湖北安陆市成年居民不同肥胖指标对高血压的预测效果

Predictive effect of different obesity indexes on hypertension in adult residents of Anlu City,Hubei Province

目的探讨安陆市成年居民身体质量指数(BMI)、腰围(WC)、腰高比(WHtR)和内脏肥胖指数(VAI)对高血压患病的预测价值。方法采用多阶段分层随机抽样的方法对安陆市成年居民进行调查。应用t检验、χ^(2)检验、Pearson相关分析和logistic回归模型进行各肥胖指标与高血压患病的分析,利用受试者工作曲线(ROC)分析不同肥胖指标对高血压患病的预测效力。结果研究共纳入2518名受试者包括705名高血压患者,患病率为28.00%。其中职业、婚姻状况、文化程度、血糖异常、血脂异常和肥胖是高血压的危险因素。BMI、WC、WHtR和VAI与收缩压和舒张压之间的相关系数分别是0.32、0.30、0.34和0.10;0.27、0.26、0.29和0.08。logistic回归分析发现,超重OR=1.79(95%CI:1.43~2.25)、肥胖OR=2.94(95%CI:2.04~4.24)、WC过大OR=1.86(95%CI:1.43~2.40)、WHtR过大OR=2.52(95%CI:1.97~3.20)和VAI较高OR=1.08(95%CI:1.02~1.15)较体重正常者有更高的患病风险。4种肥胖指标对高血压患病预测的AUC依次为WHtR(0.74)>BMI(0.70)>WC(0.69)>VAI(0.56),(P<0.001)。结论BMI、WC、WHtR和VAI与高血压之间存在正相关关系,WHtR对高血压的预测价值更高。

Objective To investigate the predictive value of body mass index(BMI),waist circumference(WC),waist to height ratio(WHtR)and visceral obesity index(VAI)in the prevalence of hypertension in adult residents of Anlu City.Methods A multi-stage stratified random sampling method was used to investigate adult residents in Anlu.T test,χ^(2) test,Pearson correlation analysis and logistic regression model were used to analyze relationship between the obesity indicators and the prevalence of hypertension.The receiver operating curve(ROC)was used to analyze the predictive power of different obesity indexes for the prevalence of hypertension.Results A total of 2518 subjects were included in this study,including 705 patients with hypertension,with a prevalence rate of 28.00%.Occupation,marital status,educational level,abnormal blood glucose,dyslipidemia and obesity were the risk factors of hypertension.The correlation coefficients of BMI,WC,WHtR and VAI with systolic blood pressure were 0.32,0.30,0.34 and 0.10,respectively,and with diastolic blood pressure were 0.27,0.26,0.29 and 0.08,respectively.Logistic regression analysis showed that overweight OR=1.79(95%CI:1.43-2.25),obesity 2.94(95%CI:2.04-4.24),waist circumference OR=1.86(95%CI:1.43-2.40),waist height ratio OR=2.52(95%CI:1.97-3.20)and higher VAI OR=1.08(95%CI:1.02-1.15)were associated with a higher risk than those with normal weight.The AUCs of the four obesity indicators for predicting the prevalence of hypertension were WHtR(0.74)>BMI(0.70)>WC(0.69)>VAI(0.56),and the difference was statistically significant(P<0.001).Conclusion BMI,WC,WHtR and VAI are positively correlated with hypertension,and WHtR has a higher predictive value for hypertension.