基于China-PAR模型的不同体重指数体检人群的心血管病风险评估  

Cardiovascular disease risk assessment of different body mass index in physical examination population based on China-PAR model

作　　者：张芮 侯钦钏 李炳宏 曾红莲[3] 杨波[3] 潘佳 朱元芳[4] 周琳[4] 李东宇 帅平 ZHANG Rui;HOU Qin-chuan;LI Bing-hong;ZENG Hong-lian;YANG Bo;PAN Jia;ZHU Yuan-fang;ZHOU Lin;LI Dong-yu;SHUAI Ping(The School of Public Health,Southwest Medical University,Luzhou 646000,China;Health Management Center,Sichuan Academy of Medical Sciences&Sichuan Provincial People′s Hospital,Chengdu 610072,China;Health Management Center,Affiliated Hospital of Chengdu University,Chengdu 610081,China;Health Examination Center,Zigong Fourth People′s Hospital,Zigong 643099,China)

机构地区：[1]西南医科大学公共卫生学院,四川成都610000 [2]四川省医学科学院·四川省人民医院健康管理中心,四川成都610072 [3]成都大学附属医院健康管理中心,四川成都610081 [4]四川省自贡市第四人民医院健康体检中心,四川自贡643099

出　　处：《实用医院临床杂志》2023年第3期113-117,共5页Practical Journal of Clinical Medicine

基　　金：成都市科技局项目(编号:2021-YF05-00498-SN);四川省科技厅重点研发项目(编号:2022YFS0600);四川省人民医院院基金项目(编号:2021LY15)。

摘　　要：目的研究不同体重指数体检人群动脉粥样硬化性心血管疾病(ASCVD)的风险分层以及危险因素状况。方法采用横断面调查方法,选择2018年1月至2020年12月于三家三级甲等综合性医院健康管理中心进行年度健康体检的受试者30281例,采用China-PAR模型进行心血管事件风险评估,分析不同性别、年龄和体重指数(BMI)人群的心血管病风险及相关影响因素。结果入组受检者中超重11191例(36.96%)、肥胖3774例(12.46%)。其中,男性超重、肥胖比例显著高于女性,年龄≥45岁者超重、肥胖比例显著高于年龄<45岁者。该人群心血管病10年心血管病风险高危、中危和低危比例分别为2.03%、7.46%、90.51%。男性中、高危人群比例显著高于女性。随着年龄、BMI水平的增长,中危、高危人群比例逐渐增加(P<0.001)。该人群心血管疾病终生发病风险为高危和低危的比例分别为2.61%、97.39%。其中,BMI>28 kg/m2组终生ASCVD风险高危比例显著高于BMI<24 kg/m2组和24 kg/m2≤BMI<28 kg/m2组(P<0.001)。年龄升高、收缩压升高、吸烟史是超重者未来10年ASCVD风险的独立危险因素(P<0.001);男性、高龄、收缩压升高、空腹血糖升高、总胆固醇升高、吸烟史是肥胖者未来10年ASCVD风险的独立危险因素(P<0.05)。结论体检人群中超重、肥胖检出率较高,超重、肥胖是ASCVD的危险因素。对于高龄男性且合并超重或肥胖的体检人群尤其需要关注ASCVD的发病风险。Objective To investigate the risk stratification and risk factors of atherosclerotic cardiovascular disease(ASCVD)in people with different body mass index.Methods A cross-sectional survey was conducted.A total of 30,281 healthy people who underwent health check-up in health management centers of three tertiary general hospitals from January 2018 to December 2020 were randomly selected.The China-PAR model was used to assess the risk of cardiovascular events and analyze the relevant risk factors in different gender,age and body mass index(BMI).Results For the enrolled subjects,11,191 cases(36.96%)were overweight and 3,774 cases(12.46%)were obese.Among them,the proportion of overweight and obesity in men was significantly higher than that in women.The proportion of overweight and obesity in those aged≥45 years was significantly higher than that in those aged<45 years.The 10-year risk assessment of cardiovascular disease showed that 90.51%of the population was at low risk,7.46%were at medium risk,and 2.03%were at high risk.The proportion of men in medium and high risk groups was significantly higher than that of women.With the increase of age and BMI,the proportion of middle and high risk groups was increased gradually(P<0.001).The lifetime risk results showed that 97.39%of the population was at low risk and 2.61%were at high risk.Among them,the lifetime high risk ratio of ASCVD in BMI≥28 kg/m 2 group was significantly higher than that in BMI<28 kg/m 2 group(P<0.001).Increased age,increased systolic blood pressure and smoking history were independent risk factors for ASCVD in overweight patients(P<0.001).Male,old age,elevated systolic blood pressure,elevated fasting blood glucose,elevated total cholesterol and smoking history were independent risk factors for ASCVD in obese patients(P<0.05).Conclusions The detection rate of overweight and obesity in the physical examination population is high.Overweight and obesity are risk factors for ASCVD.For elderly males who are overweight or obese,it is especially necessary

关 键 词：体检人群 心血管疾病 风险评估 体重指数 

分 类 号：R54[医药卫生—心血管疾病]