基于沈阳市沈河区社区居民的身体肥胖指数和正常体重肥胖与代谢综合征及其组分的关系研究

Relations of Body Adiposity Index and Normal Weight Obesity with Metabolic Syndrome and Its Components:a Cross-sectional Study Based on Community Residents Living in Shenhe District,Shenyang City

背景我国北方人群代谢综合征(MS)患病率较高,而身体肥胖指数(BAI)是一个衡量脂肪组织堆积程度的新指标,正常体重肥胖(NWO)已被证实与MS及其危险因素相关,但目前关于BAI、NWO与我国北方人群MS关系的研究报道较少。目的基于沈阳市沈河区社区居民分析BAI、NWO与MS及其组分的关系。方法2015年4—6月,采用整群随机抽样方法抽取参与当地健康调查的社区居民2338例,分析其人体测量学指标、代谢指标及生活行为因素;BAI与MS及其组分的关系分析采用多因素Logistic回归分析。结果校正年龄、吸烟状况、饮酒状况后进行的多因素Logistic回归分析结果显示:男性社区居民BAI与MS及中心性肥胖、三酰甘油(TG)升高有关(P<0.001);女性社区居民BAI与MS及中心性肥胖、血压升高、空腹血糖(FBG)升高、TG升高有关(P<0.05);在男性社区居民中,以正常体质量但BAI≥26.1者为参照,正常体质量且BAI<26.1者MS、中心性肥胖、TG升高发生风险降低,超重且BAI≥26.1者中心性肥胖发生风险升高,肥胖但BAI<26.1者血压升高发生风险升高,肥胖且BAI≥26.1者MS发生风险升高(P<0.05);在女性社区居民中,以正常体质量但BAI≥29.2者为参照,正常体质量且BAI<29.2者MS、中心性肥胖、TG升高发生风险降低,超重但BAI<29.2者血压升高、高密度脂蛋白胆固醇(HDL-C)降低风险升高,超重且BAI≥29.2者MS、中心性肥胖、血压升高发生风险升高,肥胖但BAI<29.2者HDL-C降低发生风险升高,肥胖且BAI≥29.2者MS、中心性肥胖、血压升高、FBG升高、TG升高发生风险升高(P<0.05)。结论沈阳市沈河区社区居民MS患病率较高[男性、女性分别为50.4%(386/766)、46.6%(733/1572)],BAI与其MS发生风险升高有关,且根据体质指数(BMI)和BAI评价的NWO者MS发生风险较非NWO者升高,但根据BMI和BAI评价的肥胖或超重者MS发生风险趋于接近,而BAI的常规测量可能成为监测肥胖及预防MS的好方法。

Background The prevalence rate of metabolic syndrome(MS)is relatively high in Northern China.Body adiposity index(BAI),a new indicator for estimating body fat,and normal weight obesity(NWO)have been proved to be correlated with MS and its risk factors.However,there is few reports about relations of BAI and NWO with MS in Northern China.Objective To examine the relations of BAI and NWO with MS and its components based on a survey of community residents living in Shenhe District,Shenyang City.Methods By cluster random sampling method,we extracted 2338 community residents who participated in local health survey from April to June,2015,in Shenhe District,Shenyang City.Anthropometric and metabolic indices,as well as life behavior factors were analyzed.Multivariate Logistic regression analysis was used to analyze the relations of BAI with MS and its components.Results After adjusting for age,smoking and alcohol use,multivariate Logistic regression analysis results showed that,BAI was significantly related to MS,central obesity and elevated TG in male community residents(P<0.001),and was significantly related to MS,central obesity,elevated blood pressure,elevated FBG as well as elevated TG in female community residents(P<0.05).In male community residents,compared to those with normal weight and BAI≥26.1,those with normal weight and BAI<26.1 showed lower risk of MS,central obesity,and elevated TG,those with overweight and BAI≥26.1 showed higher risk of central obesity,those with obesity and BAI<26.1 showed higher risk of elevated blood pressure,and those with obesity and BAI≥26.1 showed higher risk of MS(P<0.05).In female community residents,compared to those with normal weight and BAI≥29.2,those with normal weight and BAI<29.2 showed lower risk of MS,central obesity and elevated TG,those with overweight and BAI<29.2 showed higher risk of elevated blood pressure and lower HDL-C,those with overweight and BAI≥29.2 showed higher risk of MS,central obesity and elevated blood pressure,those with obesity and BAI<29.2 showed higher risk of lower HDL-C,those with obesity and BAI≥29.2 showed higher risk of MS,central obesity,elevated blood pressure,elevated FBG and elevated TG(P<0.05).Conclusion The MS prevalence rate is relatively high in this group of participants[which is 50.4%(386/766)and 46.6%(733/1572)in meles and females,respectively],which is associated with BAI.The risk of MS was higher in residents with NWO(evaluated by BMI and BAI)than that of those without,but the risk was similar in those with obesity and overweight.Regular evaluation of BAI may be a good method for monitoring obesity and preventing MS.