腰臀比纵向轨迹与动脉硬化的关联性  

The correlation of waist-to-hip ratio trajectories and arterial stiffness

作　　者：高竞生[1] 张芮英 张亚静[1,2] 刘杰 李俊娟 黄喆[1] 宁春红[1,2] 李蔚 赵权辉[1,2] 于俊杏 陈朔华 吴寿岭 GAO Jing-sheng ZHANG Rui-ying ZHANG Ya-jing LIU Jie LI Jun-juan HUANG Zhe NING Chun-hong LI Wei ZHAO Quan-hui YU Jun-xing CHEN Shuo-hua WU Shou-ling(Department of Cardiology, Kailuan Hospital, Tangshan Hebei 063000, Chin)

机构地区：[1]开滦总医院心内科,河北唐山063000 [2]华北理工大学研究生院 [3]开滦总医院肾内科

出　　处：《中华高血压杂志》2017年第9期847-853,共7页Chinese Journal of Hypertension

摘　　要：目的探讨腰臀比纵向轨迹与动脉硬化的关联。方法研究队列由开滦卒中队列、老年人群队列、妊娠队列和外周血管疾病筛查队列组成,其中符合入选标准的研究对象共9080名。通过SAS Proc Traj程序确定观察对象2006-2007、2008-2009、2010-2011年健康体检的腰臀比纵向轨迹,生成4组不同的腰臀比轨迹组:低-中轨迹组、中-稳定轨迹组、高-高轨迹组、高-中轨迹组,并于2010-2015年对观察对象进行了肱踝动脉脉搏波传导速度(baPWV)检测。采用协方差分析校正了年龄、性别后不同腰臀比纵向轨迹分组baPWV的差异。采用多因素Logistic回归模型分析腰臀比纵向轨迹与动脉硬化的关联。定义baPWV≥1400cm/s为动脉硬化。结果与其他腰臀比轨迹组相比,高-高轨迹组的baPWV值[(1545.56±4.31)cm/s]、动脉硬化人群比例(67.5%)均最高。低-中轨迹组、中-稳定轨迹组、高-高轨迹组、高-中轨迹组动脉硬化的发生率分别为:28.8%、50.0%、67.5%、55.4%。在多因素Logistic回归分析中,校正了其他混杂因素后,与低-中轨迹组相比,中-稳定轨迹组、高-高轨迹组、高-中轨迹组是动脉硬化发生的危险因素,对应的OR值(95%CI)分别为1.42(1.15~1.76)、1.80(1.42~2.29)、1.63(1.11~2.38),均P<0.05。此外,分别除外服用降压药、降糖药、降脂药人群后进行了敏感性分析,结果与主要研究结果趋势一致。结论腰臀比纵向轨迹水平升高是发生动脉硬化的危险因素。Objective To explore the correlation of waist-to-hip ratio trajectories and arteial stiffness.Methods The study cohort consisted of 4cohorts（the Stroke Cohort,the Elderly Cohort,the Pregnancy Cohort and the Peripheral Vascular Disease Screening Cohort,respectively）. A total of 9080 participants met the inclusion criteria and enrolled in the study. SAS Proc Traj procedure was used to identify trajectories in waist-to-hip ratio throughout 2006-2007 to 2010-2011 examinations. The 4trajectories were low-moderate group,moderate-stable group,elevated-increasing group and elevated-lowering group. The participants underwent the brachial-ankle pulse wave velocity（baPWV）examination during 2010-2015. Covariance analysis model,adjusted the age and gender,was used to analyze the difference of baPWV among 4groups. Logistic regression models were used to analyze the influence of waist-to-hip ratio trajectories on arterial stiffness. BaPWV≥1400cm/s was defined as arterial stiffness.Results Both baPWV value [（1545.56±4.31）cm/s]and proportion of population with arterial stiffness（67.5%）in elevated-increasing group were the highest. The corresponding incidence of arterial stiffness in lowmoderate group,moderate-stable group,elevated-increasing group and elevated-lowering group were 28.8%,50.0%,67.5% and 55.4% respectively. Logistic regression analysis showed that compared to the low-stable group,the moderate-stable group,elevated-increasing group and elevated-lowering group were still risk factors of arterial stiffness after adjusting for baseline risk factors,OR（95% CI）were 1.42（1.15-1.76）,1.80（1.42-2.29）and 1.63（1.11-2.38）,respectively（all P〈0.05）. The results of sensitivity analyses,which rule out separately the participants who taking antihypertensive agents,hypoglycemic drugs and lipid-lowering drugs,were similar to the results of the non-sensitivity analyses. Conclusion The elevated levels of waist-to-hip ratio trajectories is one of risk factors of arterial stiffness.

关 键 词：腰臀比轨迹 肱踝动脉脉搏波传导速度 动脉硬化 

分 类 号：R543[医药卫生—心血管疾病]