不同肥胖评价指标对贵州省侗族和苗族成人高血压预测价值分析  

Analysis on different obesity indexes for predicting hypertension among Dong and Miao adults in Guizhou Province

作　　者：王鑫 徐玉艳[1] 洪峰[1] 曾奇兵[1] 袁质平 唐学杰 WANG Xin;XU Yuyan;HONG feng;ZENG Qibing;YUAN Zhiping;TANG Xuejie(School of Public Health,the Key Laboratory of Environmental Pollution Monitoring and Disease Control,Ministry of Education,Guizhou Medical University,Guiyang,Guizhou 550025,China;不详)

机构地区：[1]贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州贵阳550025 [2]贵州医科大学大学城医院

出　　处：《中国预防医学杂志》2024年第1期32-39,共8页Chinese Preventive Medicine

基　　金：国家重点研发计划(2017YFC0907301);贵州省科技计划[黔科合平台人才(2018) 5403]。

摘　　要：目的 探讨贵州省侗族及苗族成人不同肥胖评价指标与高血压的相关性,并筛选预测高血压的最佳指标及切点值。方法 于2018年5月-2019年9月采用多阶段分层抽样方法选取贵州省30~79岁侗族及苗族人群作为研究对象。采用二分类logistic回归模型分析肥胖评价指标体质量指数(body mass index,BMI)、腰围(waist circumference,WC)、内脏脂肪指数(visceral adiposity index,VAI)、脂质蓄积指数(lipid accumulation product, LAP)、身体形态指数(a body shape index, ABSI)及身体肥胖指数(body adiposity index,BAI)与高血压之间的关系;通过受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under curve,AUC)评价不同肥胖评价指标对高血压的预测价值,并以最大约登指数确定其切点值。结果 贵州省30~79岁侗族和苗族人群,纳入符合标准的共10 076人,高血压检出率分别为22.51%和22.92%。在调整混杂因素后,多因素logistic回归分析显示,除了苗族女性ABSI与高血压无关外,其他指标均增加高血压患病风险。单个肥胖指标中,WC预测侗族男性高血压患病风险的AUC最大[0.64 (95%CI:0.61~0.67)],最佳切点值为83.55;苗族男性中,BMI的AUC最大[0.64 (95%CI:0.61~0.67)],最佳切点值为24.15。而在侗族和苗族女性中,LAP的AUC最大[侗族0.67 (95%CI:0.64~0.69);苗族0.64 (95%CI:0.61~0.67)],最佳切点值分别为45.07和32.09。联合多个肥胖指标后,对侗族男性、女性高血压预测价值最好的组合分别是BMI+ABSI和BMI+LAP+ABSI,AUC分别为0.66和0.67;对苗族男性、女性高血压预测价值最好的组合分别是BMI+WC+LAP+ABSI+BAI和BMI+VAI+LAP+ABSI,AUC分别为0.65和0.65。结论 在单个指标中,WC和BMI分别是预测侗族和苗族男性高血压的最佳肥胖指标,LAP是预测侗族和苗族女性高血压的最佳肥胖指标;联合多个指标预测高血压的效果强于单个指标,且预测不同民族及性别人群高血压患病的指标组合存在差异Objective To investigate the correlation between different obesity indexes and hypertension in Dong and Miao populations aged 30-79 years in Guizhou Province,and to screen the best indexes and cut-point values for predicting hypertension.Methods A multi-stage stratified whole-group sampling method was used to select the Dong and Miao populations aged 30-79 years in Guizhou Province as the study subjects,and a total of 10076 subjects who met the criteria were included.A dichotomous logistic regression model was used to analyze the relationship between obesity indexes body mass index(BMI),waist circumference(WC),visceral adiposity index(VAI),lipid accumulation product(LAP),a body shape index(ABSI),and body adiposity index(BAI)and hypertension;the predictive value of different obesity indexes on hypertension was evaluated by the area under the subject's working characteristic curve(ROC)(AUC),and the cut-point value was determined by the maximum Jorden index.Results The detection rates of hypertension among the Dong and Miao populations aged 30-79 years in Guizhou Province were 22.51%and 22.92%,respectively.After adjusting for confounders,multivariate logistic regression analysis showed that all indicators were positively associated with the risk of hypertension(P<0.05),except ABSI,which was not associated with hypertension in Miao women.Among the single obesity indexes,the AUC of WC predicting the risk of hypertension in Dong men was the largest(0.64,95%CI:0.61-0.67)with an optimal cut point value of 83.55;among Miao men,the AUC of BMI was the largest(0.64,95%CI:0.61-0.67)with an optimal cut point value of 24.15.While among Dong and Miao women,the AUC of LAP was the largest(Dong:0.67,95%CI:0.64-0.69;Miao:0.64,95%CI:0.61-0.67),with best cut point values of 45.07 and 32.09,respectively.After combining several obesity indexes,the combinations with the best predictive value for hypertension in Dong men and women were BMI+ABSI and BMI+LAP+ABSI,with AUCs of 0.66 and 0.67,respectively;the combinations with the best predict

关 键 词：少数民族 肥胖评价指标 高血压 预测 

分 类 号：R544.1[医药卫生—心血管疾病]