不同肥胖指标对冠心病、高血压及其合并糖尿病患者患病风险的评估作用  

Assessment of different obesity indexes on risk of coronary artery disease,hypertension and/or diabetes mellitus

作　　者：樊永旺 马骏[2] 邱健[2] 黄江明[2] 黄晓民[2] 许业灏 徐琳[1,2] FAN Yongwang MA Jun QIU Jian HUANG Jiangming HUANG Xiaomin XU Yehao XU Lin(Southern Medical University, Guangzhou 510515, China)

机构地区：[1]南方医科大学,广州510515 [2]广州军区广州总医院

出　　处：《山东医药》2017年第1期11-14,共4页Shandong Medical Journal

基　　金：广东省科技计划项目(2013A022100036;2014A020212257)

摘　　要：目的观察冠心病、高血压及其合并糖尿病状态下肥胖程度的差异,探讨不同肥胖指标对其患病风险的评估作用。方法选取冠心病、高血压、糖尿病及无上述疾病的患者共643例,根据具体疾病种类将其分为冠心病组120例,高血压组127例,冠心病合并高血压组108例,冠心病和(或)高血压合并糖尿病组164例,无上述疾病组124例。采用方差分析比较五组肥胖指标体质量指数(BMI)、腹围(WC)、腰身指数(WHtR)差异,采用二分类Logistics回归分析肥胖指标对发病风险的评估作用,采用受试者工作特征(ROC)曲线分析肥胖指标对疾病的诊断效力。结果五组间BMI、WC和WHtR比较,差异有统计学意义(P均<0.05)。Logistics回归分析显示BMI、WC和WHtR是高血压和冠心病合并高血压发生的独立危险因素;WC是冠心病和(或)高血压合并糖尿病发生的独立危险因素。ROC曲线分析显示单独应用肥胖指标对疾病的诊断效力较弱,联合心血管代谢因素可以使诊断效力提高。结论冠心病、高血压和(或)糖尿病患者不同肥胖指标存在差异,检测不同肥胖指标可用于上述疾病的初步筛查。Objective To observe the differences of obesity in patients with coronary artery disease （ CAD）, hyper- tension and/or diabetes mellitus, and to investigate the assessment of different obesity indexes on risk of these illnesses. Methods A total of 643 patients with or without CAD and/or hypertension with/without diabetes were recruited in our study. According to the specific diseases, patients were divided into five groups： the CAD group （120 cases with CAD）, the hypertension group （ 127 cases with hypertension）, CAD combined with hypertension group （ 108 eases）, the CAD and/or hypertension combined with diabetes group （164 eases, short for combined diabetes group）, and the control group （ 124 cases without the above related diseases）. Analysis of variance was used to compare the differences in the body mass index （BMI）, abdominal circumference （WC）, and Waist index （WHtR） among the 5 groups. Binary logistics regression was used to assess the risk of illness, and receiver operator characteristics （ROC） analysis was used to assess the ability of diagnosis. Results There were significant differences in BMI, WC and WHtR among the five groups （ all P 〈 0.05）. Lo- gistic regression analysis showed [hat BMI, WC and WHtR were independent risk factors for hypertension and CAD com- bined with hypertension. WC Was an independent risk factor for the combined diabetes mellitus. ROC curve analysis showed that the single obesity index for the diagnosis of disease was weak, but when combined with a number of indicators, it could improve the diagnostic efficiency. Conclusions The degree of obesity in patients with CAD, hypertension and/or diabetes is higher than that of patients without the above disease. Different obesity indexes play different roles in assessment of the degree of obesity and the risk of illness. Separately application of obesity index is an initial screening tool for illness.

关 键 词：冠状动脉疾病 高血压 糖尿病 肥胖指标 

分 类 号：R541.4[医药卫生—心血管疾病] R544.1[医药卫生—内科学]