基于限制性立方样条模型的社区居民BMI与血脂异常关联强度及剂量-反应关系分析  

Analysis of the Dose-response Relationship Between Body Mass Index and the Strength of Association with Dyslipidemia among Community Residents of Wuhan

作　　者：梁雅欣 唐聪 喻宜情 邵颖姗 胡艳芳 张荣馨 许奕华[1] LIANG Yaxin;TANG Cong;YU Yiqing;SHAO Yingshan;HU Yanfang;ZHANG Rongxin;XU Yihua(Department of Epidemiology and Biostatistics,School of Public Health,Huazhong University of Science and Technology,Wuhan,430030,China;不详)

机构地区：[1]华中科技大学同济医学院公共卫生学院流行病与卫生统计学系,湖北武汉430030 [2]武汉市江岸区疾病预防控制中心,湖北武汉430010

出　　处：《中国社会医学杂志》2024年第5期599-604,共6页Chinese Journal of Social Medicine

基　　金：武汉市横向课题项目-武汉市江岸区慢性病危险因素流行病学调查(0231513647)。

摘　　要：目的调查武汉地区居民体质量指数(body mass index,BMI)连续变化情况,探讨BMI与血脂异常患病风险的剂量-反应关系,为该地区血脂异常防控提供科学依据。方法采用多阶段分层抽样法,于2022年抽取武汉市江岸区18岁及以上常住居民进行问卷调查、身体测量和实验室检测。应用非条件逐步Logistic回归和限制性立方样条模型分析BMI与血脂异常患病关联及剂量-反应关系。结果最终共纳入3173例样本,武汉市江岸区居民超重、肥胖的标化患病率分别为31.30%和8.95%。血脂异常、高总胆固醇(TC)、高甘油三酯(TG)血症、高低密度脂蛋白(LDL-C)血症和低高密度脂蛋白(HDL-C)血症的标化患病率分别为20.49%、2.60%、9.78%、3.17%和6.08%。超重(OR=1.118,95%CI:1.083~1.154)和肥胖(OR=1.181,95%CI:1.123~1.243)与血脂异常患病显著相关。男性(χ^(2)=6.67,P<0.05)、女性(χ^(2)=6.07,P<0.05)、18~<45岁(χ^(2)=13.40,P<0.05)和45~<65岁(χ^(2)=8.02,P<0.05)人群的BMI与血脂异常患病呈非线性剂量-反应关系,随BMI升高,血脂异常患病风险逐渐增加继而又趋于平缓。而65岁及以上(χ^(2)=0.18,P>0.05)人群的BMI与血脂异常患病呈线性剂量-反应关系。结论BMI的连续变化和血脂异常的患病风险呈正相关的剂量-反应关系。血脂异常的指标预警防控工作需关口前移,应注重中青年的血脂防控工作,并通过倡导减轻体质量、进行早期预防和控制等措施,降低血脂异常患病风险。Objective To assess ongoing BMI trends in Wuhan residents and analyze the BMI-dyslipidemia dose-response relationship,aiming to provide scientific evidence for dyslipidemia prevention and control in the region.Methods A multi-stage stratified sampling method was used to select permanent residents aged 18 years and above in Jiang'an District,Wuhan.The questionnaire survey,physical measurements,and laboratory tests were conducted among them in 2022.Non-conditional Logistic regression and Restricted cubic splines were employed to analyze the association and dose-response relationship between BMI and the occurrence of Dyslipidemia.Results Ultimately,a total of 3173 participants were included.The prevalence of overweight and obesity among residents in the Jiang'an District of Wuhan were 31.30%and 8.95%,respectively.The standardized prevalence rates of dyslipidemia,high total cholesterol(TC),hypertriglyceridemia(TG),elevated low-density lipoprotein cholesterol(LDL-C),and low high-density lipoprotein cholesterol(HDL-C)were 20.49%,2.60%,9.78%,3.17%,and 6.08%,respectively.Both overweight(OR=1.118,95%CI:1.083-1.154)and obesity(OR=1.181,95%CI:1.123-1.243)were significantly associated with the occurrence of Dyslipidemia.The BMI of male(χ^(2)=6.67,P<0.05),female(χ^(2)=6.07,P<0.05),18-<45 age group(χ^(2)=13.40,P<0.05),and 45-<65 age group(χ^(2)=8.02,P<0.05)had shown a non-linear dose-response relationship with the prevalence of dyslipidemia,while the 65 and above age group(χ^(2)=0.18,P>0.05)exhibited a linear dose-response relationship.With the increasing of BMI,the risk of dyslipidemia gradually rose,reaching a plateau thereafter.Conclusion There is a positive dose-response relationship between continuous changes in BMI and the risk of Dyslipidemia.The prevention and control of Dyslipidemia need to shift the focus to the younger population.It is important to prioritize blood lipid control in middle-aged and young adults,and implement measures such as advocating weight reduction,early prevention,and control to reduce the

关 键 词：血脂异常 体质量指数 剂量-反应关系 限制性立方样条 

分 类 号：R194.3[医药卫生—卫生事业管理]