体质量指数变化对肱动脉-踝动脉脉搏波传导速度的影响

Effect of change of body mass index on brachial-ankle pulse wave velocity

目的 观察体质量指数（BMI）变化对肱动脉-踝动脉脉搏波传导速度（baPWV）的影响。方法应用前瞻性队列研究，在2006—2007年度参加健康体检的101510名开滦集团职工中随机分层抽取5852名作为研究对象，符合入选标准（年龄I〉40岁、既往无缺血性脑卒中、短暂性脑缺血发作、心肌梗死者）的5440名纳入研究队列。依据2006—2007年度、2010—2011年度两次BMI测量数据将观察对象分为BMI持续正常组（1720名）、BMI降低组（367名）、BMI升高组（467名）、BMI持续高组（2626名）。用多因素Logistic回归方法分析BMI变化对baPWV的影响。结果（1）全人群BMI降低组的动脉硬化检出率67．8％（249／367）和BMI持续高组的动脉硬化检出率65．9％（1730／2626）；较BMI持续正常组56．3％（969／1720）和BMI升高组55．5％（259／467）明显升高，差异有统计学意义（F=53．93。P〈0．01）。（2）在女性人群中，校正了基线年龄，甘油三酯，总胆固醇，高密度脂蛋白胆固醇，空腹血糖，超敏c反应蛋白，吸烟，饮酒，原发性高血压后，与BMI持续正常组相比，BMI持续高组增加动脉硬化的发病风险高（RR为1．34，95％CI为1．03—1．74，P〈0．05）。结论BMI长期持续在较高水平会加快女性脉搏波传导速度。

Objective To observe the effect of change in body mass index （BMI） on brachial-ankle pulse wave velocity （baPWV）. Methods Prospective cohort study was used to stratify random sampling 5852 workers as the study investigated from the total Kailuan group number 101 510 from 2006 to 2007. The inclusion criteria is age t〉 40 years, no previous history of ischemic stroke, transient ischemic attack, myocardial infarction. ,and 5440 were meet the standard. According to the BMI measurements in the two times health examinations between 2006 to 2007 and 2010 to 2011, the observed population divided into four groups：including continued normal group （ 1720 cases）, decreasing group （ 367 cases ）, increasing group （ 467 cases ） and continued high group （2626 cases）. Multiple logistic regression analysis was used to test the effect of change of BMI on baPWV. Results （ 1 ） The arteriosclerosis detection rate of decreased BMI group is 67. 8% （249/367） and of continued high BMI group is 65. 9% （ 1730/2626）, BMI continued normal group 56. 3% （969/1720） and the BMI elevated group is 55. 5% （259/467）. Compared with BMI of continued normal group, BMI of decreasing group and continued high group have a significantly higher of arteriosclerosis （ F = 53.93 ,P 〈 0.01 ）. （2） In the female population, adjusted the baseline of age, triglycerides, total cholesterol, high density lipoprotein cholesterol, fasting blood glucose, high-sensitivity C-reactive protein, smoking, alcohol consumption and hypertension, BMI of continued high group appears to be an independent risk factor for baPWV （RR = 1.34, 95% CI = 1.03 - 1.74, P 〈 0. 05 ）, compared with BMI of continued normal group. Conclusion Keep a high level of BMI for a long time can accelerate pulse wave velocity among women.