累积脂质蓄积指数与高血压发病相关性:一项前瞻性队列研究  

Association between Cumulative Lipid Accumulation Index and Hypertension:a Prospective Cohort Study

作　　者：梅景雁 陈敏[2] 张列强 潘昀熙 王鑫 赵小登 詹玮[2] 刘涛[2] 王艺颖 MEI Jingyan;CHEN Min;ZHANG Lieqiang;PAN Yunxi;WANG Xin;ZHAO Xiaodeng;ZHAN Wei;LIU Tao;WANG Yiying(Acupuncture Department,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China;Guizhou Provincial Center for Disease Control and Prevention,Guiyang 550004,China)

机构地区：[1]贵州医科大学附属医院针灸科,贵州省贵阳市550004 [2]贵州省疾病预防控制中心,贵州省贵阳市550004

出　　处：《中国全科医学》2025年第18期2205-2211,2227,共8页Chinese General Practice

基　　金：贵州省科技计划(黔科合支撑[2018]2819);贵州省卫生健康委省级重点建设学科项目。

摘　　要：背景高血压是造成全球疾病负担和死亡的主要因素,已成为当今社会普遍的公共卫生问题之一。累积脂质蓄积指数(LAP)可反映腹部和内脏脂肪蓄积程度,多项横断面研究表明,LAP与高血压有显著相关性,但这些研究并没有充分考虑长期暴露下LAP对高血压发病风险的影响,LAP与高血压发病因果关系的研究仍较为少见。目的评估累积LAP与高血压发病风险的相关性,探讨该指标对高血压发病的预测能力。方法采用贵州省自然人群队列研究数据库,于2010-11-20—2012-12-19纳入研究对象,收集基线资料,并于2016年4月—2020年10月进行随访,最终纳入3548例研究对象。将患者按累积LAP分为4个水平(Q1~Q4组),Q1组(累积LAP≤14.54,n=887),Q2组(14.54<累积LAP≤24.35,n=887),Q3组(24.35<累积LAP≤39.21,n=887),Q4组(累积LAP>39.21,n=887)。并依据是否有新发高血压将患者分为非高血压组(n=2696)和高血压组(n=852)。采用Cox比例回归模型评估累积LAP与高血压的关系。采用限制性立方样条评估累积LAP与高血压发病风险的量效关系。绘制累积LAP预测高血压的时间依赖性受试者工作特征(ROC)曲线。排除随访时间<3年、高血压前期人群。结果纳入的3548例成年人中男1607例(45.3%),女1941例(54.7%),平均年龄(42.5±14.1)岁,随访期间有852例(11.2%)新诊断为高血压。非高血压组和高血压组研究对象性别、年龄、受教育程度、高血压家族史、油摄入过量、盐摄入过量、新鲜水果摄入不足、缺乏睡眠占比、BMI、舒张压、空腹血糖(FPG)、累积LAP比较,差异有统计学意义(P<0.05)。Cox比例回归模型结果显示,与Q1组比较,在调整了潜在协变量后,Q2组(aHR=1.330,95%CI=1.053~1.681)、Q3组(aHR=1.706,95%CI=1.364~2.134)、Q4组(aHR=2.339,95%CI=1.869~2.928)高血压发病风险均逐渐升高(P<0.05)。限制性立方样条结果显示,累积LAP与高血压风险呈非线性量效关系(P_(非线性)<0.01),新发高Background Hypertension remains a major contributor to the global disease burden and mortality,representing a critical public health challenge.While the cumulative lipid accumulation product(LAP),a marker of abdominal and visceral fat deposition,has shown cross-sectional associations with hypertension,existing studies inadequately address the impact of long-term cumulative LAP exposure on hypertension risk.Furthermore,causal relationships between cumulative LAP and incident hypertension remain underexplored.Objective To evaluate the association between cumulative LAP and hypertension risk and assess its predictive capacity for incident hypertension.Methods Data were derived from the Guizhou Natural Population Cohort Study database.Participants were enrolled from November 20,2010,to December 19,2012,and followed up from April 2016 to October 2020.A total of 3548 subjects were ultimately included in the analysis.Participants were divided into four quartiles based on cumulative LAP(Q1-Q4 groups):Q1(cumulative LAP≤14.54,n=887),Q2(14.54<cumulative LAP≤24.35,n=887),Q3(24.35<cumulative LAP≤39.21,n=887),and Q4(cumulative LAP>39.21,n=887).Subjects were further categorized into non-hypertension group(n=2696)and hypertension group(n=852)based on the development of new-onset hypertension.The relationship between cumulative LAP and hypertension was evaluated using the Cox proportional hazards regression model.The dose-response relationship between cumulative LAP and hypertension risk was assessed using restricted cubic splines.Time-dependent receiver operating characteristic(ROC)curves were constructed to evaluate the predictive ability of cumulative LAP for hypertension.Participants with follow-up duration<3 years and those with pre-hypertension were excluded.Results Among the 3548 adults included,1607(45.3%)were men and 1941(54.7%)were women,with a mean age of(42.5±14.1)years.During the follow-up period,852(11.2%)subjects were newly diagnosed with hypertension.Significant differences were observed between the non-hyp

关 键 词：高血压 脂质蓄积指数 队列研究 预测 前瞻性队列研究 

分 类 号：R544.1[医药卫生—心血管疾病]