脉压、脉压指数对肥胖预测的前瞻性队列研究

High Pulse Pressure is Associated with Increased Risk of Obesity in Middle-aged Chinese Residents

目的:分析成都地区1992年时非肥胖中年居民脉压(PP)、脉压指数(PPI)对该人群15年后(2007年)肥胖发生的预测价值。方法:本研究纳入1992年时年龄处于45～60岁且BMI正常者1017人,依据PP(PP≤60mmHg及PP>60mmHg)及PP(I PPI≤0.450及PPI>0.450)分为PP/PPI正常组及增高组,分析两组人群在15年后(2007年)BMI分布特征及肥胖的患病情况。结果:①1992年PP/PPI增高人群2007年时BMI皆高于PP/PPI正常人群,t检验示BMI组间差异有统计学意义。2007年肥胖患病率亦呈类似BMI的特点,亦为PP/PPI增高组高于PP/PPI正常组,经x2检验,肥胖患病率的组间差异有统计学意义。②根据该队列人群1992年的PP增高与否计算2007年的肥胖患病率的相对危险度(RR)为4.109,P值为0.000,95%可信区间为2.874～8.847;1992年PPI与2007年肥胖患病的RR为4.998,P值为0.000,95%可信区间为2.876～8.687。③使用logistic回归模型分析1992年基线PP/PPI对2007年肥胖患病的影响,在调整了SBP、WC、BMI、HR、TG后,PP、PPI的相对危险度仍为1.040及1.044。其各自相应95%CI分别为1.017～1.065、1.025～1.063。结论:脉压、脉压指数的异常与肥胖的发生关系密切,脉压、脉压指数可以预测肥胖的发生。

Objective: To evaluate the predictive value of pulse pressure(PP) or pulse pressure index(PPI) to obesity in middle-aged Chinese residents.Methods: A baseline survey for CVD risk factors was carried out in a general population of Chengdu in 1992,and there are 1017 subjects with normal BMI in 1992.We divided the 1017 middle-aged people into 2 groups according PP/PPI of 1992.The normal PP group means the PP of the people is less than or equal to 60 mmHg,and the normal PPI group is PPI less or equal to 0.450 in 1992.The augmented PP/PPI group is PP more than 60 mmHg and PPI more than 0.450.We analyzed the distribution of BMI and prevalence of obesity in 2007 according to PP/PPI of 1992.Results: ①The BMI of 2007 in augmented PP/PPI group is higher than that in normal group.And the difference of BMI is statistically significant.As to prevalence of obesity,the augmented PP/PPI group is also statistically higher than that in the normal group.② According to the PP in 1992,the relative risk(RR) is 4.109(P=0.000),the 95% Confidence Interval is 2.874～8.847.As to PPI,the RR is 4.998(P=0.000),the 95% Confidence Interval is 2.876～8.687.③ Using logistic regression analysis,the adjusted RR of PP and PPI in 1992 to obesity in 2007 is 1.040 and 1.044 respectively,and the 95% Confidence Interval is 1.017～1.065 and 1.025～1.063 respectively.Conclusions: The PP and PPI are closely related to the level of BMI and obesity,and high pulse pressure is associated with increased risk of obesity.PP and PPI might be able to be used for predicting the incidence of obesity.