广西瑶族成人肥胖指标与血脂异常和高血压的关系

Comparison of different obesity indicators with dyslipidemia and hypertension in adults of Guangxi Yao ethnic group

目的 了解广西瑶族人群中各肥胖指标与血脂异常和高血压的关系。方法 于2015年采用多阶段整群随机抽样的方法检测广西784名18岁及以上瑶族居民的体成分数据,通过受试者工作特征(receiver operating characteristic, ROC)曲线分析比较各肥胖指标与血脂异常和高血压的关系。结果 58.80%调查对象患有血脂异常,男女差异无统计学意义(χ^(2)=0.24,P>0.05);15.94%患有高血压,男性显著高于女性(χ^(2)=4.76,P<0.05)。以血脂异常为因变量绘制ROC曲线,结果显示:瑶族成年人群中,对血脂异常患病风险预测效果最好的指标,男性是腰臀比(waist-to-hip ratio, WHR)(AUC=0.62,95%CI 0.56-0.68),切点为0.86;女性是腰围(AUC=0.64,95%CI 0.59-0.69),切点为75.50 cm。以高血压为因变量绘制ROC曲线,瑶族成年人群中,对高血压患病风险预测效果最好的指标,男性是内脏脂肪含量(AUC=0.62,95%CI 0.56-0.68),切点为0.65 kg;女性是WHR(AUC=0.67,95%CI 0.62-0.72),切点为0.82。结论 相较于体质指数、体脂率等反映全身肥胖的指标,腰围、WHR、内脏脂肪含量等反映腹型肥胖的指标与瑶族人群血脂异常和高血压两种代谢性疾病的关系更密切。

OBJECTIVE To investigate the relationship between obesity indicators and dyslipidemia and hypertension in the Yao population of Guangxi.METHODS In 2015, we examined the body composition data of 784 Yao residents aged 18 years or older in Guangxi using a multi-stage whole-group random sampling method, analyzed the association between 10 indicators responding to the degree of obesity and dyslipidemia and hypertension, and analyzed the predictive value of each obesity indicator for dyslipidemia and hypertension by receiver operating characteristic(ROC) curves.RESULTS There were 58.80% of Yao adults with dyslipidemia, with no difference between men and women(χ^(2)=0.24, P>0.05);15.94% of Yao adults had hypertension, with a higher prevalence in men than in women(χ^(2)=4.76, P<0.05). ROC curves plotted with dyslipidemia as the dependent variable showed that the best predictor of risk of dyslipidemia prevalence in the Yao adult population was waist-to-hip ratio(WHR)(AUC=0.62, 95% CI 0.56-0.68) with a cut point of 0.86 in men and waist circumference(AUC=0.64, 95% CI 0.59-0.69) with a cut point of 75.50 cm in women. The ROC curves were plotted with hypertension as the dependent variable, and the result showed that the best predictor of risk of hypertension in the Yao adult population was: visceral fat content(AUC=0.62, 95% CI 0.56-0.68) with a cut point of 0.65 kg in men and WHR(AUC=0.67, 95% CI 0.62-0.72) with a cut point of 0.82 in women.CONCLUSION Compared with indicators reflecting general obesity such as body mass index and percentage of body fat, indicators reflecting abdominal obesity such as waist circumference, WHR and visceral fat content are more closely related to two metabolic diseases such as dyslipidemia and hypertension in the Yao population.