BMI与血脂异常患病关联强度剂量-反应关系研究

Association between BMI and Dyslipidemia:A Dose-response Analysis

目的 采用限制性立方样条模型探讨BMI与血脂异常患病关联强度的剂量-反应关系。方法 2017-2018年开展南京市慢性病防控社会因素调查,对61098名18岁及以上常住居民进行问卷调查、身体测量以及实验室检测。采用复杂抽样基于设计的logistic回归模型和限制性立方样条模型分析BMI与血脂异常患病的关联强度及剂量-反应关系。结果 最终纳入60283名调查对象。血脂异常患者17093例,加权患病率为29.8%。多因素logistic回归调整混杂因素后,超重人群患血脂异常的风险是体重正常人群的1.43倍(95%CI:1.36~1.49),肥胖人群患血脂异常的风险是体重正常人群的1.97倍(95%CI:1.83~2.12)。限制性立方样条模型结果表明,女性、青年人以及中老年人群,其BMI与血脂异常患病风险均呈非线性剂量-反应关系;男性BMI与血脂异常患病风险呈线性剂量-反应关系。结论 控制体重对预防血脂异常有十分重要的作用。

Objective To explore the dose-response relationship between BMI and the prevalence of dyslipidemia using restricted cubic spline model.Methods Using data of Chronic Disease and Risk Factor Surveillance in Nanjing City from 2017 to 2018.A representative sample of 61098 residents aged≥18 years was surveyed by face-to-face questionnaire survey,anthropometric measurements and laboratory examinations.A logistic regression model of complex sampling and restricted cubic spline model were used to analyze the dose-response relationship between BMI and the risk of dyslipidemia.Results Finally,60283 subjects were included.Among them,there were 17093 dyslipidemia patients with a standardized prevalence rate of 29.8%.After adjusting for confounding factors by multiple logistic regression,participants with overweight(OR=1.43,95%CI:1.36~1.49)and obesity(OR=1.97,95%CI:1.83~2.12)had a significantly higher risk of dyslipidemia compared to those with normal weight.The multiple restricted cubic spline model indicated a non-linear dose-response relationship between BMI and the risk of dyslipidemia in women,young,middle-aged and elderly population,and a linear dose-response relationship between BMI and the risk of dyslipidemia in men.Conclusion Weight control plays a very important role in the prevention of dyslipidemia.