体重指数与腰围预测徐州市居民罹患高血压、糖尿病风险的横断面研究

A cross sectional study on the predictive value of body mass index and waist circumference for the risk of hypertension and diabetes of the residents in Xuzhou City

目的：探究体重指数（ BMI）、腰围预测高血压、糖尿病的最佳界值点及不同BMI、腰围状态下罹患疾病的风险。方法采用多阶段整群随机抽样的方法,对徐州市泉山区11个社区的2246名18岁及以上常住居民进行问卷调查和体格检查,运用受试者工作特征曲线（ ROC）分别计算出BMI、腰围预测高血压、糖尿病的最佳界值点,运用非条件logistic回归分析不同BMI、腰围状态下调查对象罹患高血压、糖尿病的风险。结果2246名调查对象BMI超重率37.3%,BMI肥胖率9.2%、中心性肥胖率44.9%,BMI预测高血压、糖尿病的最佳界值点分别为男性24.6 kg/m2、26.1 kg/m2,女性23.7 kg/m2、23.6 kg/m2；腰围预测高血压、糖尿病的最佳界值点分别为男性84.8 cm、89.9 cm,女性78.1 cm、78.1 cm。校正混杂因素后,不同类别BMI、腰围人群高血压患病的logistic回归分析表明,中心性肥胖人群的BMI正常、超重、肥胖时患高血压的风险分别是正常人群的1.529（95%CI 1.047~2.234）、2.386（95%CI 1.744~3.263）、3.755（95%CI 2.506~5.627）倍,腰围正常、BMI超重者患高血压的风险是正常人群的1.813（95%CI 1.271~2.586）倍；对糖尿病患病风险的logistic回归分析得出,中心型肥胖人群的BMI正常、超重、肥胖时患糖尿病的风险分别是正常人群的2.282（95%CI 1.225~4.252）、2.964（95%CI 1.741~5.044）、3.900（95% CI 2.077~7.322）倍,腰围正常、BMI肥胖者患糖尿病的风险是正常人群的5.016（95%CI 1.474~17.068）倍。结论男性糖尿病的BMI和腰围预测最佳界值大于高血压,女性糖尿病和高血压的预测最佳界值基本一致。中心型肥胖人群当随着BMI增加时,其罹患高血压的风险增大,腰围对血压的影响更大。

Objective To explore the optimal cut-off points of body mass index （ BMI ） and waist circumference （ WC） in predicting hypertension, diabetes, and the risk of diseases at different status of BMI and WC. Methods With the multistage randomized cluster sampling, questionnaire survey and physical examination were carried out among 2 246 permanent residents aged 18 years and over in 11 communities of Quanshan, Xuzhou. Receiver operating characteristic curves （ ROC） were used to calculate the optimal cut-off points of BMI and WC in detecting hypertension and diabetes. Non-conditional logistic regression was used to analyze the association of the risk of hypertension and diabetes with different status of BMI and WC. Results The rates of overweight, obesity based on BMI and central obesity in 2 246 subjects were 37. 3%, 9. 2%, and 44. 9% respectively. The optimal cut-off points of BMI in predicting hypertension and diabetes were 24. 6 and 26. 1 kg/m2 in men, and 23. 7 and 23. 6 kg/m2 in women, respectively. The optimal cut-off points of waist circumference in predicting hypertension and diabetes were 84. 8 and 89. 9 cm in men, and 78. 1 and 78. 1 cm in women, respectively. After adjusting for potential confounding factors, comparing with normal subjects, the risks of hypertension were 1. 529 （95%CI 1. 047-2. 234）, 2. 386 （95%CI 1. 744-3. 263）, and 3. 755 （95%CI 2. 506-5. 627） in central obesity subjects with normal weight, overweight, and obesity based on BMI, and 1. 813 （ 95% CI 1. 271-2. 586 ） in obese subjects with normal WC. Comparing with normal subjects, the risks of diabetes were 2. 282 （95%CI 1. 225-4. 252）, 2. 964 （95%CI 1. 741-5. 044）, and 3. 900 （95%CI 2. 077-7. 322） in central obesity subjects with normal weight, overweight, and obesity based on BMI, and 5. 016 （95% CI 1. 474-17. 068） in obese subjects with normal WC. Conclusion The optimal cut-off points of BMI and WC in predicting the risk of diabetes were greater than those for hypertension in men, and similar in predicting diabetes and hypertension in women. The risk of hypertension in central obesity population was＆amp;nbsp;increased with the increase of BMI. WC showed greater impact on blood pressure compared with BMI.