中国成人肥胖、中心性肥胖与高血压和糖尿病的相关性研究

Association of body mass index and waist circumstance with risk of hypertension and diabetes in Chinese adults

目的评价体重指数（BMI）、腰围（WC）对高血压和糖尿病患病的影响,为制定肥胖及相关慢性病的干预策略提供科学依据。方法采用整群抽样随机抽取参加健康体检的20~80岁成年人共计79 012名,测量其身高、体重、WC、血压和空腹血糖水平,计算不同BMI、WC水平下高血压和糖尿病的患病情况,采用logistic回归分析计算肥胖、中心性肥胖对高血压和糖尿病患病的影响。结果肥胖、中心性肥胖程度与高血压和糖尿病呈剂量反应关系。BMI每增加一个标准差,高血压和糖尿病的患病风险均增加1.7倍;WC每增加一个标准差,高血压和糖尿病的患病风险分别增加1.7和2.0倍。当BMI由正常增加至≥30.0kg/m2、WC由正常增加至中心性肥胖,年龄较轻者和女性发生两种慢性病的风险较大,并且糖尿病患病风险随BMI、WC增长而增加的速度高于高血压。无论男性还是女性,超重、肥胖人群中合并中心性肥胖者的慢性病患病率普遍较高,WC与BMI联用能够更加有效地筛选慢性病高危人群。结论肥胖、中心性肥胖会增加慢性病的患病风险,应通过多种预防和治疗手段遏制肥胖及相关慢性病的进一步发展。

Objective To evaluate the influences of body mass index （BMI） and waist circumference （WC） on hypertension and diabetes among Chinese adults. Methods Seventy-nine thousand and twelve adults, aged 20-80 years old, were randomly selected in a cross-sectional survey using cluster sampling. Height, weight, WC, blood pressure （BP）, and fasting blood glucose （FBG） level were measured, the prevalence of hypertension and diabetes was calculated with reference to BMI and WC distributions. Logistic regression was used to explore the risk factors. Results BMI is positively associated with hypertension and diabetes, and WC showed the similar pattern. The adjusted odds ratios （OR） of hypertension and diabetes were 1.7 and 1.7, respectively, for 1 s.d. increase in BMI; the corresponding OR were 1.7 and 2.0, respectively, for 1 s.d. increase in WC. Younger obese people and women were at higher risk of hypertension and diabetes when BMI（≥ 30kg/m2） and WC increased. Diabetes showed a higher raising rate with BMI and WC increase than that of hypertension. The combined indicators of BMI and WC were more strongly associated with hypertension and diabetes in both men and women. Conclusion Obesity or central obesity is associated with an increased risk of hypertension and diabetes, implying a practical need of developing strategies to prevent and control obesity and related chronic diseases.