中国社区人群肥胖与心血管疾病风险的相关性研究  

Associations between obesity status and cardiovascular disease risk in Chinese community population

作　　者：程棣 林琳[1] 彭魁[1] 杜瑞[1] 徐瑜[1] 徐敏[1] 陈宇红[1] 毕宇芳[1] 王卫庆[1] 陆洁莉[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院内分泌代谢病科 上海市内分泌代谢病研究所 上海市内分泌代谢病临床医学中心,200025

出　　处：《中华内分泌代谢杂志》2017年第6期465-472,共8页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金（81370960）;上海市教委曙光计划（15SG15）

摘　　要：目的探讨中国社区人群肥胖与自报心血管疾病及10年心血管疾病风险的相关性。方法本研究于2010年采取整群抽样的方法在上海嘉定地区抽取40岁以上的常驻居民10 375名作为调查对象。每位受试者均接受标准化问卷调查、体格检查以及空腹采血测量血糖、血脂等生化指标。肥胖程度采用我国卫生部在《中国成人超重和肥胖症预防控制指南》中公布的诊断标准。将男性和女性按照肥胖程度分为正常体重、超重和肥胖组，比较各组心血管危险因素、自报心血管疾病及心血管疾病预测风险。心血管疾病预测风险采用Framingham 10年冠心病风险评分与2013美国心脏病学院/美国心脏协会（ACC/AHA）推荐的10年首次严重动脉粥样硬化心血管疾病（ASCVD）事件风险评估方法。结果男性和女性中的心血管危险因素、自报心血管疾病的患病率和心血管疾病预测风险均随着肥胖程度的增加而逐渐升高。男性自报心血管疾病的患病率在正常体重、超重和肥胖组中分别为7.3%、7.6%和11.2%；女性中分别为6.2%、7.7%和10.6%。与正常体重人群相比，超重和肥胖人群的心血管疾病预测风险均显著增加，其中男性肥胖人群增加更为明显，ASCVD风险和Framingham风险评估分别增加1.02倍（OR＝2.02，95%CI 1.50～2.71）和1.57倍（OR＝2.57，95%CI 1.56～4.22）。结论在中国中老年社区人群中，超重与肥胖人群的自报心血管疾病患病风险和心血管疾病预测风险均显著上升。Objective To investigate the association between obesity status, self-reported history of cardiovascular diseases（CVD） and CVD risk among community population in Chinese adults.MethodsA total of 10 375 subjects aged 40 or older from Jiading Community, Shanghai Municipality were recruited to undergo questionnaire interview, anthropometric measurements and fasting blood sampling. Biochemical features were evaluated and the obesity statuses were categorized according to the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults. Subjects were assigned to three groups based on body mass index, and sex-specific analyses was performed. Estimated 10-year Framingham risk for coronary heart disease and 10-year risk for a first hard atherosclerotic cardiovascular diseases（ASCVD） event was calculated.ResultsIncreased body mass index was associated with higher prevalence of self-reported history of CVD, 10-year Framingham risk for coronary heart disease, and 10-year risk for ASCVD. The prevalence of self-reported CVD in male participants with increasing body mass index levels（7.3%, 7.6%, and 11.2% respectively） were higher than in females（6.2%, 7.7%, and 10.6% respectively）. Compared with subjects in the normal weight group, those in both overweight and obesity groups had higher 10-year Framingham risk for coronary heart disease and 10-year risk for ASCVD. Male obese participants had increased 10-year Framingham risk for coronary heart disease（OR=2.02, 95%CI 1.50-2.71） and 10-year risk for ASCVD（OR=2.57, 95%CI 1.56-4.22）, respectively.ConclusionIn Chinese middle-aged and elderly community population, high body mass index was independently associated with increased risk of self-reported history of CVD and 10-year risk for CVD.

关 键 词：肥胖症 心血管疾病 ASCVD风险评分 Framingham风险评分 

分 类 号：R54[医药卫生—心血管疾病] R589.2[医药卫生—内科学]