肥胖测量指标对H型高血压的预测价值  

Predictive value of obesity measurement index for H-type hypertension

作　　者：张影 洪秀琴[2,3,4] 王佳 李璟[2,3,4] 曾丹 彭倩[2,3,4] 杨凡[2,3,4] Zhang Ying;Hong Xiuqin;Wang Jia;Li Jing;Zeng Dan;Peng Qian;Yang Fan(School of Public Health, University of South China, Hengyang 421001, China;Research Department of Hunan Provincial People′s Hospital, Changsha 410005, China;Hunan Provincial Key Laboratory of Molecular Epidemiology, Changsha 410013, China;Department of Epidemiology, Institute of Translational Medicine, Hunan Normal University, Changsha 410013, China)

机构地区：[1]南华大学公共卫生学院,衡阳421001 [2]湖南省人民医院科研部,长沙410005 [3]湖南省分子流行病学重点实验室,长沙410013 [4]湖南师范大学转化医学研究所流行病学研究室,长沙410013

出　　处：《中国医师杂志》2019年第5期668-671,676,共5页Journal of Chinese Physician

基　　金：国家自然科学基金(81202281,81773530);湖南省科技厅科技计划项目(2011SK3178)~~

摘　　要：目的通过调查湖南地区成年人群的BMI、腰围、腰臀比和腰身比等反映肥胖的指标,分析这些指标与H型高血压之间的关系,探讨肥胖测量指标预测H型高血压的价值。方法采用多阶段随机抽样方法,对湖南省六个地区的4 012例>30岁的社区成年人群进行问卷调查、体格检查和实验室检测。采用ROC曲线评价肥胖测量指标BMI、腰围(WC)、腰臀比(WHR)和腰身比(WHtR)对H型高血压的预测效果。结果 ROC曲线分析,在男性中,WC、WHtR、WHR和BMI各单独指标评价H型高血压的曲线下面积(AUC)依次为:0.637、0.640、0.601、0.639,其中AUC最大的是WC+BMI和WHtR+BMI组合,均为0.647。在女性中,WC、WHtR、WHR和BMI各单独指标评价H型高血压的AUC依次为:0.660、0.670、0.660、0.604,AUC最大的是WHtR+WHR组合,为0.675。ROC曲线分析,结果显示:WC预测青年人群H型高血压的AUC最大,为0.723;WC+BMI和WHR+BMI组合预测中年人群H型高血压的AUC最大,均为0.687;WC预测老年年人群H型高血压的AUC最大,为0.590。结论 WC、WHtR、WHR和BMI是H型高血压重要的预测因子,不同性别、年龄最优的预测指标有所差异,联合指标优于单独指标。Objective By investigating the obesity of the adult population in Hunan, we explored the relationship between body mass index (BMI)[including waist circumference (WC), waist-to-hip ratio (WHR), waist-to-body ratio (WHtR) and H-type hypertension] in predicting H-type hypertension. Methods A multi-stage random sampling method was used to conduct a questionnaire survey, physical examination and laboratory testing on 4 012 adults >30 years old in 6 districts of Hunan Province. The receiver operator characteristic (ROC) curve was used to evaluate the predictive effects of BMI, WC, WHR and WHtR on H-type hypertension. Results ROC curve analysis indicated that the area under curve (AUC) of the evaluation of H-type hypertension of WC, WHtR, WHR and BMI in men were: 0.637, 0.640, 0.601, 0.639, of which the largest were combination of WC+ BMI and WHtR+ BMI, both being 0.647. In women, the AUC of individual indexes WC, WHtR, WHR and BMI for evaluating H-type hypertension were 0.660, 0.670, 0.660 and 0.604 respectively. The combination of WHtR and WHR had the largest AUC, which was 0.675. The WC for evaluating H-type hypertension in youth people had the largest AUC(0.732);the WC+ BMI, WHR+ BMI for evaluating H-type hypertension in middle-aged people had the largest AUC, all being 0.687;the WC predicted the largest AUC of H-type hypertension in elderly people (0.590). Conclusions WC, WHtR, WHR and BMI are important predictors of H-type hypertension. The optimal indicators for different genders and ages are different, and the combined indicators are better than the individual indicators.

关 键 词：高同种半胱氨酸血症 高血压 肥胖症 体重与身体测量 

分 类 号：R544.1[医药卫生—心血管疾病]