体检人群BMI与视网膜动脉硬化的相关性研究

The association between body mass index and retinal arteriosclerosis among adults having physical checkup programs

目的:探讨成人体检人群体质量指数(BMI)与视网膜动脉硬化的相关性,为早发现、早干预微小血管病变提供新证据。方法:采用横断面研究方法,选取2019年1—12月在武汉同济医院健康管理中心进行过眼底照相的常规体检者,收集每个样本人口学信息、体格测量指标、血生化指标及既往疾病史等特征,并对视网膜血管进行分级,采用多因素Logistic分析方法探讨BMI与视网膜动脉硬化的关系。结果:本研究纳入研究对象8678人,其中男性5378人,女性3300人,年龄为(48.6±10.4)岁。视网膜动脉硬化患病率在对照组(BMI<24.0 kg/m^(2))、超重组(BMI 24.0~27.9 kg/m^(2))、肥胖组(BMI≥28.0 kg/m^(2))中分别为2.0%、3.7%、6.4%,整体呈上升趋势(趋势P<0.001)。在调整了年龄、性别、高血压、糖尿病、血脂异常、高尿酸血症、谷丙转氨酶、谷草转氨酶、肾小球滤过率混杂因素后,BMI与视网膜动脉硬化患病风险成正相关关系,与对照组相比,超重组和肥胖组的OR值(95%CI)分别为1.13(0.83~1.55)、1.89(1.31~2.73),趋势P<0.001;BMI每增加1 kg/m^(2),视网膜动脉硬化患病风险OR值为1.09(1.05~1.14)。结论:超重或肥胖与视网膜动脉硬化的发生密切相关,是视网膜动脉硬化的独立危险因素。

Objective:To investigate the association between body mass index(BMI)and retinal arteriosclerosis in adults who had a physical examination,and to provide new evidence for early detection and early intervention of microvascular disease.Methods:This was a cross-sectional study.Participants who had underwent fundus photography in the health management center of Tongji Hospital during 2019 were selected.Demographic characteristics,anthropometric index,biochemical variables,and medical history were collected.Classification of retinal blood vessels was performed.Multivariate analyses were performed to assess the relationship between BMI and retinal arteriosclerosis.Results:A total of 8678 subjects(5378 males and 3300 females)were included,with an average age of(48.6±10.4)years.The prevalence of retinal arteriosclerosis in the reference group(BMI<24.0 kg/m^(2)),overweight(BMI 24.0-27.9 kg/m^(2)),and obese group(BMI≥28.0 kg/m^(2))were 2.0%,3.7%,and 6.4%,respectively,P for trend<0.001.After adjustment for several confounding factors,BMI was significantly associated with an elevated risk of retinal arteriosclerosis,with ORs(95%CI)of 1.13(0.83-1.55)and 1.89(1.31-2.73)for overweight participants and obese participants,respectively;P for trend<0.001.For every 1 kg/m^(2)increment in BMI,the risk of retinal atherosclerosis was 1.09(1.05-1.14).Conclusion:Overweight or obesity is closely related to retinal arteriosclerosis.It may be an independent risk factor for retinal arteriosclerosis.