新疆、西藏地区35岁及以上人群身体脂肪率、内脏脂肪指数与心脏代谢性危险因素聚集的关系

Association between body fat percentage, visceral fat index and cardiometabolic risk factor clustering among population aged 35 year old or over, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region

目的 探讨我国新疆、西藏地区35岁及以上人群身体脂肪率（BFP）和内脏脂肪指数（VFI）与心脏代谢性危险因素聚集的关系。方法 2015－2016年，采用分层多阶段随机抽样，选取新疆、西藏地区35岁及以上调查对象7 571人，有效数据5 643人。危险因素聚集定义为两种及以上危险因素（高血压、糖尿病、高甘油三酯血症、低高密度脂蛋白胆固醇血症）同时存在。采用logistic回归和受试者工作特征（ROC）曲线进行分析。结果 新疆、西藏地区35岁及以上居民危险因素聚集患病率为9.78%。BFP、VFI按照四分位数分组，调整性别、年龄、民族、吸烟、饮酒、教育程度、职业劳动强度和海拔后，随着BFP或VFI水平升高，BFP或VFI与危险因素聚集关联的OR值增大。以BFP为5.0%～27.0%组OR值为1，BFP为27.1%～31.7%组、31.8%～36.6%组和36.7%～50.0%组OR值（95% CI）分别为1.15（0.86～1.54）、1.48（1.05～2.07）和1.72（1.10～2.68）；以VFI为1～6组OR值为1，VFI为7～9组、10～13组和14～30组OR值（95% CI）分别为1.20（0.81～1.79）、1.91（1.30～2.80）和3.91（2.64～5.77）。BFP、VFI预测危险因素聚集的曲线下面积（AUC）分别为0.55和0.70，差异有统计学意义（P〈0.01）。结论 BFP和VFI水平与心脏代谢性危险因素聚集相关，VFI对危险因素聚集的预测价值较好。

Objective To investigate the association between body fat percentage （BFP）, visceral fat index （VFI） and Cardiometabolic Risk Factor Clustering （CRFC）, among population aged 35 or older in Tibet and Xinjiang areas. Methods Using the stratified multi-stage random sampling method, 7 571 residents aged 35 or above were examined with international standardized examination between 2015 and 2016. Of the eligible 5 643 participants, association of BFP and VFI with CRFC was defined as having two or more of the four risk factors：hypertension, diabetes mellitus, high TG and low HDL-C, at the same time. Logistic regression analysis and receiver operating characteristic （ROC） curve analysis were employed to further explore the relationships. Results The overall prevalence of CRFC among aged 35 and older population in Tibet and Xinjiang areas was 9.78%. BFP and VFI were divided into four groups by quartile. After adjustment for age, gender, race, cigarette smoking, alcohol consumption, education attainments, and altitude of residence, ORs of CRFC seemed to have increased with BFP and VFI. Compared with people having BFP of 5.0%-27.0%, the OR（95%CI） were 1.15（0.86-1.54）, 1.48（1.05-2.07） and 1.72（1.10-2.68） for the ones who presented 27.1%-31.7%, 31.8%-36.6% and 36.7%-50.0% of BFP. Compared to people of having 1-6 of VFI, with OR （95%CI） as 1.20（0.81-1.79）, 1.91（1.30-2.80） and 3.91（2.64-5.77） for the ones having 7-9, 10-13 and 14-30 of VFI. Areas under the curve （AUC） of CRFC appeared as 0.55 for BFP and 0.70 for VFI, respectively, with statistically significant difference （P〈0.01）. Conclusion Both BFP and VFI levels were closely associated with CRFC while VFI seemed to have a better predictive value than the BFP.