35岁以上人群肥胖指标与高血压的关系研究

Association between Adiposity Indicators and Hypertension over 35 Years Old

目的探讨广州地区35岁以上人群腰臀比(WHR)、腰围(WC)和体质指数(BMI)与高血压的关系。方法 2009年在广州市两个独立社区采用分层整群随机抽样的方法抽取35岁以上居民2 745人进行身高、体质量、WC、臀围、血压、心率的测量,并进行问卷调查。采用Pearson相关分析、多元逐步回归分析及受试者工作特征曲线(ROC曲线)分析各肥胖指标与高血压水平的关系。结果广州地区35岁以上居民中,不同BMI的男女居民收缩压(SBP)和舒张压(DBP)水平间差异均有统计学意义(P<0.05),而腹型肥胖组的血压水平及其高血压和高血压前期患病率均高于正常体型组,差异均有统计学意义(P<0.05)。在校正了年龄因素后,男性以WHR的OR值最高(1.526),而女性以WC的OR值最高(2.813),BMI的OR值在两性中均为最低(0.719/0.391)。ROC曲线表明,男性BMI、WC和WHR诊断高血压的切点、曲线下面积及95%CI间差异均无统计学意义;而在女性中,WC的曲线下面积最大(0.854),与BMI(0.77)、WHR(0.787)比较有统计学意义(P<0.05)。结论广州地区35岁以上人群,尤其在女性人群中,WC是反映肥胖对高血压影响的较好测量指标,而BMI和WHR可以作为有效补充。

Objective To investigate the relationship between adiposity indicators and hypertension over 35 - years old in Guangzhou, capital city of Guangdong Province. Methods Totally 2, 745 residents aged 35 years old or above were selected using random cluster sampling in two independent communities of Guangzhou. Fasting blood samples were collected for routine blood tests and biochemical examinations. Pearson＇s correlation coefficient, multiple linear stepwise regressions, and receiver operating characteristic curve （ROC） were used to analyze the relationship between adiposity indicators And hypertension. Re- suits The systolic blood pressure （ SBP）, diastolic blood pressure （DBP） showed signifiant differences among subjects with dif- ferent body mass index （BMI） （ P 〈 0. 05 ） , and the blood pressure and the prevalences of hypertension and prehypertension in subjects with abdominal obesity were significantly higher than those with normal BMI （ P 〈 0. 01 ）. Multiple linear stcpwise re- gressions revealed that, after adjustment for age, the increased waist -hip ratio （WHR） （OR = 1. 526） was the most remarkable predictor for hypertension in men, and WC （OR =2. 813） for woman. The areas under the ROC of BMI, waist circumference （WC） , and WHR were not signifsent different among male subjects with blood pressure, but the AUC for WC （0. 854 ） was highest among the studied adiposity indicators in woman （P 〈 0. 05, compared with BMI and WHR）. Conclusion WC may be an ideal adiposity indicator for predicting hypertension among Guangzhou residents over 35 years, especially for women. BMI and WHR can also provide useful information.