老年女性腹型肥胖与血压昼夜节律及动脉僵硬度的关系

Relationship of abdominal obesity with circadian blood pressure rhythm and arterial stiffness in elderly women

目的：探讨老年女性腹型肥胖与血压昼夜节律及动脉僵硬度的关系。方法选择老年女性353例，根据腰围将受试者分为2组，即非腹型肥胖组160例，腹型肥胖组193例。所有受试者监测颈桡动脉脉搏波传导速度（crPWV）、24 h动态血压。结果腹型肥胖组非杓型血压（32．6％ vs 10．0％）、crPWV [（11．83±1．19）m/s vs （10.90±1．04）m/s]、对称动态动脉硬化指数[（0．31±0．15） vs （0．24±0．17）]显著高于非腹型肥胖组，夜间收缩压下降率、夜间舒张压下降率显著低于非腹型肥胖组（P＜0．01）。多元线性回归分析显示，调整年龄、血脂和体质量指数后，腰围是crPWV、对称动态动脉硬化指数的主要影响因素（P＜0．05）。logistic回归分析显示，腹型肥胖是血压昼夜节律改变的主要危险因素（OR＝1．104，95％ C I：1．074～1．134，P＜0．05）。结论腹部脂肪沉积对老年女性血压昼夜节律改变及动脉僵硬度有着显著的影响，控制腰围对预防动脉硬化有着重要的意义。

Objective To study the relationship of abdominal obesity with circadian blood pressure rhythm and arterial stiffness in elderly women .Methods Three hundred and fifty-three elderly women were divided into non-abdominal obesity group （n= 160） and abdominal obesity group （n=193）according to their waist circumference .Their carotid radial pulse wave velocity（crPWV） and 24 h ambulatory blood pressure were monitored .Results The non-dipper blood pressure , crPWV and symmetric AASI were significantly higher in abdominal obesity group than in non-abdominal obesity group （32 .6% vs 10 .0% ,11 .83 ± 1 .19 m/s vs 10 .90 ± 1 .04 m/s ,0 .31 ± 0 .15 vs 0 .24 ± 0 .17 ,P〈0 .05） wile the nocturnal systolic and diastolic blood pressure were significantly lower in abdominal obesity group than in non-abdominal obesity group （P〈0 .01） .Multiple linear regression analysis showed that waist circumference was the main risk factor for crPWV and sym-metric AASI after adjustment for age ,blood lipid and BMI （P〈0 .05） .Logistic regression analysis revealed that abdominal obesity was the main risk factor for circadian blood pressure rhythm （OR=1 .104 ,95% CI：1 .074 -1 .134 ,P〈0 .05） .Conclusion Abdominal fat deposit can signifi-cantly affect circadian blood pressure rhythm and arterial stiffness in elderly women .It is of great importance to control waist circumference in preventing arteriosclerosis .