Abstract
ObjectiveTo investigate the effects of lifestyle-related factors on ischemic heart disease (IHD) according to body mass index (BMI) and fasting blood glucose (FBG) levels among Korean adults.MethodsA total of 119,929 men and 89,669 women (from National Sample Cohort version 2.0, National Health Insurance Service) aged ≥20 years who were examined during 2003–2006 and had no preexisting type 2 diabetes or circulatory diseases were followed until December 2015 to confirm IHD incident cases. Data on lifestyle-related factors (BMI, FBG, diet, smoking, alcohol consumption, and physical activity) were collected at baseline. Lifestyle-related risk factors were defined as mainly vegetable/mainly meat diet, former/current smoking, alcohol consumption ≥3 times/week, and no physical activity. Associations between these factors and IHD were examined using Cox proportional hazards regression models.ResultsHigh BMI (≥25 kg/m2), high FBG (≥100 mg/dL), mainly meat diet, and former/current smoking were associated with increased risk for IHD. Alcohol consumption ≤twice/week and physical activity ≤twice/week were associated with lower risk of IHD. With increased lifestyle-related risk factors, the risk of IHD also increased in women (hazard ratio [HR] = 3.21, 95% confidence interval [CI] 2.18–4.73) and men (HR = 1.66, 95% CI 1.48–1.85). This increase was larger in women, with a significant sex interaction (p = 0.0001). Significant interactions between BMI and alcohol consumption (p = 0.0002) and between BMI and physical activity (p = 0.0063) were observed. Interactions were seen between FBG level and meal type in both BMI<25 kg/m2 (p = 0.0106) and BMI≥25 kg/m2 (p = 0.0281) and between FBG level and alcohol consumption in BMI ≥25 kg/m2 (p = 0.0118).ConclusionsThe impact of lifestyle-related factors on IHD was more pronounced in women than in men and may be modified by BMI and FBG level among Korean adults. This might be taken into account when planning individual interventions to reduce IHD risk.
Highlights
Ischemic heart disease (IHD), known as coronary heart disease, is one of the leading causes of death globally [1, 2]
High body mass index (BMI) ( 25 kg/m2), high fasting blood glucose (FBG) ( 100 mg/dL), mainly meat diet, and former/current smoking were associated with increased risk for IHD
With increased lifestyle-related risk factors, the risk of IHD increased in women and men (HR = 1.66, 95% confidence interval (CI) 1.48–1.85)
Summary
Ischemic heart disease (IHD), known as coronary heart disease, is one of the leading causes of death globally [1, 2]. The morbidity and mortality rates associated with IHD among people with obesity or impaired glucose tolerance were reported to be higher than those of healthy people [9,10,11,12,13]. People who are overweight or obese were found to have a higher IHD risk than those with normal BMI. Heavy smoking and sedentary lifestyle were strongly related to IHD risk in people with an increased BMI [9]. FBG levels strongly interacted with the other lifestyle-related factors in intervention studies on IHD risk; a lower calorie intake and more vigorous physical activity decreased FBG levels [23, 24]. The association between lifestyle-related factors and IHD has not been investigated in large-scale cohorts in Korea
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