中老年人群腰围对颈动脉斑块检出率的影响

Effect of Waist Circumference on the Detection Rate of Carotid Plaque in the Middleaged and Elderly People

目的探讨中老年人群腰围增加对颈动脉斑块检出率的影响。方法从开滦（集团）有限责任公司2006~2007年度健康体检的10510名职工中随机分层抽取5852名职工为观察对象,符合入选标准的（年龄≥40岁、既往无缺血性脑卒中、短暂性脑缺血发作及心肌梗死者）5440名,其中腰围资料缺失3名,最终纳入统计分析的有效数据为5437名,其中男性3255名,女性2182名,年龄40~94岁,平均55.2±11.8岁。依据2006~2007年度基线腰围测量值将观察对象分为中心性肥胖组和非肥胖组,同时依据基线腰围测量值将观察对象分为第一分位组、第二分位组、第三分位组和第四分位组,比较2010年颈动脉斑块的检出率。采用多因素Logistic回归分析腰围增加对颈动脉斑块检出率的影响。结果中心性肥胖组颈动脉斑块检出率高于非肥胖组（57.1%比42.9%,P〈0.01）。随着腰围的增加,颈动脉斑块检出率逐渐升高,第一分位组、第二分位组、第三分位组和第四分位组颈动脉斑块检出率分别为43.6%、53.0%、58.0%和61.0%。影响颈动脉斑块检出率的多因素Logistic回归分析显示,与第一分位组比较,第二分位组、第三分位组和第四分位组均增加颈动脉斑块检出率的风险,OR值分别为1.203、1.305、1.302。结论中老年人群腰围增大增加颈动脉斑块形成的风险。

Aim To explore the effect of waist circumference（ WC） on the detection rate of carotid plaque in the middle-aged and elderly people. Methods Prospective cohort study method was used in this study. A total of 5852 individuals were stratified randomly and selected from the 101510 participants in Tangshan Kailuan Company community in2006 ~ 2007 health examination survey. A total of 5440 people（ age above 40 years old,free of stroke,free of TIA or free of mycardial infarction） were enrolled in this study. A total of 3 individuals who had no waist circumference information were excluded and thus 5437 subjects were included for final analysis. It contained 3255 males and 2182 females,the average age was 55. 2 ± 11. 8 years. According to the baseline WC measurement and its quartile in the health examination during 2006 ~ 2007,the observed subjects were divided into two groups（ central obesity group and non-obesity group） or four groups（ first,second,third and forth quartile groups）. Multiple Logistic regression analysis was used to test the relation between the change in WC and the detection rate of carotid plaques. Results The detection rate of carotid plaques in central obesity group was higher than that in non-obesity group（ 57. 1% vs. 42. 9%,P 〈0. 01）. Along with increasing WC in the 4 quartile groups,the detection rate of carotid plaques was progressively increased,being43. 6%,53. 0%,58. 0%,and 61. 0%,respectively in the total population. Multiple Logistic regression analysis showed that compared with the first quartile group,the second,third and forth quartile groups had increased risk of carotid plaques,the OR value was 1. 203,1. 305 and 1. 302,respectively. Conclusion The detection rate of carotid plaques was increased with increasing WC in the middle-aged and elderly population.