陕西省成年居民肥胖测量指标与血脂异常患病关系

Association of obesity indexes with dyslipidemia among adult residents in Shaanxi province:a cross-sectional survey

目的了解陕西省成年居民体质指数、腰围和腰高比等肥胖测量指标与血脂异常患病的关系,为科学制定血脂异常防控策略提供数据支持。方法于2018年5—11月采用多阶段随机整群抽样方法在陕西省10个慢性病及其危险因素监测点抽取6202名≥18岁常住居民进行问卷调查、体格检查和实验室检测,采用偏相关分析和多因素非条件logistic回归模型分析陕西省成年居民不同体质指数、腰围和腰高比水平与血脂异常患病的关系。结果陕西省最终有效调查的6036名成年居民中,血脂异常者1994例,血脂异常患病率为33.04%。体质指数为体重过轻/正常体重、超重和肥胖成年居民总胆固醇(TC)水平分别为(4.56±0.89)、(4.75±0.95)和(4.79±0.90)mmol/L,甘油三酯(TG)水平分别为(1.42±0.99)、(1.80±1.24)和(2.14±1.39)mmol/L,低密度脂蛋白胆固醇(LDL-C)水平分别为(2.61±0.78)、(2.79±0.82)和(2.79±0.81)mmol/L,高密度脂蛋白胆固醇(HDL-C)水平分别为(1.45±0.37)、(1.28±0.32)和(1.17±0.30)mmol/L;腰围为正常、轻度中心性肥胖和重度中心性肥胖TC水平分别为(4.52±0.90)、(4.73±0.89)和(4.83±0.98)mmol/L,TG水平分别为(1.36±0.96)、(1.76±1.05)和(2.08±1.57)mmol/L,LDL-C水平分别为(2.59±0.77)、(2.77±0.79)和(2.82±0.86)mmol/L,HDL-C水平分别为(1.46±0.37)、(1.31±0.33)和(1.21±0.31)mmol/L;腰高比为正常和肥胖成年居民TC水平分别为(4.46±0.88)和(4.76±0.92)mmol/L,TG水平分别为(1.32±0.95)和(1.83±1.24)mmol/L,LDL-C水平分别为(2.55±0.76)和(2.78±0.81)mmol/L,HDL-C水平分别为(1.46±0.37)和(1.29±0.34)mmol/L;不同肥胖测量指标成年居民比较,不同体质指数(BMI)、腰围(WC)和腰高比(WHtR)成年居民的TC、TG、LDL-C、HDL-C水平差异均有统计学意义(均P<0.001)。偏相关分析结果显示,体质指数、腰围和腰高比与TC、TG、LDL-C水平均呈正相关,与HDL-C水平呈负相关(均P<0.001)。在调整了性别、年龄、文化程度、家庭人均年收入、居住地、吸烟情况和饮酒情况等混杂因素后,多因素非条件logistic回归分析结果显示,体质指数为超重和肥胖成年居民血脂异常患病风险分别为体重过轻/正常体重成年居民的1.58倍(OR=1.58,95%CI=1.36~1.82)和2.22倍(OR=2.22,95%CI=1.79~2.74),腰围为轻度中心性肥胖和重度中心性肥胖成年居民血脂异常患病风险为正常成年居民的1.49倍(OR=1.49,95%CI=1.23~1.81)和2.25倍(OR=2.25,95%CI=1.79~2.83),腰高比为肥胖成年居民血脂异常患病风险为正常成年居民的1.39倍(OR=1.39,95%CI=1.13~1.70)。结论陕西省成年居民血脂异常患病率较高,体质指数、腰围和腰高比水平与血脂异常患病密切相关,血脂异常的患病风险随肥胖程度的增加相应上升。

Objective To explore the associations of body mass index(BMI),waist circumference(WC),and waist to height ratio(WHtR)with dyslipidemia among adult residents in Shaanxi province for developing relevant intervention strategies.Methods Using stratified multistage random cluster sampling,we recruited 6202 urban and rural permanent residents aged 18 years and above in 10 regions covered by national surveillance on chronic diseases and risk factors in Shaanxi province.Face-to-face interview with the questionnaire for China Adult Chronic Disease and Nutrition Surveillance–2018,physical examination,and laboratory detections were conducted among the participants during May–November,2018.Partial correlation analysis and unconditional multivariate logistic regression were adopted in analyses on the correlations of BMI,WC,and WHtR with the risk of dyslipidemia.Results Dyslipidemia were detected in 1994(33.04%)of the 6036 participants completing the survey.Laboratory detections revealed following results:(1)the mean levels(mmol/L)of the participants with underweight or normal weight/overweight/obesity were 4.56±0.89/4.75±0.95/4.79±0.90 for total cholesterol(TC),1.42±0.99/1.80±1.24/2.14±1.39 for triglyceride(TG);2.61±0.78/2.79±0.82/2.79±0.81 for low-density lipoprotein cholesterol(LDL-C),and 1.45±0.37/1.28±0.32/1.17±0.30 for high-density lipoprotein cholesterol(HDL-C);(2)the mean levels(mmol/L)of the participants with normal WC/mild central obesity/severe central obesity were 4.52±0.90/4.73±0.89/4.83±0.98 for TC,1.36±0.96/1.76±1.05/2.08±1.57 for TG,2.59±0.77/2.77±0.79/2.82±0.86 for LDL-C,and 1.46±0.37/1.31±0.33/1.21±0.31 for HDL-C;and(3)the mean levels(mmol/L)of the participants with normal WHtR/obesity were 4.46±0.88/4.76±0.92 for TC,1.32±0.95/1.83±1.24 for TG,2.55±0.76/2.78±0.81 for LDL-C,and 1.46±0.37/1.29±0.34 for HDL-C,respectively.There were significant differences in levels of TC,TG,HDL-C,and HDL-C among the participants with different BMI,WC,and WHtR(all P<0.001).Partial correlation analysis showed that BMI,WC,and WHtR were correlated positively with TC,TG and LDL-C but negatively with HDL-C(all P<0.001).After adjusting for gender,age,education,annual household income per capita,place of residence,smoking,and alcohol drinking,the results of multivariate logistic regression analysis demonstrated that the participants with overweight and obesity were at significantly higher risk of dyslipidemia,with the odds ratio(OR)(95%confidence interval[95%CI])of 1.58(1.36–1.82)and 2.22(1.79–2.74)compared to the participants with underweight/normal weight;the results also showed that the risk of dyslipidemia was significantly higher for the participants with mild central obesity(OR=1.49,95%CI:1.23–1.81)and severe central obesity(OR=2.25,95%CI:1.79–2.83)in comparison with the participants with normal body weight;the dyslipidemia risk was significantly higher(OR=1.39,95%CI:1.13–1.70)for the participants with the WHtR indicating obesity contrasting to the participants with normal WHtR.Conclusion The prevalence of dyslipidemia was high among adult residents in Shaanxi province;the dyslipidemia prevalence was closely correlated with BMI,WC,and WHtR and increased with obese conditions.