青年职业人群肥胖在血糖与血脂关系中的中介效应研究

Study on the mediating effect of obesity on the relationship between blood glucose and blood lipid in young occupational population

目的:探讨肥胖指标体重指数(BMI)、腰围(WC)在青年职业人群血糖与血脂关系中的中介效应,为预防青年职业人群血脂异常提供新思路。方法:依托上海市某三级医院体检中心,采用便利抽样法抽取2022年7月至12月符合纳入标准的青年职业个体,应用现场问卷调查和体检信息导出的方法进行数据收集。通过收集一般人口学资料、身高、体重、WC、空腹血糖(GLU)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等,分析肥胖在血糖与血脂异常中的中介作用。结果:共纳入研究对象1 068例(年龄18~44岁),血脂异常检出率为20.60%。BMI、WC分别与GLU、TG、TC、LDL-C均呈正相关(r_(BMI-GLU)=0.259、r_(BMI-TG)=0.369、r_(BMI-TC)=0.160、r_(BMI-LDL-C)=0.257、r_(WC-GLU)=0.279、r_(WC-TG)=0.372、r_(WC-TC)=0.166、r_(WC-LDL)-C=0.236,均P<0.05);与HDL-C呈负相关(r_(BMI-HDL)-C=-0.467、r_(WC-HDL-C)=-0.471,均P<0.05)。GLU与TG、TC、LDL-C呈正相关(r_(TG-GLU)=0.243、r_(TC-GLU)=0.136、r_(LDL-GLU)=0.151,均P<0.05);与HDL-C呈负相关(rHDL-GLU=-0.245,P<0.05)。在控制年龄、性别、高血压、吸烟及饮酒因素下,血脂水平在GLU、BMI和WC低、中、高3组中的差异具有统计学意义(P<0.001)。中介模型结果显示,在“血糖-血脂”路径中,引入中介(BMI或WC)时,血脂(TG、TC、HDL-C和LDL-C)和GLU之间的关联减弱,存在部分中介效应。结论:BMI、WC是青年职业人群血糖与血脂关系的中介变量,改善肥胖是减少青年职业人群预防血脂异常的重要途径。

Objective:To explore the mediating effect of body mass index(BMI),waist circumference(WC)on the relationship between blood glucose and blood lipids in young professionals,and to provide new ideas for preventing dyslipidemia in young professionals populations.Methods:From July 2022 to December 2022,the convenient sampling method was used to select young professional individuals who met the inclusion criteria based on the physical examination center of a tertiary hospital in Shanghai,and the data were collected by on-site questionnaire survey and physical examination information derivation.The mediating role of obesity in glycemia and dyslipidemia was analyzed by collecting general demographic information,height,weight,WC,fasting blood glucose(GLU),triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C),etc.Results:A total of 1068 subjects(age 18-44)were included in the study,and the detection rate of dyslipidemia was 20.60%.BMI and WC were positively correlated with GLU,TG,TC and LDL-C,respectively(r_(BMI-GLU)=0.259,r_(BMI-TG)=0.369 r_(BMI-TC)=0.160,r BMI-LDL=0.257,r_(WC-GLU)=0.279,r_(WC-TG)=0.372,r_(WC-TC)=0.166,r_(WC-LDL)=0.236,all P<0.05),and negatively correlated with HDL-C(r_(BMI-HDL)=-0.467,r_(WC-HDL)=-0.471,P<0.05).TG,TC and LDL-C were positively correlated with GLU(r_(TG-GLU)=0.243,r_(TC-GLU)=0.136,r_(LDL-GLU)=0.151,all P<0.05),while HDL-C was negatively correlated with GLU(r _(HDL-GLU)=-0.245,P<0.05).Under the control of age,gender,high blood pressure,smoking and drinking factors,the mean differences of GLU,BMI and WC in different levels of blood lipid levels were significantly different(P<0.001).The mediation model results showed that the association between blood lipids(TG,TC,HDL-C and LDL-C)and GLU was weakened by the introduction of the mediator(BMI or WC),and there was a partial mediation effect in the“glucose-blood lipid”pathway.Conclusion:BMI and WC are intermediary variables for the relationship between blood glucose and blood lipids in young professional population,and improving obesity is an important way to reduce the prevention of dyslipidemia in young professional population.