中老年高血压人群肥胖与骨质疏松相关性研究  

Relationships Between Obesity and Osteoporosis Among Chinese Middle-aged and Elderly Hypertensive Adults

作　　者：邓桂娟 程晓光[2] 尹潞[1] 李凯[2] 王玲[2] 胡泊[1] 孙毅[1] 王杨[1] 成小如[1] 李卫[1] 江宇[3] DENG Guijuan;CHENG Xiaoguang;YIN Lu;LI Kai;WANG Ling;HU Bo;SUN Yi;WANG Yang;CHENG Xiaoru;LI Wei;JIANG Yu(State Key Laboratory of Cardiovascular Disease,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管疾病国家重点实验室,北京市100037 [2]北京积水潭医院 [3]中国医学科学院北京协和医学院公共卫生学院

出　　处：《中国循环杂志》2019年第11期1091-1097,共7页Chinese Circulation Journal

基　　金：中国医学科学院医学与健康科技创新工程(2016-I2M-2-004)

摘　　要：目的:探索中老年(≥40岁)高血压人群肥胖与骨质疏松的相关性。方法:本研究基于中国脊柱和髋状态(CASH)研究,共纳入中老年(≥40岁)高血压患者1394例。使用标准化问卷和定量CT扫描技术采集人体信息和腰椎骨密度数据。根据骨密度将人群划分为骨质疏松组(骨密度≤80 mg/m3)和非骨质疏松组(骨密度>80 mg/m3)。采用二分类Logistic回归,分析体重指数、腰围、腰臀比、腰高比和身体形态指数与骨质疏松的相关性。结果:1394例研究对象的年龄范围为40~82岁,男性846例,女性548例;骨质疏松组478例,非骨质疏松组916例。校正模型中,总人群和女性患骨质疏松的风险与体重指数和身体形态指数均相关(P均<0.05),女性的身体形态指数与骨质疏松相关最强(OR=1.84,95%CI:1.28~2.64,P=0.001),其次为总人群中的身体形态指数(OR=1.72,95%CI:1.28~2.32,P<0.001)。以第一分位数作为参照,女性中体重指数和身体形态指数各分位数组骨质疏松的趋势性检验P均<0.05;男性校正模型中未观察到统计学意义(P均>0.05)。结论:与体重指数、腰围、腰臀比和腰高比相比,中老年高血压人群中身体形态指数与骨质疏松的相关性最强,尤其是在女性中,男性中尚未观察到统计学相关性。Objectives:To assess the associations between obesity index and osteoporosis(OP)risk in Chinese middle-aged and elderly hypertensive population.Methods:Data were derived from 1394 patients participating the China Action on Spine and Hip status study(CASH study).Related information and spine bone mineral density data(BMD)were obtained and measured using standardized questionnaires and quantitative computed tomography(QCT),respectively.The total cohort was divided into OP group(≤80 mg/m3)and non-OP group(>80 mg/m3)based on BMD value.The associations between body mass index(BMI),waist circumstance(WC),waist-to-hip ratio(WHR),waist-to-height ratio(WHtR),body shape index(ABSI)and OP risk were analyzed using unconditional logistic regression.Results:There were 846 males and 548 females in the cohort(aged 40 to 82 years old)included 478 OP and 916 non-OP patients.In adjusted models,BMI and ABSI were significantly correlated with the risk of OP among total cohort and female participants(P<0.001),and the largest OR was observed for ABSI in female participants(OR=1.84,95%CI:1.28-2.64),followed by ABSI in total population(OR=1.72,95%CI:1.28-2.32).Taking the first quantile as reference group,P for trend of OR for BMI and ABSI in female participants reached statistical significance;while no statistical significance was observed in male participants.Conclusions:ABSI had the strongest association with risk of OP compared with BMI,WC,WHR and WHtR,especially among female participants,while no significant correlation was observed in male participants.

关 键 词：高血压 肥胖 骨质疏松 相关性 

分 类 号：R54[医药卫生—心血管疾病]