原发性高血压患者臂围、腰臂比与腹型肥胖的关系

The relationship between arm circumference,waist to arm ratio and abdominal obesity in essential hypertensive patients

目的探讨原发性高血压及代谢综合征人群臂围、腰臂比与腹型肥胖及其他传统心血管危险因素的关系。方法连续入选初诊或未经治疗的原发性高血压患者540例,以臂围28.8 cm为切点将所有入选对象分为A组（臂围≥28.8 cm）238例和B组（臂围〈28.8 cm）302例;再将所有患者分为代谢综合征组236例与非代谢综合征组304例,分别进行比较。结果 A组患者的体质量指数（BMI）、腰围、腰身比、收缩压、丙氨酸氨基转移酶（ALT）、血清肌酐（SCr）、血清尿酸（UA）、三酰甘油（TG）、空腹血糖（FPG）、血红蛋白（Hb）均高于B组（均P〈0.05）,年龄、脉压、高密度脂蛋白胆固醇（HDL—C）均低于B组（均P〈0.05）。代谢综合征组患者的腰臂比、BMI、腰围、腰身比、臂围及AIT、UA、TG、TC、FPG等代谢指标高于非代谢综合征组（均P〈0.05）,而HDL—C低于非代谢综合征组（P〈0.01）。直线相关分析显示高血压人群臂围与腰围、腰臂比与腰围均呈正相关（r=0.688、0.703,P均〈0.01）。代谢综合征患者臂嗣与腰围、腰臂比与腰围亦呈正相关（r=0.683,r=0.706,均P〈0.01）。以腹型肥胖为因变量经多因素ogistic逐步回归分析显示,高臂嗣、高腰臂比、ALT、TG是腹型肥胖发生的危险因素,OR（95%CI）分别为13.358~71.422、8.925~49.715、1.004~1.051、1.098~1.604。腰臂比、臂围作为诊断腹型肥胖的标准,其ROC曲线下面积均大于0.7（P〈0.01）。结论臂围、腰臂比与腰围呈正相关,与诊室收缩压及ALT、SCr、UA、TG、FPG等生化指标及代谢综合征组分密切相关。臂围、腰臂比可能成为新的评价腹型肥胖程度的简易指标。

Objective To investigate whether arm circumference（AC） and waist to arm ratio＇s relationship with abdominal obesity and other traditional risk factors in patients with essential hypertension and metabolic syndrome.Methods Continuous selected newly diagnosed or untreated patients with primary hypertension 540 cases,according to arm circumference 28.8 cm as the cutoff point,all subjects were divided into group A（arm circumference≥28.8 cm） with 238 cases and group B（arm circumference 28.8 cm） of 302 cases;then all patients were divided into groups of metabolic syndrome with236 cases and non-metabolic syndrome group with 304 cases,then data were compared among groups.Results Patients of group A＇body mass index（BM1）,waist circumference,waist ratio,systolic blood pressure,alanine aminotransferase（ALT）,serum creatinine,serum uric acid,triglycerides,fasting blood glucose,hemoglobin were higher than group B（all P 0.05）,age,pulse pressure,high-density lipoprotein cholesterol（HDL-C） in group A were lower than group B（all P 0.05）.patients in group of metabolic syndrome＇WHR,BM1,waisl circumference,waist ratio,arm circumference and ALT,serum uric acid,triglycerides,total cholesterol,fasting blood glucose and other metabolic indices higher than non-metabolic syndrome group（P 0.05）,while HDL-C lower than that of non-metabolic syndrome group（P 0.01）.Linear correlation analysis showed that hypertension arm circumference and waist circumference,WHR was positively correlated with waist circumference（r=0.688,r=0.703.respectively,all P 0.01）.Metabolic syndrome arm circumference and waist circumference,WHR was positively correlated with waist circumference（r=0.683,r=0.706,all P 0.01）.Metabolic syndrome arm circumference and waist circumference,WHR was positively correlated with waist circumference（r= 0.683,r= 0.706,both P 0.01）.With abdominal obesity as the dependent variable,Multivariate Logistic regression analysis showed that high arm circumference,waist arm ratio,ALT,triglycerides are risk factors for abdominal obesity occurred,OR（95%CI） were13.358-71.422,8.925-49.715,1.004-1.051,1.098-1.604.WHR,arm circumference as the diagnosis standard of abdominal obesity,the area under the ROC curve were greater than 0.7（P 0.01）.Conclusion Arm circumference,WHR and waist circumference was positively correlated with clinic systolic and ALT,creatinine,serum uric acid,triglycerides,fasting glucose and other closely related biochemical parameters and metabolic syndrome components.Arm circumference,WHR may become a new evaluation of abdominal obesity indicators.