中国成人身体形态指数构建及其与血压水平关系

A body shape index constructed and its association with blood pressure among Chinese adults

目的构建中国成人身体形态指数(ABSI),评价其与血压水平的关联性,为研制适用于中国人群的肥胖指标提供参考依据。方法于2010年5-6月和2014年6-7月采用分层整群随机抽样方法在辽宁省沈阳、丹东和朝阳3个国民体质国家定点监测城市抽取9 592名20~69岁成人进行体质测定;应用体重、身高和腰围3个人体测量指标构建ABSI公式,根据异速生长模型,以In(腰围)为因变量,In(体重)和In(身高)为自变量进行线性回归分析,推导出男性和女性的ABSI。结果男性线性回归方程为In(腰围)=-2.641+0.700×In(体重)-0.945×In(身高)(R2=0.748,P<0.001),女性线性回归方程为In(腰围)=-2.750+0.734×In(体重)-1.060×In(身高)(R2=0.688,P<0.001);男性ABSI公式为ABSI(kg-0.7m1.945)=腰围(m)/(BMI(kg/m2)0.7×(身高(m)0.455),女性ABSI公式为ABSI(kg-0.734m2.06=腰围(m)/(BMI(kg/m2)0.734×身高(m)0.408)。本研究人群中,男性ABSI为(0.072±0.004) kg-0.7m1.945,高于女性ABSI的(0.064±0.004)kg-0.734m2.06(t=73.09,P<0.001)。相关分析结果显示,本研究构建公式计算的男性和女性ABSI均与腰围呈正相关(r=0.487和0.550,均P<0.01),与身高、体重、BMI均不存在相关关系(均P>0.05)。二分类logistic回归分析结果显示,男性ABSI 0.070~0.072和≥0.073 kg-0.7m1.945组患高血压的风险分别为ABSI<0.070 kg-0.7m1.945组的1.45倍(OR=1.45,95%CI=1.23~1.71)和1.63倍(OR=1.63,95%CI=1.38~1.92);女性ABSI 0.062~0.065和≥0.066 kg-0.734m2.06组患正常偏高血压、高血压的风险分别为ABSI<0.062kg-0.734m2.06组的1.37倍(OR=1.37,95%CI=1.10~1.71)和1.69倍(OR=1.69,95%CI=1.36~2.11)、1.66倍(OR=1.66,95%CI=1.35~2.04)和2.49倍(OR=2.49,95%CI=2.04~3.03)。结论ABSI是腰围以体重和身高标准化的中心性肥胖指标,与BMI不存在相关关系;ABSI的增加能增大中国成人患高血压的风险。

Objective To construct a body shape index(ABSI) for Chinese adults and explore the index’s association with blood pressure and to provide references for constructing an obesity index for Chinese adult population.Methods Totally 9 592 adults aged 20-69 years were recruited with stratified cluster random sampling at three of the National Physical Fitness Surveillance Monitoring Cities(Shenyang,Dandong and Chaoyang) in Liaoning province and then measurements of body weight,height and waist circumference(WC) were performed among the residents during May-June 2010 and JuneJuly 2014.The collected anthropometric data were used to derive an ABSI formula.According to the allometric model,linear regression analysis was performed with natural logarithm function In(WC) as a dependent variable and with In(body weight) and In(height) as the independent variables to derive ABSI formulas for male and female adults,respectively.Results The established linear regression equations were as following:for male:In(WC)=-2.641+0.700 × In(weight)-0.945 × In(height)(R2=0.748,P <0.001) and ABSI(kg-0.7m1.945=WC(m)/(body mass index(BMI,kg/m2)0.7×height(m)0.455)for female:In(WC)=-2.750+0.734 × In(weight)-1.060 × In(height)(R2=0.688,P <0.001) and ABSI(kg-0.734m2.06=WC(m)/(BMI(kg/m2)0.734×height(m)0.408). The ABSI of the male adults(0.072±0.004 kg-0.7 m1.945) was significantly higher than that of female adults(0.064 ± 0.004 kg-0.734m2.06)(t=73.09,P <0.001).Correlation analysis revealed that the ABSI was positively correlated with WC in both the male and female adults(r=0.487,0.550;all P <0.01),but the ABSI was not correlated with height,weight,and BMI(all P>0.05).Binary logistic regression analysis demonstrated that compared to the males with the ABSI of <0.070 kg-0.7m1.945,the males with the ABSI of 0.070-0.072 kg-0.7m1.945and≥ 0.0732 kg-0.7m1.945 were at a significantly increased risk of hypertension(odds ratio [OR]=1.45,95% confidence interval [95% CI]:1.23-1.71;OR=1.63,95% CI:1.38-1.92);while,the females with the ABSI of 0.062-0.066 kg-0.734m2.06and≥0.066 kg-0.734m2.06 were more likely to have normal high blood pressure(OR=1.37,95% CI:1.10-1.71 and OR=1.69,95% CI:1.36-2.11) and hypertension(OR=1.66,95% CI:1.35-2.04 and OR=2.49,95% CI:2.04-3.03) in comparison with the females with the ABSI <0.062 kg-0.734m2.06(P <0.01 for all).Conclusion The study constructs a body shape index based on waist circumference standardized by weight and height for Chinese adults.As a central obesity index,a body shape index is not correlated with body mass index but positively associated with the risk of hypertension in the population.