中国人群体重指数及其与心脑血管病的关系

Relationship between body mass index and major cardiovascular diseases in Chinese population

目的 分析中国人群的体重指数与主要心脑血管疾病的关系并探讨适合中国成年人的体重指数标准。方法 利用 1991年第三次全国高血压抽样调查的成年人 (18岁及以上 ) 881498人的资料。分析体重指数在中国的分布状况 ,不同体重指数人群的心血管病患病率 ;应用多因素Logistic回归分析 ,调整年龄、吸烟、饮酒等混杂因素后 ,分析不同体重指数人群的高血压、心肌梗死、脑卒中以及合并两种以上疾病的患病危险。以平均数± 1个标准差和平均数± 1 96个标准差分别作为中国成年人超重和肥胖的切点。结果 成年人体重指数均值为 2 1 7kg/m2 ± 3 1kg/m2 ,其中男性和女性分别为 2 1 5kg/m2 ± 2 9kg/m2 和 2 1 8kg/m2 ± 3 3kg/m2 ,体重指数随年龄增加呈上升趋势 ,至 45～ 5 4岁年龄组达到高峰后 ,又有一下降趋势。我国成年人超重和肥胖的体重指数切点分别是 2 4 8kg/m2 和2 7 8kg/m2 。调整年龄后 ,我国北部、西部和南部地区人群的体重指数均值分别为 2 2 4kg/m2 ± 3 3kg/m2 ,2 1 5kg/m2 ± 3 0kg/m2 和 2 1 1kg/m2 ± 2 9kg/m2 ,任意两组间差异都有显著意义 (P <0 0 1)。随体重指数升高 ,高血压、心肌梗死和脑卒中的患病呈增加趋势。多因素Logistic回归模型分析显示 ,调整年龄、吸烟和饮酒量后 ,以体重指数

Objective To study the relationship between body mass index (BMI) and major cardiovascular diseases (CVD) in Chinese population and explore an optimal range of BMI among adult Chinese in terms of prevention of CVD. Methods Relevant data of 881 498 Chinese persons aged 18 and over in the Third National Sampling Survey on Hypertension held in 1991 were collected. The distribution of body weight and height and the relationship between BMI and prevalence of CVD were analyzed. Results The average BMI was 21.7 kg/m 2±3.1 kg/m 2, 21.5 kg/m 2±2.9 kg/m 2, and 21.8 kg/m 2±3.3 kg/m 2 for the whole surveyed adults, the males and females respectively. The BMI was on the upward trend along with the age, reached the peak at the age 45～54, and then on a downward trend. The mean BMI was 22.4 kg/m 2±3.3 kg/m 2 for the northern population, 21.5 kg/m 2±3.0 kg/m 2 for the western population, and 21.1 kg/m 2±2.9 kg/m 2 for the southern population with a significantly difference between any two groups (all P<0.01). The higher the mean BMI, the greater the prevalence of hypertension, myocardial infarction and stroke. The odds ratios for hypertension, myocardial infarction and stroke among those with the BMI ≥25.0 ～<28 kg/m 2 were 2.8, 3.1, and 2.6 respectively, and were 4.8, 4.0, and 2.9 respectively among those with the BMI ≥28 kg/m 2 (all P<0.01) in comparison with the values among those with the BMI <25.0 kg/m 2 after adjustment for age, and smoking and drinking habits using multivariate Logistic regression model. The odds ratio for clustering of ≥2 kinds of diseases was 2.9～4.9 among those with the BMI ≥25～<28 kg/m 2 and 3.4～8.9 among those with the BMI ≥28 (P<0.01 in comparison with that among those with the BMI <25 kg/m 2). The risks of myocardial infarction and hypertension by BMI were greater than the risk of stroke. Conclusion BMI less than 25 kg/m 2 is considered as an optimal range among Chinese adults. The BMI values of 25 kg/m 2 and 28 kg/m 2 can be recommended as thresholds of overweight and obesity for Chinese adults aged ≥18 respectively.