不同肥胖指标与泸州地区中老年原发性高血压前期人群转归高血压的关系  

Association among Different Adiposity Indices and the Outcome of Prehypertension in Middle-Aged and Old People in Luzhou Area

作　　者：汪宇 刘庆虹[1] 王家伟 李劲松 林强[1] 高毅滨[1] 田茂[1] 缪莹 WANG Yu;LIU Qinhong;WANG Jiawei;LI Jinsong;LIN Qiang;GAO Yibin;TIAN Mao;MIAO Ying(Department of Cardiology,Luzhou People′s Hospital,Luzhou,Sichuan 646000,China;Department of Endocrinology,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]泸州市人民医院心内科,四川泸州646000 [2]西南医科大学附属医院内分泌科,四川泸州646000

出　　处：《岭南心血管病杂志》2023年第4期420-426,共7页South China Journal of Cardiovascular Diseases

摘　　要：目的分析4个不同肥胖指标:内脏脂肪指数(visceral adiposity index,VAI)、体质量指数(body mass index,BMI)、腰围(waist circumference,WC)、腰臀比(waist-to-hip ratio,WHR)与泸州地区中老年原发性高血压(高血压)前期(prehypertension,PHT)人群转归高血压的相关性。方法选取于2015年1月至2017年9月泸州市人民医院体检中心健康体检确诊为PHT的中老年人群982人,分别将研究对象按不同肥胖指标的四分位数分组,非干预性随访3年,观察转归高血压的情况。通过单因素及多因素Logistic回归分析不同肥胖指标对PHT对象转归高血压的影响,同时运用受试者工作特征(receiver operating characteristic,ROC)曲线探讨和计算不同肥胖指标对高血压的预测价值。结果纳入研究的982人中,转归为高血压425人;Logistic回归分析结果显示在未调整任何变量及调整性别、年龄、收缩压、舒张压、空腹血糖、三酰甘油、高密度脂蛋白胆固醇后,按不同肥胖指标较高四分位数分组的PHT对象较较低四分位数分组的研究对象转归高血压的风险高,其中Q4组与Q1组的差异均有统计学意义(P<0.05);ROC曲线下面积结果显示在4个不同肥胖指标中,WC(曲线下面积为0.600,P<0.001)略大于VAI(曲线下面积为0.574,P<0.001)、BMI(曲线下面积为0.569,P<0.001)及WHR(曲线下面积为0.591,P<0.001)。结论VAI、BMI、WC、WHR均与增加PHT对象转归高血压的风险相关,并且WC的预测价值略优于BMI、WHR及VAI。在临床中,或可使用中央型肥胖指标WC预测PHT对象转归高血压的风险,并对肥胖的PHT人群进行相应指导,通过减小WC从而减少PHT转归高血压的风险。Objectives To investigated the predictive value of the 4 adiposity indices[visceral adiposity index(VAI),body mass index(BMI),waist circumference(WC)and waist-to-hip ratio(WHR)]for prehypertension development of hypertension in middle-aged and old people in Luzhou area.Methods The participants in this study were selected from the physical examination center of Luzhou People′s Hospital from January 2015 to October 2017.A total of 982 participants with prehypertension were selected from the baseline survey.The subjects were divided into different groups according to the quartiles of the different adiposity indices and followed for three years.We assessed the predictive power of adiposity indices by performing univariate and multivariate binary Logistic regression analysis and calculating the area under the receiver operating characteristic(ROC)curve according to their quartiles.Results Of the 982 participants,425 were progressed to hypertension.Logistic regression analysis showed that after adjusting for any variables and adjusting for gender,age,systolic blood pressure,diastolic blood pressure,fasting glucose,triglycerides,high density lipoprotein cholesterol,individuals in higher adiposity indices quartiles at baseline were more likely to develop hypertension than those in lower adiposity indices quartiles.The difference between Q4 group and Q1 group was statistically significant(P<0.05).The area under the ROC curve for WC was slightly greater than that of other adiposity indices.Conclusions VAI,BMI,WC and WHR all associate with increasing risk of hypertension among prehypertension subjects,and the predictive value of WC is slightly better than that of BMI,WHR and VAI.In clinical practice,adiposity indices may be used to predict the risk of hypertension with prehypertension subjects,and corresponding guidance should be given to obese prehypertension subjects to reduce the risk of hypertension with prehypertension.

关 键 词：高血压 内脏脂肪指数 高血压前期 

分 类 号：R544.1[医药卫生—心血管疾病]