48 research outputs found
Influence of Calendar Period on the Association Between BMI and Coronary Heart Disease: A Meta-Analysis of 31 Cohorts
Objective: The association between obesity and coronary heart disease (CHD) may have changed over
time, for example due to improved pharmacological treatment of CHD risk factors. This meta-analysis of
31 prospective cohort studies explores the influence of calendar period on CHD risk associated with
body mass index (BMI).
Design and Methods: The relative risks (RRs) of CHD for a five-BMI-unit increment and BMI categories
were pooled by means of random effects models. Meta-regression analysis was used to examine the
influence of calendar period (>1985 v 1985) in univariate and multivariate analyses (including mean
population age as a covariate). Results: The age, sex, and smoking adjusted RR (95% confidence intervals) of CHD for a five-BMI-unit
increment was 1.28(1.22:1.34). For underweight, overweight and obesity, the RRs (compared to normal
weight) were 1.11(0.91:1.36), 1.31(1.22:1.41), and 1.78(1.55:2.04), respectively. The univariate analysis
indicated 31% (95%CI: 56:0) lower RR of CHD associated with a five-BMI-unit increment and a 51%
(95%CI: 78: 14)) lower RR associated with obesity in studies starting after 1985 (n ¼ 15 and 10,
respectively) compared to studies starting in or before 1985 (n ¼ 16 and 10). However, in the multivariate
analysis, only mean population age was independently associated with the RRs for a five-BMI-unit
increment and obesity ( 29(95%CI: 55: 5)) and 31(95%CI: 66:3), respectively) per 10-year
increment in mean age).
Conclusion: This study provides no consistent evidence for a difference in the association between BMI
and CHD by calendar period. The mean population age seems to be the most important factor that
modifies the association between the risk of CHD and BMI, in which the RR decreases with increasing
age
Markers of Dysglycaemia and Risk of Coronary Heart Disease in People without Diabetes: Reykjavik Prospective Study and Systematic Review
BACKGROUND: Associations between circulating markers of dysglycaemia and coronary heart disease (CHD) risk in people without diabetes have not been reliably characterised. We report new data from a prospective study and a systematic review to help quantify these associations.
METHODS AND FINDINGS: Fasting and post-load glucose levels were measured in 18,569 participants in the population-based Reykjavik study, yielding 4,664 incident CHD outcomes during 23.5 y of mean follow-up. In people with no known history of diabetes at the baseline survey, the hazard ratio (HR) for CHD, adjusted for several conventional risk factors, was 2.37 (95% CI 1.79-3.14) in individuals with fasting glucose > or = 7.0 mmol/l compared to those or = 7 mmol/l at baseline were excluded, relative risks for CHD, adjusted for several conventional risk factors, were: 1.06 (1.00-1.12) per 1 mmol/l higher fasting glucose (23 cohorts, 10,808 cases, 255,171 participants); 1.05 (1.03-1.07) per 1 mmol/l higher post-load glucose (15 cohorts, 12,652 cases, 102,382 participants); and 1.20 (1.10-1.31) per 1% higher HbA(1c) (9 cohorts, 1639 cases, 49,099 participants).
CONCLUSIONS: In the Reykjavik Study and a meta-analysis of other Western prospective studies, fasting and post-load glucose levels were modestly associated with CHD risk in people without diabetes. The meta-analysis suggested a somewhat stronger association between HbA(1c) levels and CHD risk
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