to those with a body mass index (BMI) < 28 kg/m2.
Hypothesis: WC trajectories predict the risk of developing CVD.
Methods: We included 75,744 participants aged 18+ y, free of stroke, coronary heart disease, and cancer in 2010 (the baseline), from the Kailuan study, a community-based cohort in China. Waist circumference and other covariates were repeatedly measured in 2006, 2008, and 2010. WC trajectories were identified by latent mixture modeling. Incident CVD cases were confirmed by review of medical records. Cox proportional hazards model was used to assess the association between WC trajectories and the risk of CVD, after adjustment for age, sex, income, education, systolic blood pressure, and plasma concentrations of triglycerides, glucose, HDL-C, LDL-C, and C-reactive protein.
Results: We identified four WC trajectories based on their 2006 WC measurement and change pattern during 2006-2010: low stable (n=11,789, mean WC ranged from 74.1-75.1cm), moderate stable (n=41,400; mean WC ranged from 85.0-86.7cm), moderate-high stable (n=20,585; mean WC ranged from 95.4-97.3 cm), high stable (n=1,970; mean WC ranged from 106-110 cm). During 4 years of follow-up (2010-2014), we documented 1,523 CVD events. Compared with the low stable group, trajectories with elevated WC had greater odds of having CVD events during 2010-2014. Adjusted hazard ratios were 1.27 (95% CI, 1.03-1.58) for the moderate stable group, 1.39 (95% CI, 1.11-1.74) for the moderate-high stable group, and 1.44 (95% CI, 1.05-1.98) for the high stable group (P<0.05 for all). After we excluded participants with BMI ≧ 28 kg/m2, we observed similar results: adjusted hazard ratio was 2.25 (95% CI, 1.13-4.50), comparing two extreme WC trajectories.
Conclusion: Long-term WC patterns were associated with altered risk of CVD, even among non-obese people.
Author Disclosures: Y. Lee: None. C. Jin: None. J. Gao: None. Y. Wu: None. S. Wu: None. P.M. Kris-Etherton: None. X. Gao: None.
- © 2016 by American Heart Association, Inc.