中国中老年人肥胖表型与高血压风险关联队列研究

Association between obesity phenotype and hypertension in middle-aged and elderly adults in China:a cohort study

【目的】探讨肥胖表型与我国中老年人高血压发病风险的关联性,为我国中老年人群高血压的防治提供参考依据。【方法】基于中国健康与养老追踪调查(CHALRS)数据,将参加2011年和2015年2次调查且基线年龄≥45岁的中老年人群纳入研究对象。肥胖表型根据体重和代谢状态分为代谢正常非超重/肥胖组(MHNO)、代谢正常超重/肥胖组(MHO)、代谢异常非超重/肥胖组(MANO)及代谢异常超重/肥胖组(MAO)。采用Cox比例风险回归模型分析各肥胖表型与高血压发病风险的关联性。【结果】共纳入3781个研究对象,其中男性1775人(46.95%),平均年龄为(57.76±8.57)岁。经过4年随访,高血压发病率为22.59%,控制性别、年龄等混杂因素后,MHO、MANO和MAO组高血压的发病风险显著高于MHNO组(均P<0.01),其HR值和95%CI分别为1.35(1.11~1.63)、1.51(1.15~1.97)、2.00(1.68~2.38)。【结论】MHO表型和代谢不健康表型(MAO/MANO)均会显著增加中老年人高血压发病风险。

[Objective]To investigate the association between obesity phenotype and the occurrence of hypertension in middle-aged and elderly adults in China.[Methods]Data were obtained from the China Health and Retirement Longitudinal Study(CHARLS)in 2011 and 2015.Participants who completed two visits with≥45 years old age at baseline were enrolled.Obesity phenotype was defined as the following four groups according to weight and metabolic status:metabolically healthy non-overweight/obesity(MHNO),metabolically healthy overweight/obesity(MHO),metabolically abnormal non-overweight/obesity(MANO),and metabolically abnormal overweight/obesity(MAO).Cox proportional risk regression model was used to analyze the relationship between obesity phenotype and the incidence of hypertension.[Results]A total of 3781 subjects with 1775(46.95%)males and mean age of(57.76±8.57)years were included in this study.When the metabolically normal nonoverweight/obese group(MHNO)was regarded as the reference group,the risk of developing hypertension was significantly increased(P<0.01)in MHO,MANO,and MAO with HRs of 1.35(1.11-1.63),1.51(1.15-1.97),and 2.00(1.68-2.38)respectively.[Conclusion]Both MHO phenotype and MAO/MANO are significantly associated with the occurrence of hypertension in middle-aged and elderly adults.