老年高血压人群腰围身高比与新发脑梗死的关系  

The association between the waist-to-height ratio and novel cerebral infarction in the elderly with hypertension

作　　者：郭晓斌[1] 刘苹[2] 于文霞 GUO Xiaobin;LIU Ping;YU Wenxia(Department of General Medicine,the Second Hospital of Tangshan,Tangshan 063000,China;不详)

机构地区：[1]唐山市第二医院内科,河北唐山063000 [2]开滦总医院营养科,河北唐山063001

出　　处：《实用医学杂志》2024年第11期1592-1596,共5页The Journal of Practical Medicine

基　　金：河北省医学科学研究课题计划项目(编号:20230233)。

摘　　要：目的研究腰围身高比(WHtR)与老年人新发脑梗死的相关性。方法纳入开滦地区研究人群9096例老年高血压患者,以首次发生脑梗死为终点事件,采取前瞻性队列研究方法进行研究,依据观察对象WHtR值以0.05为间距等距分为四组,分别为G1组(WHtR<0.45)、G2组(0.45≤WHtR<0.50)、G3组(0.50≤WHtR<0.55)及G4组(WHtR≥0.55),用寿命表方法统计各人群的累积终点事件发生率,采用Cox比例风险分析方法,探讨WHtR在新发脑梗死中的作用。模型一为单一因子Cox比例风险分析模式,只考察WHtR对脑梗死发生风险的作用;在此基础上,模型二为校正性别、年龄、体重及血清超敏C反应蛋白、收缩压、血清甘油三酯、抽烟史、血清空腹血糖、饮酒情况、高密度脂蛋白胆固醇、舒张压、体育运动、低密度脂蛋白胆固醇、文化程度、服降压药史后观察WHtR对新发脑梗死的作用。结果随访时间为(9.3±2.7)年,期间共新发脑梗死848例。以G2组为对照,单因素Cox比例风险回归模型分析显示G1组、G3组和G4各组发生脑梗死的HR(95%CI)分别为1.00(0.67~1.50)、1.29(1.05~1.60)、1.36(1.12~1.66);多因素Cox比例风险回归模型分析显示G1组、G3组和G4各组发生脑梗死的HR(95%CI)分别为1.09(0.72~1.65)、1.24(0.99~1.54)、1.31(1.05~1.62)。结论老年高血压人群当0.45≤WHtR<0.50时脑卒中发病风险最低,WHtR≥0.55与新发脑梗死风险增加相关。Objective To study the relationship between waist-to-height ratio(WHtR)and new-onset cerebral infarction in the elderly with hypertension.Methods A total of 9096 elderly hypertensive patients were enrolled from the Kailuan study population.Using the first occurrence of cerebral infarction as the endpoint event,a prospective cohort study was performed.According to the WHtR value of the subjects with an interval of 0.05,the subjects were divided into G1 group(WHtR<0.45),G2 group(0.45≤WHtR<0.50),G3 group(0.50≤WHtR<0.55),and G4 group(WHtR≥0.55).The cumulative incidence rate of endpoint event in each population were statistically analyzed using the life table method.Cox proportional hazards regression analysis was used to explore the role of WHtR in the occurrence of new cerebral infarction.Model 1 was a single factor Cox proportional hazards analysis model,only considering the influence of WHtR on the risk of cerebral infarction.After adjusting sex,age,body weight,serum hypersensitive C-reactive protein,systolic blood pressure,serum triglycerides,smoking history,fasting blood glucose,alcohol consumption,high-density lipoprotein cholesterol,diastolic blood pressure,exercise,low-density lipoprotein cholesterol,educational level,antihypertensive drug history,model 2 was established to observe the influence of WHtR on the occurrence of new-onset cerebral infarction.Results The follow-up lasted(9.3±2.7)years.Compared to the G2 group,multivariate Cox proportional hazards regression model showed that the hazard ratio HR(95%CI)for cerebral infarction in model 1 was 1.00(0.67~1.50),1.29(1.05~1.60)and 1.36(1.12~1.66)respectively in G1,G3 and G4;and that in model 2 was 1.09(0.72~1.65),1.24(0.99~1.54)and 1.31(1.05~1.62)respectively in G1,G3 and G4.Conclusion The risk of cerebral infarction in the elderly with hypertension is the lowest when WHtR between 0.45≤WHtR<0.50,and WHtR greater than or equal to 0.55 is associated with an increased risk of new-onset cerebral infarction.

关 键 词：腰围身高比 脑梗死 老年高血压 队列研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学]