农村高血压人群体质指数与血脂水平的相关性研究

The relationship between body mass index and lipid profile among hypertensive populations in Chinese rural districts

目的探讨我国农村高血压人群中体质指数(body mass index,BMI)和血脂水平的关系。方法2008年5月~2009年7月,在安庆和连云港农村地区进行流行病学调查,测量身高体重,并检测血清总胆固醇(total cholesterol TC)、甘油三醋(triglyceride TG)和高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C),用Friedewald公式计算低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)。采用多重线性回归模型分析BMI和血脂的关系。结果 19 347名受试者纳入最终分析,其中,超重(24≤BMI<28 kg/m^2)与肥胖(BMI≥28kg/m^2)的患病率分别为38.6%和18.7%。在调整了其它影响因素后,与体重正常组相比,肥胖组的TC(β=3.00,P<0.001),TG(β=42.23,P<0.001)和LDL-C(β=3.69,P<0.001)水平升高,而HDL-C(β=-9.06,β<0.001)水平明显降低;并且在男性(TG:β_男=51.02 vsβ_女=37.67,P_(交互)<0.001;LDL-C:β_男=3.88 vsβ_女=3.14,P_(交互)=0.016;HDL-C:β_男=-12.37 vsβ_女=-7.27,P_(交互)<0.001)、吸烟(TG:β_(现在吸)=52.01 vsβ_(从不吸)=39.96,P_(交互)<0.001;LDL-C:β_(现在吸)=6.44 vsβ_(从不吸)=2.86,P_(交互)=0.018;HDL-C:β_(现在吸)=-12.53 vsβ_(从不吸)=-7.95,P_(交互)<0.001)和饮酒(TG:β_(现在饮)=50.57 vsβ_(从不饮)=39.99,P_(交互)<0.001;LDL-C:β_(现在饮)=8.15 vsβ_(从不饮)=2.46,P_(交互)<0.001;HDL-C:β_(现在饮)=-13.02 vsβ_(从不饮)=-7.74,P_(交互)<0.001)人群,BMI和TG,LDL-C以及HDL-C有更强的关联,但BMI和TC的关系在各个分层中差异无统计学意义(性别:P_(交互)=0.499,吸烟:P_(交互)=0.142,饮酒:P_(交互)=0.056)。结论超重和肥胖与血脂水平密切相关,且BMI和TG、LDL-C、HDL-C的关联性在男性、吸烟和饮酒人群中更强。

Objective The purpose of the study was to investigate the relationship between body mass index（BMI） and lipid profile among hypertensive populations in Chinese rural districts.Methods An epidemiological investigation was conducted from May 2008 to July 2009 in rural districts of Anqing and Lianyungang.Height,weight,total cholesterol（TC）,triglyceride（TG） and high-density lipoprotein cholesterol（HDL-C） were measured at baseline.Low-density lipoprotein cholesterol（LDL-C） was calculated using Friedewald formula.Multiple linear regression model was applied to evaluate the association between BMI and lipid profile.Results A total of 19 347 participants were included in the final a—nalysis.The prevalence of overweight and obesity were 38.6%and 18.7%,respectively.Compared with normal weight participants,overweight and obese population had increased TC（β = 3.00,P〈0.001）,TG（β = 42.23,P〈0.001） and LDL-C（β=3.69,P〈0.001） levels,while HDL-C（β =-9.06,P〈0.001） levels was significantly decreased.Furthermore,a stronger correlation between BMI and TG,LDL-C,HDL-C was observed in males（TG：βmale= 51.02 vs βfemale37.67,P for interaction 0.001;LDL-C：βmale=3.88 vs βfemale3.14,P for interaction = 0.016;HDL-C：βmale- 12.37 vs βfemale-7.27,P for interaction 0.001）,smokers（TG：βcurrent=52.01 vs βnever）=39.96,P for interaction 〈0.001;LDL-C：βcurrent=6.44 vs βnever）=2.86,P for interaction =0.018;HDL-C：βcurrent=- 12.53 vs βnever）=-7.95,P for interaction 〈0.001） and drinkers（TG：βcurrent 50.57 vs βnever）= 39.99,P for interaction 〈0.001;LDL-C：βcurrent= 8.15 vsβnever）2.46,P for interaction 〈0.001;HDL-C：βcurrent=-13.02 vs βnever）=-7.74,P for interaction 〈0.001）.However,there was no significant correlation between BMI and TC（sex：P for interaction = 0.499,smoking：P for interaction = 0.142,drinking：P for interaction = 0.056） in any of these stratification.Conclusions Overweight and obesity is closely related to lipid levels and stronger relationship between BMI and TG,LDL-C,HDL-C is observed in males,smokers and drinkers.