糖脂代谢指标对中老年高血压体检人群体质量指数的影响分析

Glucolipid metabolism indicators on body mass index of middle-aged and elderly people with hypertension undergoing physical examination

目的研究中老年高血压体检人群体质量指数(BMI)分布并探讨糖脂代谢对BMI的影响。方法选取2019年4月至2021年4月在四川大学华西医院中老年体检人群576例为样本,详细采集基本资料并测量BMI、收缩压(SBP)、(DBP)、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(IR)、餐后2 h血糖(2hPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)及低密度脂蛋白(LDL-C)等指标,诊断高血压、糖尿病、肥胖和高脂血症发生情况,分析糖脂代谢对中老年高血压患者BMI的影响。结果576例研究对象确诊高血压119人(20.66%),超重227人(39.41%),肥胖53人(9.20%),糖耐量受损(IGT)113人(19.62%),糖尿病83人(14.41%),高脂血症93人(16.15%),高血压组肥胖、IGT、糖尿病和高脂血症发病率高于非高血压组,差异均有统计学意义(P<0.05)。超重组和肥胖组HbA1c、2hPG和HOMA-IR高于偏瘦或正常组,且肥胖组HbA1c、2hPG和HOMA-IR高于超重组,差异有统计学意义(P<0.05);肥胖组血清TG高于偏瘦或正常组,超重组和肥胖组血清LDL-C水平高于偏瘦或正常组,且肥胖组LDL-C水平高于超重组,差异有统计学意义(P<0.05)。肥胖组IGT、糖尿病和高脂血症发生率均高于超重组以及偏瘦或正常组,差异有统计学意义(P<0.05);多元线性回归分析显示FINS、HOMA-IR、HDL-C和LDL-C为中老年高血压患者BMI影响因素(P<0.05)。结论中老年高血压患者超重、IGT、肥胖、糖尿病和高脂血症发生率明显升高,且胰岛素抵抗和血脂代谢异常均可对BMI增加造成明显影响,可能在肥胖发生和进展中占有重要地位。

Objective To study the distribution of body mass index(BMI)of middle-aged and elderly people with hypertension undergoing physical examination and to explore the effects of glucolipid metabolism on BMI.Methods A total of 576 middle-aged and elderly people who underwent physical examination in the hospital between April 2019 and April 2021 were selected as samples.The basic data were collected in detail and BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),fasting insulin(FINS),glycosylated hemoglobin(HbA1c),insulin resistance index(IR),2 h postprandial blood glucose(2hPG),total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)were measured.The occurrence of hypertension,diabetes mellitus,obesity and hyperlipidemia were statistically analyzed,and the effects of glucolipid metabolism on BMI of middle-aged and elderly people with hypertension were analyzed.Results Among the 576 study subjects,there were 119 cases of hypertension(20.66%),227 cases of overweight(39.41%),53 cases of obesity(9.20%),113 cases of impaired glucose tolerance(19.62%),83 cases of diabetes mellitus(19.62%)and 93 cases of hyperlipidemia(16.15%).The incidence rates of obesity,IGT,diabetes mellitus and hyperlipidemia in hypertension group were higher than those in non-hypertension group(P<0.05).The levels of HbA1c,2hPG and HOMA-IR were higher in overweight group and obesity group than those in thin or normal group,and were higher in obesity group than those in overweight group(P<0.05).Serum TG in obesity group was higher than that in thin or normal group,and the level of serum LDL-C was higher in overweight group and obesity group than that in thin or normal group and was higher in obesity group than that in overweight group(P<0.05).The incidence rates of IGT,diabetes mellitus and hyperlipidemia in obesity group were higher compared with those in overweight group and thin or normal group(P<0.05).Multiple linear regression analysis showed that FINS,HOMA-IR,HDL-C and LDL-C were the influencing factors for BMI in middle-aged and elderly patients with hypertension(P<0.05).Conclusion The incidence rates of overweight,IGT,obesity,diabetes mellitus and hyperlipidemia are significantly increased in middle-aged and elderly patients with hypertension.In addition,insulin resistance and abnormal lipid metabolism can significantly affect the increase of BMI,which may play an important role in the occurrence and progression of obesity.