苏州工业园区成人体质指数、腰围与血脂异常的关系研究

Association of body mass index and waist circumference with dyslipidemia among adults in Suzhou Industrial Park District

目的 研究苏州工业园区成人的体质指数（body mass index,BMI）和腰围与血脂异常的相关性及两者在不同水平发生血脂异常的风险比较.方法 采用分层随机整群抽样的方法,按苏州工业园区的4个街道进行分层,每层随机选取一个社区进行整群抽样,共完成6219人的问卷调查,测量身高、体重、腰围,同时采集空腹静脉血检测总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇.采用χ2检验、Pearson相关分析以及Logistic回归进行统计描述和分析.结果 调查对象血脂异常患病率为35.9％;超重率为36.6％,肥胖率为9.6％,中心性肥胖率为49.5％.男性在体重过轻、体重正常、超重以及肥胖组的血脂异常患病率分别为13.6％、30.2％、47.7％和59.0％,女性在体重过轻、体重正常、超重以及肥胖组的血脂异常患病率分别为17.2％、27.3％、38.6％和48.8％,男性和女性血脂异常患病率均随着BMI的升高而升高（趋势χ2=139.848,P〈0.001;趋势χ2=92.387,P〈0.001）;男性腰围超标组和不超标组血脂异常患病率分别为50.2％和30.9％,女性腰围超标组和不超标组血脂异常患病率分别为40.8％和23.8％,男性和女性腰围超标组血脂异常患病率均高于不超标组（χ2=108.669,P〈0.001;χ2=110.642,P〈0.001）.总胆固醇、三酰甘油、低密度脂蛋白胆固醇与BMI呈正相关（r=0.153,P〈0.001;r=0.227,P〈0.001;r=0.192,P〈0.001）,与腰围呈正相关（r=0.138,P〈0.001;r=0.234,P〈0.001;r=0.159,P〈0.001）;高密度脂蛋白胆固醇与BMI呈负相关（r=-0.189,P〈0.001）,与腰围呈负相关（r=-0.185,P〈0.001）.在调整了年龄后,与BMI和腰围均不超标者（BMI以24.0 kg/m2为切点,腰围以85 cm、80 cm为切点）相比,男性腰围单独超标者、BMI单独超标者和两者均超标者患病风险的OR值分别为1.602、1.834和3.064;女性腰围单独超标者、两者均超标者患病风险的OR值分别为1.703和2.381,而女性BMI单独超标者患病风险与两者均不超标者比较差异无统计学意义.结论 BMI和腰围与血脂异常关系密切,女性腰围超标对血脂异常的影响更大.

Objective To study the association of body mass index （BMI） and waist circumference （WC） with dyslipidemia and the risk of dyslipidemia at different BMI and WC level among adults in Suzhou Industrial Park District. Methods A total of 6219 participants were chosen by stratified random cluster sampling method. Four streets were selected form the district first, then one community as a cluster was selected randomly from each street. Questionnaire survey, physical examination and laboratory tests were done by all subjects. Results The prevalence of dyslipidemia was 35.9%;the rates of overweight, obesity and central obesity were 36.6%, 9.6% and 49.5% respectively. The prevalence of dyslipidemia in underweight group, normal weight group, overweight group and obesity group were 13.6%, 30.2%, 47.7%and 59.0% for male, and 17.2%, 27.3%, 38.6%和 48.8% for female respectively. The prevalence of dyslipidemia for male and female both rose with BMI （χ2=139.848, P〈0.001; χ2=92.387, P〈0.001）. The prevalence of dyslipidemia in the high waist circumference group and normal group were 50.2%and 30.9%for male, and 40.8%and 23.8%for female respectively. Prevalence of groups with high waist circumference for male and female were significantly higher than normal groups （χ2=108.669, P〈0.001; χ2=110.642, P〈0.001）. Pearson correlation analysis showed that total cholesterol （TC）, triglyceride（TG）, and low density lipoprotein cholesterol （LDL-C） were positively correlated with BMI （ r=0.153, P〈0.001;r=0.227, P〈0.001;r=0.192, P〈0.001）, and were also positively correlated with WC（r=0.138, P〈0.001; r=0.234, P〈0.001; r=0.159, P〈0.001）. High density lipoprotein cholesterol（HDL-C） was negatively correlated with BMI （r=-0.189, P〈0.001） and WC （r=-0.185, P〈0.001）. Logistic regression analysis after age adjustment showed that, compared to the group with BMI〈24 kg/m2 and WC〈85 cm（male）/WC〈85 cm （female）, odds ratios （OR） for male in group with BMI〈24 kg/m2 and WC≥85 cm, group with BMI≥24 kg/m2 and WC〈85 cm and group with BMI≥24.0 kg/m2and WC≥85 cm were 1.602, 1.834 and 3.064 respectively, and ORs for female in group with BMI〈24.0 kg/m2 and WC≥80 cm and group with BMI≥24.0 kg/m2 and WC≥80 cm were 1.703 and 2.381 respectively, however, the OR for female in group with BMI≥24.0 kg/m2 and WC〈85 cm was not statistically significant （P〉0.05）. Conclusions BMI, waist circumference and dyslipidemia were closely correlated. Waist circumference is more important than BMI for female.