内脏脂肪指数对高血压的预测价值

Prediction capability of visceral adiposity index for hypertension

目的探讨内脏脂肪指数(VAI)对高血压的预测价值。方法纳入“多国人群心血管疾病趋势及决定因素方案”调查研究中,来自四川成都社区的711名研究对象,所有研究对象在1992年测量身高、体质量、腰围和血压,测定血生化指标,在2007年重复一次上述检测。采用多因素Cox回归分析VAI、腰围和体质量指数(BMI)预测高血压的价值,并且使用受试者工作特征曲线来检测VAI、腰围和BMI的预测能力。结果调整混杂因素后,与VAI、腰围和BMI的第1四分位组比较,第4四分位组的高血压发生的HR(95%CI)分别是1.535(1.075~2.193),2.245(1.550~3.251)、2.385(1.673~3.398)。受试者工作特征曲线下面积(AUC)结果显示,相比于VAI(AUC=0.589),腰围(AUC=0.649)和BMI(AUC=0.648)显示出有更好的识别高血压的能力(均P<0.001)。结论VAI可以预测高血压的发生,但是相比于腰围、BMI,VAI没有更好的预测能力。

Objective To investigate the prediction capability of visceral adiposity index(VAI)for hypertension.Methods A total of 711 subjects were included from communities in Chengdu,Sichuan province,China,as a part survey of"Programme on trends and determinants of cardiovascular disease in a multinational population".All subjects underwent examinations including body height,weight,waist circumference,blood pressure and blood biochemical indicators in 1992 and 2007,respectively.Multivariate Cox regression analysis was used to assess the prediction capability of VAI,waist circumference and body mass index(BMI)for hypertension,and the receiver operating characteristic curve(ROC)were further performed to examine their discrimination.Results After adjusting for confounders,compared with the lowest quartile group,the hazard ratios(95%CI)of VAI,waist circumference and BMI in the highest quartile group were 1.535(1.075-2.193),2.245(1.550-3.251)and 2.385(1.673-3.398)for the incidence of hypertension,respectively.ROC analysis showed that compared with VAI[area under the curve(AUC)=0.589,P<0.001],waist circumference(AUC=0.649,P<0.001)and BMI(AUC=0.648,P<0.001)had better performance in discrimination for hypertension.Conclusions VAI can predict the incidence of hypertension,yet its discrimination for hypertension is not better than BMI and waist circumference.