| Background: Cardiovascular diseases and obesity are major global public health problems.Increasing morbidity of cardiovascular diseases and obesity not only increase socio-economic burdens,but also lead to decline in life quality of people and social productivity.Increased arterial stiffness is an independent signal that predicts early vascular disease of cardiovascular disease,so researchers mostly use the degree of arterial stiffness as an indicator of cardiovascular disease to conduct a series of studies.Exploring the relationship between obesity and arteriosclerosis has been a research hotspot.However,the conclusions about obesity and arteriosclerosis are still controversial.Moreover,researchers have focused attention on the qualitative relationship between body mass index(BMI)and arteriosclerosis indicators.However,few studies have focused on how the weight changes and how much the changes will affect the degree of arteriosclerosis.In addition,most of the existing related researches have focused on the effects of "weight loss" or "weight gain" on arteriosclerosis,the research object was a population with certain characteristics(obese people,type 2 diabetes patients),and the study time span was short.This makes the conclusions of the study not adaptable enough.Research purposes: The main purpose of this study is to explore the impact of BMI and weight change indicators(absolute weight change,relative weight change,annual weight change,absolute BMI change)on arteriosclerosis in different genders,and provide scientific basis for departments to formulate preventive measures for obesity and arterial stiffness.Methods: This study collected data on the examination people who participated in the physical examination at the First Affiliated Hospital of Chongqing Medical University from 2011 to 2018.According to personal information such as name and ID number,selected adults with no less than2 times physical examinations(age ≥18 years),and required no loss of height,weight,and BMI,and no arteriosclerosis at the first physical examination(cardio-ankle vascular index(CAVI)≥ 9.0 on one side).The arterial sclerosis follow-up cohort composed of the above population included a total of 4393 subjects,with an average age of 47.35 years old,including 3040 males and 1353 females.At the end of follow-up,a total of372 people developed arteriosclerosis.This study introduced four indicators of weight change: absolute weight change(the difference between the weight of one physical examination and the weight of the first physical examination),relative weight change(the ratio of absolute weight change to baseline weight),and annual weight change(absolute weight changes divided by year of follow-up),absolute BMI change(the difference between the BMI of one physical examination and the BMI of the first physical examination).BMI and four weight change indicators were included in the study for statistical analysis by gender.Restrictive cubic spline(RCS)analysis was used to draw the dose-effect curve of BMI,each weight change index and the probability of arteriosclerosis to exploring the qualitative relationship between each variable and arteriosclerosis.Using multiple Logistic regression analysis,explored the correlation between different BMI,weight change index and atherosclerosis by gender.GEE model was used to analyze the quantitative relationship between indexes and the change of CAVI under different BMI and weight index subgroups by gender.Results:(1)Baseline analysis of the cohort indicated that:(1)Except for age and high-density lipoprotein(HDL),the mean values of other variables in men were greater than women(total cholesterol(TC)was not statistically significant);(2)The mean CAVI of men decreased with the increase of BMI;women take normal weight group as for reference,the mean of CAVI increased with the degree of overweight and obesity.(2)There was no obvious change in the incidence of arteriosclerosis between different groups of weight change indicators.Obesity female had the highest incidence of arteriosclerosis(20.290/ 100 person-years).The incidence density was highest in males with 10 kg ≤ absolute weight loss <5kg(17.073 / 100 person-years).(3)RCS analysis showed that the probability of arteriosclerosis in men decreased with the increase of BMI,but the opposite in women;The dose-effect curves of weight change indicators of men,the absolute weight change of women,the relative weight change and the probability of arteriosclerosis had a turning point in "slightly greater than 0",and there was a decreasing trend before it and an increasing trend after it;when annual weight change and absolute BMI change of women were near "0",there was a downward trend in the dose-effect curves,but there was an upward trend elsewhere in these two curves.(4)Compared with normal weight people,regardless of male and female,underweight was a risk factor of arteriosclerosis(β were 3.896 and1.588 respectively),and overweight was a protective factor for arterial stiffness(β were-1.506 and-0.638);obesity of male was also a protective factor of arteriosclerosis(β was-1.221).The results of the GEE model showed that in female over-weight group,there was a positive correlation between the change in BMI and CAVI.For every increase of BMI,the change in CAVI increased by an average of 0.068.(5)Compared with the reduction of absolute weight loss> 10 kg,The absolute weight change of men and women ≤ 5kg is the protective factor of arteriosclerosis(male and female β are-1.501 and-1.628,respectively);and the increase in male absolute weight gain > 10 kg was a risk factor for arteriosclerosis(β = 1.287, P = 0.005).The GEE model results showed that females with absolute weight loss of women > 10 kg had the greatest impact on the CAVI change value.At this time,for every one less weight loss,the CAVI change value decreased by 0.394 on average.There was a positive correlation between the 10 kg ≤ absolute weight loss < 5kg and the CAVI change value.For every one less weight loss,the CAVI change value increased by 0.296 on average.(6)Compared with those with a relative weight change reduction of more than 10%,men and women with a relative weight loss of less than5% and a relative weight change of less than 5% were protective factors for arteriosclerosis(β values were-0.740,-0.670,-1.125,-1.018);the increased in relative weight change > 10% of men and women were a risk factor for arteriosclerosis(β were 1.362,0.938,respectively).The results of the GEE model showed that there was a negative correlation between the change of female relative weight ≤ 5% and the change of CAVI.For every increase of the relative weight change by one percentage point,the change of CAVI decreased by an average of 0.027.(7)Compared with those with annual weight loss > 3 kg,males and females with 1 kg < annual weight loss ≤ 3kg,and annual weight change ≤ 1 kg were protective factors of arteriosclerosis(β were-0.588,-0.756,-0.792,-0.757);males and females with annual weight gain > 3 kg were risk factors of arteriosclerosis(β were1.424,1.657,respectively).The results of the GEE model showed that there was a negative correlation between the average annual body weight change of women ≤ 1kg and the CAVI change value.For each unit increase in the average annual weight change,the average CAVI change value decreased by 0.129.(8)Compared with those with a decrease in absolute BMI > 2kg/m2,men with 1kg/m2 < absolute BMI reduction ≤ 2 kg/m2,men and women with absolute BMI change ≤ 1kg/m2 were protective factors of atherosclerosis(β were-0.601,-0.998,and-0.786 respectively);men and women with an absolute BMI increase of > 2 kg / m2 were risk factors of arteriosclerosis(β were 1.107,0.709,respectively).The results of the GEE model showed that there was a negative correlation between the female absolute BMI change ≤ 1kg / m2 group and the CAVI change value.For every increase of the absolute BMI change,the average CAVI change decreased by 0.117.Conclusion:(1)The risk of arteriosclerosis in men was greater than women.(2)Compared with normal weight,those with lower body weight had a higher risk of arteriosclerosis,and those who were overweight had a lower risk of arteriosclerosis;in addition,obese men had a lower risk of arteriosclerosis.(3)For women whose weight changes were more stable,the reduction of each index became smaller or the increase became bigger,the risk of arteriosclerosis and CAVI changes reduced.There was a positive correlation between BMI and CAVI changes in over-weight female. |
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