上海市梅陇社区中老年高血压人群体质指数与全因死亡的关系

Correlation between body mass index and all-cause mortality in middle-aged and elderly subjects with hypertension in Meilong community, Shanghai

目的对上海市闵行区梅陇社区中老年高血压人群体格检查资料进行回顾性分析,探讨该人群体质指数(BMI)与全因死亡的关系。方法收集2007年4月—2008年12月首次参加上海市闵行区梅陇镇社区卫生服务中心体格检查的辖区常住居民中年龄≥40岁的高血压患者14618例,每年进行1次随访,随访截止时间为2012年12月31日。根据BMI分为4组:低体重组(BMI<17.9kg/m2,273例,占2.1%),正常体重组(BMI18～<23.9kg/m2,8405例,占63.9%),超重组(BMI24～<27.9kg/m2,3998例,占30.4%)和肥胖组(BMI≥28kg/m2,469例,占3.6%)。结果共随访13145例,全因死亡人数620例,平均随访时间为4.2年,总随访人年数为53625.2。采用Cox回归方法分析不同BMI分组的全因死亡风险,校正可能混杂因素后,正常体重组、超重组和肥胖组的全因死亡风险下降比例分别为41%(HR=0.59,95%CI为0.40～0.89,P<0.05)、48%(HR=0.52,95%CI为0.34～0.79,P<0.05)和56%(HR=0.44,95%CI为0.24～0.80,P<0.05)。结论年龄≥40岁的社区高血压人群中,低体重可增加全因死亡风险。

Objective To retrospectively investigate the relation between body mass index （BMI） and all-cause mortality in middle-aged and elderly subjects with hypertension in Shanghai Meilong community. Methods A total of 14 618 subjects aged 40 years or above received a baseline investigation from April 2007 to December 2008 and were followed up every year until December 31,2012. They were divided into four groups according to BMI= underweight group （n = 273, BMI〈17.9 kg/m2）, normal weight group （n = 8 405, 18 kg/m2≤BMl〈 23.9 kg/m2 ）, overweight group （n = 3 998, 24 kg/m2 ≤BMI〈27.9 kg/m2 ） and obesity group （n = 469, BMI ≥28 kg/m2）. Results A total of 13 145 subjects responded and participated in the final visit with a mean follow-up of 4.2 years and the total number of person-years of follow-up was 53 625. 2. All-cause mortality was 620 subjects. Cox regression models were used to investigate the all-cause mortality risks in four BMI groups. After adjustments for all possible confounders, all-cause mortality decreased by 41% in normal weight group （ HR = 0.59, 95 % CI 0.40- 0.89, P〈0.05）, 48 % in overweight group （HR = 0.52, 95 % CI 0. 34- 0.79, P〈0.05） and 56% in obesity group （ HR = 0.44, 95% CI 0.24 - 0.80, P 〈 0.05） compared with underweight group. Conclusion Underweight will increase the risk of all-cause death in community-dwelling subjects aged 40 years or above with hypertension.