冠心病患者入院体重指数与静息心率的关系研究

Relationship between body mass index and resting heart rate at admission in patients with coronary heart disease

目的评估冠心病患者入院体重指数(BMI)与静息心率(RHR)的关系。方法收集深圳市人民医院2018年1月至2021年12月2533例冠心病患者的原始数据。排除BMI(n=914)、入院时RHR(n=155)变量数据缺失及其他协变量缺失资料(n=122)的患者,最终纳入1342例冠心病患者。采用单变量和多变量回归模型评价BMI和RHR之间的关系,为了确定BMI和RHR之间的关联,进行分层分析和交互检验,最后通过调整潜在混杂因素后的平滑曲线拟合探讨BMI和RHR之间的关系。结果BMI与入院时的RHR呈负相关(校正后的β=-0.50,95%CI-0.67~-0.33,P<0.001)。以BMI的最低组作为参考,RHR随着BMI的增加而下降(β=-1.96,95%CI-3.55~-0.37,P=0.016;β=-3.45,95%CI-5.13~-1.76,P<0.001;β=-5.35,95%CI-7.13~-3.57,P<0.001),趋势性检验P<0.001。然而,BMI和RHR之间存在非线性关系。BMI<27.6 kg/m^(2)调整后的回归系数为-0.70(95%CI-0.93~-0.48,P<0.001),而BMI≥27.6 kg/m^(2)则为0.11(95%CI-0.37~0.59,P=0.649)。结论在冠心病患者入院时,BMI与RHR呈显著负相关,存在饱和效应。

Objective To assess the relationship between the body mass index(BMI) and the resting heart rate(RHR) at admission in the patients with coronary heart disease(CHD).Methods The original data of 2 533 patients with CHD in Shenzhen Municipal People′s Hospital.The univariate and multivariate regression models were used to evaluate the relationship between BMI and RHR,and in order to determine the association between BMI and RHR,the stratified analysis and interaction tests were conducted.Lastly,the relationship between BMI and RHR was investigated by the smooth curve fitting after adjusting the potential confounding factors.Results BMI was negatively correlated with RHR at admission(adjusted β=-0.50,95%CI-0.67--0.33,P<0.001).Using the lowest group of BMI as the reference,RHR was decreased with the increase of BMI(β=-1.96,95%CI-3.55--0.37,P=0.016;β=-3.45,95%CI-5.13--1.76,P<0.001,and β=-5.35,95%CI-7.13--3.57,P<0.001),trend test P<0.001.However,a nonlinear relationship existed between BMI and RHR.The regression coefficient was-0.70(95%CI-0.93--0.48,P<0.001) after BMI<27.6 kg/m^(2) adjustment,while which was 0.11(95%CI-0.37-0.59,P=0.649) for BMI ≥27.6 kg/m^(2).Conclusion BMI has significantly negative correlation with RHR at admission in the patients with CHD,and the saturation effect exists.