不同腹型肥胖指标对老年人群心血管疾病的预测价值比较研究

Comparative study on the predictive values of different abdominal obesity indicators for cardiovascular disease in the elderly population

目的探讨体质指数(body mass index,BMI)、腰围(waist circumference,WC)、腰臀比(waist-to-hip ratio,WHR)、身体形态指数(a body shape index,ABSI)和身体圆度指数(body roundness index,BRI)与心血管疾病(cardiovascular disease,CVD)的相关性,并比较这些指标在老年CVD患者中的临床预测价值。方法选取来自中国老年健康影响因素跟踪研究2017—2018年调查的5594名受试者为研究对象;根据医生诊断CVD,定义为心肌梗死、心绞痛、冠心病和脑卒中的复合终点;通过logistic回归探索不同腹型肥胖指标与CVD的相关性,并计算C指数比较不同腹型肥胖指标对CVD的预测价值。结果多因素logistic回归结果显示BMI、WC、ABSI、BRI与老年人群CVD均具有相关性(P<0.05),其中BRI的OR值最为显著,OR值为1.113(95%CI:1.062~1.166),而WHR与心血管疾病无统计学关联(P>0.05)。在老年女性人群中,仅有WC对预测心血管疾病的C指数有统计学意义,为0.541(95%CI:0.511~0.572);在老年男性人群中,基于BMI,WC和BRI预测CVD的C指数均有统计学意义,其中BRI计算的C指数最大,为0.555(95%CI:0.522~0.687)。结论BMI、WC、ABSI、BRI与老年人群CVD密切相关,其中WC对女性CVD的预测价值更高,而BRI对男性CVD的预测价值更高。

Objective To explore the correlations of body mass index(BMI),waist circumference(WC),waist-to-hip ratio(WHR),a body shape index(ABSI)and body roundness index(BRI)with cardiovascular disease(CVD),and to compare the clinical predictive values of these indicators in elderly CVD patients.Methods A total of 5,594 participants from the Chinese Longitudinal Healthy Longevity Study(CLHLS)from 2017 to 2018 were selected as the study subjects.Physician-diagnosed CVD was defined as the composite endpoint of myocardial infarction,angina pectoris,coronary heart disease and stroke.Logistic regression was used to explore the correlations between different indicators of abdominal obesity and CVD,and the C index was calculated to compare the predictive values of different indicators of abdominal obesity for CVD.Results The results of multivariate logistic regression analysis revealed that BMI,WC,ABSI and BRI were all associated with CVD in the elderly(all P<0.05),and BRI was most significantly associated with CVD(OR=1.113,95%CI:1.062-1.166),while WHR was not statistically associated with CVD(P>0.05).In female elderly population,only WC was statistically significant for predicting the C index of CVD(C=0.541,95%CI:0.511-0.572).In male elderly population,BMI,WC and BRI were statistically significant for predicting the C index of CVD,and the C index based on BRI was the largest(C=0.555,95%CI:0.522-0.687).Conclusion BMI,WC,ABSI and BRI are closely related to CVD in the elderly population.WC has a higher predictive value for CVD in women,while BRI has a higher predictive value for CVD in men.