体质量指数<25kg/m^2的肥胖:一个高血压相关的危险因素?  

Obesity with Body Mass Index <25 kg/m^2:A Risk Factor for Hypertension?

作　　者：沈喜妹[1] 杨立勇[1] 严孙杰[1] 黄凌宁[1] 张松菁[1] 易如海[1] 颜晓芳[1] 

机构地区：[1]福建医科大学附属第一医院内分泌科,福建福州350005

出　　处：《中华高血压杂志》2010年第11期1048-1052,共5页Chinese Journal of Hypertension

基　　金：福建省教育厅科技项目(JA05263)

摘　　要：目的探讨体质量指数(BMI)<25kg/m2但总体脂肪含量(%BF)增加的肥胖是否为高血压的危险因素。方法入选BMI介于18.5～24.9kg/m2的福州地区成人785例;双能X线骨密度仪(DEXA)检测%BF,将%BF≥25%(男)或%BF≥35%(女)者定义为隐性肥胖。疾病关联度应用χ2检验的比数比(OR值)分析,疾病危险度分析用非条件logistic回归。结果①BMI<25kg/m2的成人隐性肥胖检出率男、女分别为19.4%、23.6%,隐性肥胖的高血压检出率明显高于非肥胖者(男24.1%比9.8%,女22.6%比8.8%,均P<0.01)。BMI<23kg/m2的男、女隐性肥胖检出率分别为6.7%、10.1%,隐性肥胖男女伴随的高血压检出率分别为25.0%、26.1%。②与非肥胖组比较,BMI<25kg/m2的隐性肥胖者患高血压的OR值男性:2.913(95%CI1.575～5.389),女性:3.021(95%CI1.560～5.850);校正年龄影响,则OR值男性:2.692(95%CI1.445～5.015),女性:2.362(95%CI1.203～4.637);下调BMI<23kg/m2,则OR值男性:3.832(95%CI1.046～12.128),女性:3.484(95%CI1.144～10.603)。③非条件logistic回归分析显示男、女隐性肥胖对非肥胖高血压患病的OR值分别为1.663、2.451。结论 BMI<25甚至<23kg/m2的成人同样存在着不容忽视的"肥胖",后者可能是高血压相关的危险因素。Objective To investigate whether the subjects with body mass index （BMI） 〈25 kg/m^2 , but high body fat （BF） content are at a higher risk for hypertension. Methods Seven hundred eighty-five subjects with BMI ranged from 18.5 to 24.9 kg/m^2 in Fuzhou were recruited. The percentage of BF was measured using dual-energy X ray ahsorptiometry （DEXA）. Percentage of BF ≥25% in male or ≥35% in female were defined as normal weight obesity （NWO）. The odd ratio （OR） of hypertension was analyzed by chi-square test, the disease risk was analyzed by logistic regression. Results （1）In subjects with BMI 〈25 kg/m^2 , the relevance ratio of NWO in men and women were 19.4 % and 23.6 % respectively; the prevalence of hypertension has a remarkable increase compared to the normal group （ 24.1% vs9.8% inmale, 22.6% vs8.8% infemale, P〈0.01）. WithBMI〈23kg/m^2, the ratios of NWO in men and women were 6.7% and 10.1%, and the ratios of hypertension were 25.0% and 26.1% respectively in the group of NWO. （2） In subjects with BMI 〈25 kg/m^2 , the OR of hypertension for NWO in men and women were 2. 913（95% CI 1. 575-5. 389）and 3. 021195% CI 1. 560-5. 850）compared to the low BF group; After adjusted for age, the OR were 2. 692（95% CI 1. 445--5. 015）and 2. 362（95% CI 1. 203-4. 637） ; When down regulated to BMI 〈23 kg/m^2 , the OR were 3. 832（95% CI 1. 046-12. 128）and 3. 484（95% CI 1. 144--10. 603）.（3）With logistic regression analysis, the expectated morbidity ratio of hypertension in NWO was increased to 1. 663 for male and 2. 451 for female compared to the normal group. Conclusion Subjects with BMI 〈25 even %23 kg/m^2 still existed ＂obesity＂ that can＇t be neglected, NWO may be with a risk factor for hypertension.

关 键 词：双能X线骨密度仪 体脂含量 体质量指数 肥胖 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]