职业人群的体质指数和血脂水平在饮酒行为与高血压关联间的中介效应  

Mediating effects of body mass index and lipid levels on the association between alcohol consumption and hypertension in occupational population

作　　者：董舒 余彬 杨波[3] 范云喆 付瑶 冯传腾 曾红莲[3] 贾鹏 杨淑娟 Dong Shu;Yu Bin;Yang Bo;Fan Yunzhe;Fu Yao;Feng Chuanteng;Zeng Honglian;Jia Peng;Yang Shujuan(West China School of Public Health/The Fourth Hospital of West China,Sichuan University,Chengdu 610041,China;Institute for Disaster Management and Reconstruction,Sichuan University-the Hong Kong Polytechnic University,Chengdu 610207,China;Affiliated Hospital of Chengdu University,Chengdu 610081,China;School of Resource and Environmental Sciences,Wuhan University,Wuhan 430072,China;School of Public Health,Wuhan University,Wuhan 430071,China;International Institute of Spatial Lifecourse Health,Wuhan University,Wuhan 430072,China)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院,成都610041 [2]四川大学-香港理工大学灾后重建与管理学院,成都610207 [3]成都大学附属医院,成都610081 [4]武汉大学资源与环境科学学院,武汉430072 [5]武汉大学公共卫生学院,武汉430071 [6]武汉大学空间全生命周期健康国际研究中心,武汉430072

出　　处：《中华流行病学杂志》2024年第3期440-446,共7页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(42271433);国家重点研发计划(2023YFC3604702);四川省重点研发项目(2023YFS0251);武汉大学人民医院交叉创新人才项目(JCRCYG-2022-003);武汉大学学院国际化发展重点专项支持计划(WHU-GJZDZX-PT07)。

摘　　要：目的探讨职业人群饮酒行为与高血压及SBP、DBP的关联,分析体质指数(BMI)和血脂水平的中介作用,为职业人群的高血压预防提供参考。方法基于西南地区职业人群队列,通过问卷调查、体格和血生化检查收集人口学特征、行为生活方式、血压和血脂等情况。采用logistic回归分析和线性回归分析饮酒行为与高血压及SBP、DBP的关联,采用因果中介分析估计BMI、HDL-C、LDL-C、TG和TC的独立和联合中介效应,并结合网络分析探索饮酒行为、BMI、血脂水平与高血压之间的相互关联。结果共纳入22887名研究对象,其中新发高血压1825名。Logistic回归分析发现,与从不饮酒人群相比,现在饮/既往饮酒可使高血压风险增加33%(OR=1.33,95%CI:1.19~1.48);饮酒行为可使SBP(β=1.05,95%CI:0.69~1.40)和DBP(β=1.10,95%CI:0.83~1.38)增加。联合中介分析发现,BMI和血脂介导了饮酒行为与高血压及SBP、DBP间21.91%、28.40%和22.64%的效应,其中BMI和TG为主要的中介因素,也是饮酒行为、BMI、血脂水平和血压网络中边权和桥强度中心性最高的2个中介节点。结论饮酒行为与患高血压风险升高有关,BMI和TG是重要的中介因素和网络中关键节点,提示应重点关注饮酒行为、BMI和TG,有助于职业人群的高血压预防。Objective To investigate the association between alcohol consumption and hypertension and SBP,DBP and the mediating effects of body mass index(BMI)and lipid level in occupational population,and provide reference for the intervention and prevention of hypertension.Methods Based on the data of Southwest Occupational Population Cohort from China Railway Chengdu Group Co.,Ltd.,the information about the demographic characteristics,behavior and lifestyle,blood pressure and lipids level of the participants were collected through questionnaire survey,physical examination and blood biochemical test.Logistic/linear regression was used to analyze the association between alcohol consumption and hypertension,SBP and DBP.The individual and joint mediating effects of BMI,HDL-C,LDL-C,TG,and TC were explored through causal mediating analysis.A network analysis was used to explore the correlation between alcohol consumption,BMI and lipid levels,and hypertension.Results A total of 22887 participants were included,in whom 1825 had newly detected hypertension.Logistic regression analysis found that current/former drinkers had a 33%increase of risk for hypertension compared with never-drinkers(OR=1.33,95%CI:1.19-1.48).Similarly,alcohol consumption could increase SBP(β=1.05,95%CI:0.69-1.40)and DBP(β=1.10,95%CI:0.83-1.38).Overall,BMI and lipid levels could mediate the associations between alcohol consumption and hypertension,SBP and DBP by 21.91%,28.40%and 22.64%,respectively.BMI and TG were the main mediators,and they were also the two nodes with the highest edge weight and bridge strength centrality in the network of alcohol consumption,BMI,lipid levels and hypertension.Conclusions Alcohol consumption was associated with increased risk for hypertension,and BMI and TG were important mediators and key nodes in the network.It is suggested that paying attention to the alcohol consumption,BMI and TG might help prevent hypertension in occupational population.

关 键 词：饮酒行为 高血压 体质指数 血脂 中介分析 网络分析 

分 类 号：R544.1[医药卫生—心血管疾病]