中老年人群腰围与臂踝动脉脉搏波传导速度的关系

The relationship between waist circumference and brachial-ankle pulse wave velocity in middle-aged and elderly populations

目的分析中老年人群腰围与臂踝动脉脉搏波传导速度(baPWV)的相关性。方法 2010年6月至2011年10月随机分层抽取唐山开滦(集团)有限责任公司≥40岁在职及离退休职工既往无脑卒中、短暂性脑缺血发作、心肌梗死者为调查对象,共5852例,进行统一问卷调查、血液生化及动脉硬化监测,依据腰围四分位数将观察对象分为腰围第一分位(<80cm)、第二分位(80~<86cm)、第三分位(86~<93cm)和第四分位组(≥93cm),比较4组高baPWV(baPWV≥1400cm/s)的占比,并用多因素Logistic回归分析腰围增加与高baPWV发生风险的关系。结果1共有5221例纳入统计分析,其中男性3131人,女性2090人,年龄40~94(55.1±11.8)岁;2有3237例baPWV≥1400cm/s,占总人群的62.0%。腰围第一分位、第二分位、第三分位和第四分位组高baPWV占总人群的比例分别为46.9%、58.2%、66.6%和75.2%(趋势P值<0.01)。3影响高baPWV的多因素Logistic回归分析显示,校正年龄、性别、体质量指数、收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、吸烟、饮酒、高敏C反应蛋白和同型半胱氨酸等混杂因素后,与第一分位组比较,第四分位组高baPWV的发生风险增加38%。结论随着腰围的增加,高baPWV占总人群的比例逐渐升高;中老年人群腰围≥93cm是高baPWV的独立危险因素。

Objective To explore the relationship between waist circumference and brachial-ankle pulse wave veloci- ty （baPWV） in middle-aged and elderly populations. Methods From June 2010 to October 2011, a total of 5852 workers aged 40 and over were enrolled from Tangshan Kailuan Group by a stratified random sampling method, and they were free of cerebral apoplexy, transient ischemic attack, and myocardial infarction. Data from unified ques- tionnaires, blood biochemistry indexes and baPWV were recorded or measured. All study workers were categorized in quartiles according to waist circumstance （%80 cm, 80 to %86 cm, 86 to %93 cm, and ~93 cm）. The rate of high baPWV （baPWV^1400 cm/s） was compared across four groups. Multivariate Logistic regression analysis was used to examine the relationship between waist circumstance and baPWV. Results 1） A total of 5221 workers with an average age of 55.1 （standard deviation： 11.8; range： 40-94） years were eligible in this study, including 3131 males and 2090 females. 2） A total of 3237 workers had baPWV of at least 1400 cm/s with an proportion of 62.0%, and this rate was 46.9%, 58.2%, 66.60% and 75.2%in the first, second, third and fourth quartile of waist circumstance, respectively （P for trend %0.01 ）. 3 ） Multivariate Logistic regression analysis showed that compared with those with waist circumstance of less than 80 cm, the odds ratio of having high baPWV was 1.38 in workers with waist circumstance ≥93 cm after adjusting for age, gender, body mass index, fast plasma glucose, to- tal cholesterol, triglyceride, low- and high-density lipoprotein cholesterol, systolic and diastolic blood pressure, smoking, drinking, high-sensitivity C-reaction protein and homocysteine. Conclusion The risk of having high baPWV was gradually increased with the increase of waist circumstance, and waist circumstance of at least 93 cm isan independent risk factor for high baPWV in middle-aged and elderly populations.