Metabolic and lifestyle predictors of ischemic heart disease and all-cause mortality among normal weight, overweight, and obese men: a 16-year follow-up in the Copenhagen Male Study.
OBJECTIVE
The aim of this study was to identify metabolic and lifestyle risk factors for ischemic heart disease (IHD) and all-cause mortality (ACM) among normal weight, overweight, and obese men.


METHODS
This was a 16-year follow up of 2982 men 53 to 75 years without overt cardiovascular disease. POTENTIAL RISK FACTORS: These were blood pressure, diabetes, fasting serum triglycerides (TGs) and high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glucosuria, cancer, body mass index (BMI), alcohol, tobacco, leisure-time physical activity, social class, and age.


RESULTS
This was to determine mortality during 16 years of follow-up.


RESULTS
A total of 194 men (6.5%) died due to IHD and 1184 (39.8%) from all causes. All lifestyle factors and clinical/metabolic risk factors were associated with BMI, positively or negatively. Risk of IHD and ACM increased gradually from the normal weight (BMI 20.0-25.0) to higher BMI groups. With respect to IHD, compared to normal weight men, obese men (BMI > or = 30.0) had an age-adjusted hazard ratio (HR) (95%CI) of 1.67(1.04-2.68); adjusted for potential confounders HR was 0.99 (0.59-1.66); corresponding estimates for ACM were 1.21 (0.98-1.49) and 0.86 (0.68-1.09). High TG (>1.70 mmol/L) was an independent risk factor for IHD mortality only among men with BMI < or = 27.5 kg/m(2); low HDL-C (< or =1.03 mmol/L) was an independent risk factor for IHD mortality only among men with BMI > 27.5 kg/m(2). Cumulative smoking and type 2 diabetes/glucosuria were the strongest risk factors of ACM among men with a BMI < or = 27.5 as well as men with a BMI > 27.5.


CONCLUSIONS
The importance of risk factors for IHD mortality, in particular serum TG and serum HDL-C, depends on BMI.
Suadicani
Poul
P
Copenhagen Male Study, Epidemiologic Research Unit, Copenhagen University Hospital, Denmark. ps11@bbh.regionh.dk
Hein
Hans Ole
HO
von Eyben
Finn Edler
FE
Gyntelberg
Finn
F
D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D015444:Exercise; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology / Q000378:metabolism / Q000401:mortality* / Q000503:physiopathology; D009369:Neoplasms / Q000150:complications; D009765:Obesity / Q000150:complications / Q000378:metabolism / Q000401:mortality* / Q000503:physiopathology; D050177:Overweight / Q000150:complications / Q000378:metabolism / Q000401:mortality* / Q000503:physiopathology; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012923:Social Class; D013997:Time Factors
D001786:Blood Glucose; D008055:Lipids