广州市某社区老年人超重和肥胖与中医体质及心血管危险因素分析

Correlation Analyses between Obesity/Overweight and Constitutions of Chinese Medicine/Cardiovascular Risk Factors in Elderly Residents of a Community in Guangzhou

目的探讨广州市某社区老年人超重和肥胖与中医体质类型及心血管危险因素的相关性。方法采用随机抽样法将2014年10月—2015年9月在广州市天河区五山街社区进行免费健康体检,年龄在60岁以上的1 054名社区老年人纳入研究,按体重指数（BMI）分为肥胖组（107名）、超重组（431名）及体重正常组（516名）,采用《中医体质分类与判定》量表进行体质判定,填写健康档案,并进行腰围、血压等一般指标及空腹血糖、血脂、尿酸、血肌酐等血生化指标检测,采用多元Logistic回归分析中医体质类型与肥胖和超重的相关性。结果 1 054名社区老年人平和体质为24.38%（257/1 054）,偏颇体质为75.62%（797/1 054）。痰湿（247名,23.43%）、阴虚（150名,14.23%）和气虚质（136名,12.90%）为社区老年人最常见的3种偏颇体质。多元Logistic回归分析显示,痰湿质肥胖和超重危险性分别是平和质的61.641倍（CI：24.491-155.144）和9.393倍（CI：5.910-14.929）;湿热质肥胖和超重危险性是平和质的21.478倍（CI：6.978-66.102）和4.505倍（CI：2.308-8.793）,差异均有统计学意义（均P〈0.01）;气虚质肥胖和超重危险性是平和质的3.408倍（CI：1.161-10.004）和1.655倍（CI：1.062-2.580）,差异有统计学意义（P〈0.05）;与正常体重老年人比较,肥胖、超重老年人腹型肥胖、高血压、糖尿病发生率明显升高（P〈0.01,P〈0.05）,其空腹血糖、甘油三脂、高密度脂蛋白、尿酸值亦明显高于正常体重老年人（P〈0.01）。结论社区肥胖和超重老年人具有痰湿质、湿热质和气虚质体质倾向,心血管危险因素较正常体重者增多,高血压、糖尿病、血脂异常发生风险增高。

Objective To analyze the correlation between obesity / overweight and constitutions of Chinese medicine（ CM） / cardiovascular risk factors in elderly residents of Tianhe District Wushan Community,Guangzhou City. Methods Recruited were 1 054 elderly residents（ over 60 years）,who had free health examinations in Tianhe District Wushan Community of Guangzhou City from October 2014 to September 2015. They were assigned to the obesity group（ 107 cases）,the overweight group（ 431 cases）,and the normal weight group（ 516 cases） according to body mass index（ BMI） by randomized sampling. Constitution types of CM were assessed using Classification and Judgment of Constitution Types of CM. Health files were filled in. General indices such as waist circumference,blood pressure,etc.,and blood biochemical indicators such as fasting blood glucose,blood lipids,uric acid,blood creatinine,etc. were detected. The correlation between constitution types of CM and obesity / overweight was analyzed using multivariate Logistic regression analysis. Results Among the 1 054 elderly residents,75. 62%（ 797 / 1 054） of those were of biased constitution and 24. 38%（ 257 /1 054） were of normal constitution. Phlegm dampness（ 247 cases,23. 43%）,yin deficiency（ 150 cases,14. 23%）,and qi deficiency（ 136 cases,12. 90%）constitution were top 3 commonly seen biased constitution types. Multiple Logistic regression analysis showed that the risk of obese / overweight patients of phlegm dampness constitution was 61. 641 times（ CI： 24. 491- 155. 144）and 9. 393 times（ CI： 5. 910- 14. 929） that of subjects of normal constitution respectively（P〈0. 01）; the risk of obese / overweight patients of dampness heat constitution was 21. 478 times（ CI： 6. 978- 66. 102） and 4. 505 times（ CI： 2. 308-8. 793） that of subjects of normal constitution respectively（P〈0. 01）; the risk of obese/overweight patients of qi deficiency constitution was 3. 408 times（ CI： 1. 161- 10. 004） and 1. 655 times（ CI： 1. 062- 2. 580）that of subjects of normal constitution respectively（P〈0. 05）. Compared with normal body weight senile,the incidences of abdominal obesity,hypertension,diabetes were obviously higher in obese / overweight senile（P〈0. 01,P〈0. 05）. Their values of fasting blood glucose,triglyceride,high-density lipoprotein,and uric acid were obviously higher than those in normal body weight senile（P〈0. 01）. Conclusions Community obese / overweighed elderly residents have the tendency of phlegm dampness,dampness heat,and qi deficiency constitutions. Compared with the normal body weight senile,they have higher risk of cardiovascular risk factors,and increased risks of suffering from hypertension,diabetes,and dyslipidemia.