甘肃省武威市肥胖、中心性肥胖对高血压的交互性分析

Interactivity of obesity and central obesity on hypertension in Wuwei of Gansu province

目的分析肥胖和糖尿病、肥胖和中心性肥胖、中心性肥胖和糖尿病这三者对高血压的交互作用。方法采用多阶段随机抽样的方法于2018年9-12月在武威市凉州区纳入35~75岁的常住汉族居民7622例进行问卷调查。采用相对超危险度比、归因比和交互作用指数及三者的95%CI评价相加交互作用,采用logistic回归分析相乘交互作用。结果共检出高血压3212例,粗患病率为42.14%,标准化患病率为33.81%;高血压与性别、年龄、肥胖、中心性肥胖、吸烟、家庭经济情况、职业、糖尿病的患病情况差异均有统计学意义(均P<0.05);具有小学、初中、高中文化程度是高血压的保护因素,而肥胖、中心性肥胖、糖尿病、男性、年龄>45岁则是高血压的危险因素。多因素logistic回归分析显示,三者与高血压之间均不存在相加交互作用;高血压与肥胖和中心性肥胖之间存在着相乘交互作用(P=0.031,95%CI 0.53~0.97)并且为拮抗作用,其余两者与高血压之间不存在相乘交互作用。结论肥胖、中心性肥胖与高血压存在着负向相乘交互作用。

Objective To analyze the interaction between obesity and diabetes,obesity and central obesity,central obesity and diabetes on hypertension.Methods A questionnaire survey on 7622 residents of Han Chinese ethnicity,aged 35-75 years,of Liangzhou district of Wuwei city were performed using multi-stage random sampling method in September to December 2018.Relative excess risk due to interaction,attributable proportion,synergy index,and 95%CI of the three were used to evaluate the additive interaction.Logistic regression analysis was used to analyze the multiplicative interaction.Results Among the 7622 residents,hypertension was detected in 3212 residents,with a crude prevalence rate of 42.14%and a standardized incidence of 33.81%.There was a significant difference in incidence of hypertension between residents of different sexes,between residents at different ages,between obese residents and normal weight residents,between residents who had central obesity and those who had no central obesity,between residents who smoked and those who did not,between residents of different family economic situations,between residents who had different occupations,and between residents who had diabetes and those who had no diabetes(all P<0.05).Getting primary,middle,and high school education was a protective factor against hypertension,while obesity,central obesity,diabetes,male gender,age greater than 45 years were the risk factors for hypertension.Multivariate logistic regression analysis showed that there was no additive interaction between obesity and diabetes,obesity and central obesity,central obesity and diabetes on hypertension.There was a multiplicative interaction between obesity and central obesity on hypertension(P=0.031,95%CI:0.53-0.97)and the interaction was antagonistic,but there were no multiplicative interaction between obesity and diabetes,central obesity and diabetes on hypertension.Conclusion There was a negative multiplicative interaction between obesity and central obesity on hypertension.