肥胖测量指标对我国中老年高血压患病预测价值

目的探讨我国中老年人不同肥胖测量指标与高血压的相关性。方法对2022年12月至2023年10月浙江金华、河南济源、安徽淮南及江苏扬州等4个城市中老年人进行横断面调查,收集该地区人群的人口学资料和身体测量指标,采用Logistic分析肥胖指标与高血压的相关性,采用ROC曲线计算比较BMI、WHR、WHTR、ABSI、BRI对高血压预测的曲线下面积(AUC)及95%置信区间(CI)。结果本研究共纳入4,157例中老年人(≥45岁),男1,783例,女2,374例,高血压患病率37.94%。BMI、WHR、WHTR、BRI的高血压患病率在四分位数中有所增加,经多因素调整后,与测量指标下四分位数相比,男性BMI的OR值最高(OR=2.43,95%CI:1.62~3.63),女性BRI和WHTR的OR值较高且相似(BRI:OR=1.82,95%CI:1.47~2.27;WHTR:OR=1.80,95%CI:1.39~2.21)。男性患者BMI的AUC最高(AUC:0.61,95%CI:0.57~0.63),女性患者BRI和WHTR的AUC最高(AUC:0.61,95%CI:0.58~0.63)。结论BRI、BMI及WHTR可作为预测我国中老年人高血压的肥胖测量指标,BMI用于预测男性高血压方面,BRI和WHTR用于预测女性高血压,分别具有更好的能力。

Objective To explore the relationship between various obesity measures and hypertension among middle-aged and elderly individuals in China.Methods A cross-sectional survey was conducted on middle-aged and elderly individuals from four cities using a multi-stage,stratified,randomized whole-cluster sampling method.Demographic information and body measurements were collected,and Logistic analysis was employed to analyze the relationship between obesity indicators and hypertension.The receiver operating characteristic curve(ROC)was used to assess and compare the predictive abilities of body mass index(BMI),waist-to-hip ratio(WHR),waist-to-height ratio(WHTR),a body shape index(ABSI),and body roundness index(BRI)for hypertension.Results The study included 4,157 middle-aged and older adults(≥45 years),comprising 1,783 males and 2374 females,with a hypertension prevalence of 37.94%.Hypertension prevalence increased across quartiles for BMI,WHR,WHTR,and BRI.After adjusting for multiple factors,the odds ratio(OR)for BMI was highest among males(OR=150)compared to the lowest quartile.Among females,BRI and WHTR had higher and similar ORs(BRI:OR=1.82,95%CI:1.47~2.27;WHTR:OR=1.80,95%CI:1.39~2.21).For males,BMI had the highest area under AUC(AUC:0.61,95%CI:0.57~0.63),while for females,BRI and WHTR had the highest AUC(BRI:AUC=0.61,95%CI:0.58~0.63;WHTR:AUC=0.61,95%CI:0.58~0.63).Conclusion BRI,BMI and WHTR can be used as measures of obesity to predict hypertension in middle-aged and older adults,with BMI having a better ability to predict hypertension in the male population,and BRI and WHTR having a better ability to predict hypertension in the female population.