低脂联素血症与中国大城市老年人群腰围及体质指数相关性研究

Associations of waist circumference and body mass index with hypoadiponectinemia in older adults in major cities in China

目的比较中国大城市老年人群体质指数(BMI)及腰围与脂联素的相关性强度。方法从2002年营养与健康状况调查数据中选取大城市60岁以上老年人为研究对象,共2049人,检测他们血浆的脂联素浓度,并进行脂联素浓度与BMI及腰围的相关性分析。结果脂联素的浓度随年龄的增加而升高,女性高于男性。脂联素水平随BMI及腰围的增加而降低。校正年龄和性别后,与第一四分位组比,脂联素浓度在BMI的第二、第三及第四分位组中分别降低15%、26%及28%,而在腰围的第二、第三及第四分位组中分别降低25%、31%及35%。BMI及腰围每增加一个标准差,脂联素水平分别下降13%及15%。校正腰围后,BMI与脂联素浓度不再相关,反之,校正BMI后,腰围与脂联素水平的相关性依然存在。以脂联素第25分位浓度(7.8μg/ml)作为切点,低于此浓度判定为低脂联素血症,腰围与BMI的增加均使低脂联素血症发生的危险度上升,腰围与BMI每增加1个标准差,OR值分别为1.46(95%CI:1.32～1.62)及1.32(95%CI:1.19～1.47)。结论与BMI相比,中国大城市老年人群的腰围与脂联素水平的相关性更高。提示与全身性肥胖相比,脂联素与向心性肥胖更相关。

Objective To assess and compare the associations of body mass index （BMI） and waist circumference with plasma adiponectin levels in older adults in major Chinese cities. Methods A total of 2049 adults aged 60 - 96 years from 18 major cities of the China National Nutrition and Health Survey in 2002 were included. Plasma adiponectin concentrations were measured and the associations of adiponectin with waist circumference and BMI were analyzed. Results Adiponectin concentrations increased with increasing age and were higher in women than in men. Adiponectin concentrations decreased with increasing BMI and waist circumference. After adjusting for age and sex, the adiponectin concentration decreased 15%, 26% and 28% in the 2nd the 3rd and the 4th BMI quartile groups, and 25%, 31% and 35 % for the 2nd, 3rd and 4th in waist circumference quartiles, respectively, relative to the values in the corresponding I st quartiles. One standard deviation （SD） increase in BMI and waist circumference was associated with 13% and 15% decrease in the adiponectin concentrations, respectively. After adjusting for waist circumference, BMI was no longer significantly associated with adiponectin while the association between waist circumference and adiponectin remained significant after adjusting for BMI. Odds ratios for hypoadiponectinemia were 1.46 （95% CI： 1.32 - 1.62） and 1.32 （95 % CI： 1.19 - 1.47） corresponding to 1 SD increase in waist circumference and BMI, respectively. Conclusion The association between waist circumference and adiponectin is stronger than the association between BMI and adiponectin in older Chinese adults. This implies that adiponectin level is more correlated with visceral obesity than with whole body obesity.