上海老年人群腰臀比与急性缺血性脑卒中发生风险研究

Association between Waist-hip ratio and risk of acute ischemic stroke in shanghai elderly population

目的探讨老年人群腰臀比(Waist-to-Hip Ratio,WHR)与急性缺血性脑卒中(Acute ischemic stroke,AIS)发生风险的关系及其临床意义。方法回顾性分析2019年花木社区随访的8375例居民的人口学信息、疾病诊断及血液生化资料。根据随访期间居民是否新发AIS将患者分为AIS组(506例)与非AIS组(7869例);比较两组患者间的数据资料,分析WHR与AIS的相关性;采用多因素二元Logistic回归分析WHR对AIS发生风险的影响。结果本研究AIS组与非AIS组居民人数百分比分别为6.04%(506/8375)与93.96%(7869/8375);AIS组与非AIS组居民WHR均值分别为(0.91±0.07)与(0.90±0.07),两组间差异有统计学意义(t=2.715,P=0.007)。两组患者间年龄、体质指数(Body Mass Index,BMI)、腰围、WHR、荤食、高血压、糖尿病、冠心病、血肌酐、低密度脂蛋白及总胆固醇等指标比较有统计学差异(P<0.05);两组间性别、收缩压、舒张压、臀围、吸烟史、饮酒史、房颤、血小板、血红蛋白、血清谷丙转氨酶、血尿素氮、空腹血糖、高密度脂蛋白及甘油三酯等指标比较无统计学差异(P>0.05)。调整混杂因素前WHR对AIS发生风险[OR(95%CI)P]为5.07(1.31,19.57)0.018,调整因素后为4.34(1.08,17.39)0.038。结论老年人群WHR升高增加AIS发生风险,上述发现对于倡导老年人群控制体重、预防脑血管疾病方面具有一定的意义。

Objective To explore the relationship between waist-hip ratio(WHR)and the risk of acute ischemic stroke(AIS)in elderly population and its clinical significance.Methods Demographic information,disease diagnosis and blood biochemical data of 8375 residents who were followed up in Huamu Community in 2019 were retrospectively analyzed.Patients were divided into AIS group(506 cases)and non-AIS group(7869 cases)according to whether residents had newly developed AIS during the follow-up period.The data between the two groups were compared to analyze the correlation between WHR and AIS.Multivariate binary Logistic regression was used to analyze the influence of WHR on the risk of AIS.Results In this study,the percentages of residents in the AIS group and non-AIS group were 6.04%(506/8375)and 93.96%(7869/8375)respectively.Mean WHR of residents in the AIS group and non-AIS group was(0.91±0.07)and(0.90±0.07),respectively,and the difference between the two groups was statistically significant(t=2.715,P=0.007).There were statistical differences in age,BMI,waist circumference,WHR,meat diet,hypertension,diabetes,coronary heart disease,serum creatinine,low density lipoprotein and total cholesterol between 2 groups(P<0.05).There were no significant differences in gender,systolic blood pressure,diastolic blood pressure,hip circumference,smoking history,drinking history,atrial fibrillation,platelets,hemoglobin,serum glutamic pyruvic transaminase,blood urea nitrogen,fasting blood glucose,high density lipoprotein and triglyceride between the two groups(P>0.05).The correlation between WHR and AIS risk[OR(95%CI)P]was 5.07(1.31,19.57)0.018 before,and 4.34(1.08,17.39)0.038 after adjusting for confounding factors.Conclusions Elevated WHR increases the risk of AIS in elderly population.These findings have certain significance for advocating weight control and prevention of cerebrovascular diseases in elderly population.