中国成年人超重和肥胖与高血压发病关系的随访研究  

Relationship between overweight/obesity and hypertension among adults in China： a prospective study

作　　者：冯宝玉[1] 陈纪春[1] 李莹[1] 黄建凤[1] 李建新[1] 赵连成[1] 曹杰[1] 刘小清[2] 黄辰[1] 邓颖[3] 阮连生 郭东双 俞玲[6] 陈娜萦[7] 杨睿海 杨小平 顾东风[1] 

机构地区：[1]北京协和医学院中国医学科学院阜外医院国家心血管病中心心血管疾病国家重点实验室流行病研究部,100037 [2]广东省心血管病研究所广东省人民医院广东省医学科学院流行病学研究室,广州510080 [3]四川省疾病预防控制中心慢性非传染性疾病预防控制所,成都610044 [4]浙江省舟山市普陀心脑血管病防治研究所普陀人民医院心内科,舟山316100 [5]山西省盂县人民医院心血管病研究室,阳泉045100 [6]福建省立医院心内科,福州350001 [7]广西壮族自治区疾病预防控制中心慢性非传染性疾病防制所,南宁530021 [8]陕西省汉中市心血管病研究所,723000 [9]金坛区疾病预防控制中心慢性非传染性疾病防制科,常州213200

出　　处：《中华流行病学杂志》2016年第5期606-611,共6页Chinese Journal of Epidemiology

基　　金：国家“十一五”科技支撑计划（2006BA101A01）;国家“十二五”科技支撑计划（2011BAI11B03,2011BA109803）;北京市自然科学基金（2015-BZJ01）

摘　　要：目的探讨中国成年人超重和肥胖与高血压发病的关系。方法研究对象来自中国心血管病流行病学多中心协作研究和中国心血管健康多中心合作研究，两项研究分别于1998年和2000--2001年开展基线调查，并在2007--2008年开展统一的健康状况随访。共纳入13739名研究对象进入最终分析，按照BMI将研究对象分成四组：低体重组（〈18．5kg／m2）、正常体重组（18．5-23．9kg／m2）、超重组（24．0—27．9kg／m2）和肥胖组（≥28．0kg／m2）。计算四组人群年龄标化的高血压累积发病率；并以正常体重组为参照，使用广义线性回归模型计算其他三组高血压发病风险RR值及其95％CI。结果本研究平均随访8．1年，确诊新发高血压4271例，其中男性2012例，女性2259例。低体重组、正常体重组、超重组和肥胖组的年龄标化高血压累积发病率分别为21．6％、30．6％、42．4％和50．8％，随着BMI的升高而升高（趋势P〈0．001）。以正常体重组为参照调整协变量，男性低体重组、超重组和肥胖组的RR值（95％CI）分别为0．78（0．64—0．95）、1．22（1．13～1．30）和1．28（1．16～1．42）；女性分别为0．89（0．77～1．03）、1．16（1．09～1．23）和1．28（1．18～1．38）。结论我国超重和肥胖者的高血压发病风险明显升高，应加强对超重和肥胖人群的高血压防控。Objective To evaluate the influence of overweight/obesity on the incidence of hypertension among adults in China. Methods The subjects of this prospective study were 13 739 Chinese adults aged 35-74 years recruited at the baseline surveys of China Multicenter Collaborative Study of Cardiovascular Disease Epidemiology and International Collaborative Study of Cardiovascular Disease in Asian. Baseline surveys were conducted in 1998 and during 2000-2001, respectively, and the follow-up was conducted during 2007-2008. According to the body mass index, the subjects were divided into four groups： underweight group （〈18.5 kg/m2）, normal weight group （18.5-23.9 kg/m2）, overweight group （24.0-27.9 kg/m2） and obesity group （≥28.0 kg/m2）. Age-standardized cumulative incidence of hypertension was calculated for each group, respectively. The relative risks （RRs） and 95% confidence intervals （C/s） for the incidence of hypertension of underweight, overweight and obesity groups were estimated by using generalized linear regression model with normal weight group as reference. Results During 8.1 years of follow-up, 4 271 hypertension cases were detected （2 012 in men and 2 259 in women）. Age-standardized cumulative incidence of hypertension for the underweight, normal weight, overweight and obesity groups were 20.3%, 30.9%, 43.6% and 50.8% in men, respectively; and 22.9%, 30.4%, 41.1% and 50.8% in women, respectively. Compared with the normal weight group, multivariate-adjusted RR （95%C/） for the incidence of hypertension in underweight, overweight and obesity groups were 0.78 （0.64-0.95）, 1.22 （1.13-1.30） and 1.28 （1.16-1.42） in men, respectively; and 0.89 （0.77-1.03）, 1.16 （1.09-1.23） and 1.28 （1.18-1.38） in women, respectively. The overweight and obese subjects had higher risk for the incidence of hypertension, with the population attributable risk proportion of 7.4% in men and 8.8% in women, respectively. Conclusion Overweight or obese people are at an increased risk

关 键 词：高血压 肥胖 发病风险 体质指数 队列研究 

分 类 号：R589.2[医药卫生—内分泌] R544.1[医药卫生—内科学]