摘要
目的评价肥胖指标与高血压的关联性,筛选预测老年人高血压风险的良好肥胖指标。方法分析辽宁省国民体质监测点1608名60~69岁老年人的数据资料。传统肥胖指标包括体质指数(BMI)、体格指数(PI)、腰围(WC)、腰臀比(WHR)和锥削度指数(CI);新肥胖指标包括腰围身高比(WHtR)、身体形态指数(ABSI)、身体圆润指数(BRI)、腰臀脂肪指数(AVI)、臀围指数(HI)和身体脂肪指数(BAI)。应用受试者工作特征(ROC)曲线比较不同肥胖指标预测高血压的效果,采用logistic回归分析评价肥胖指标与高血压风险的关联强度。结果辽宁省60~69岁老年人高血压率为38.6%(620/1608),男性为41.5%(323/778),女性为35.8%(297/830)。男、女性BMI、WC、WHtR、AVI、PI、BRI、BAI预测高血压的ROC曲线下面积均有统计学意义,最佳切点值为:BMI(男:25.4 kg/m^2,女:25.6 kg/m^2),WC(男:83.5 cm,女:86.6 cm),WHtR(男:0.50,女:0.53),AVI(男:14.3 cm^2,女:15.2 cm^2),PI(男:14.6 kg/m3,女:16.1 kg/m^3),BRI(男:3.4,女:4.1)和BAI(男:25.4,女:32.6)。多元logistic回归分析表明,BMI和WHtR是预测男、女性高血压风险的良好肥胖指标;男性BMI≥25.4 kg/m^2者高血压风险是BMI<25.4 kg/m^2者的1.53倍,WHtR≥0.50者高血压风险是WHtR<0.50者的1.55倍;女性BMI≥25.6 kg/m^2者高血压风险是BMI<25.6 kg/m^2者的1.62倍,WHtR≥0.53者高血压风险是WHtR<0.53者的1.81倍。将BMI与WHtR结合,男性BMI≥25.4 kg/m^2且WHtR≥0.50者高血压风险是BMI<25.4 kg/m^2且WHtR<0.50者的2.33倍(95%CI=1.63~3.34);女性BMI≥25.6 kg/m^2且WHtR≥0.53者高血压风险是BMI<25.6 kg/m^2且WHtR<0.53者的2.88倍(95%CI=2.03~4.09)。结论BMI和WHtR是预测老年人高血压风险的良好肥胖指标;BMI与WHtR联合应用,能够显著提高预测高血压风险的效果。
Objective To assess relationships between obesity indexes and hypertension and to identify strong obesity indexes for predicting hypertension risk in older adults.Methods We extracted physical measurement data on 1608 community residents aged 60–69 years from the dataset of two waves of the National Physical Fitness Surveillance conducted in 2010 and 2014 in Liaoning province.We calculated conventional obesity indexes including body mass index(BMI),ponderal index(PI),waist circumference(WC),waist-to-hip ratio(WHR),and conicity index(CI)for all the partipants and some other novel obesity indexes such as waist-to-height ratio(WHtR),a body shape index(ABSI),body roundness index(BRI),abdominal volume index(AVI),a new hip index(HI),and body adiposity index(BAI)were also calculated simultaneously.Receiver operating characteristic(ROC)curve was applied to compare the power of different obesity index in predicting hypertension and logistic regression analysis was used to evaluate the strength of association between obesity indexes and hypertension risk.Results The prevalence of hypertension was 38.6%(620/1608)for all the participants and was 41.5%(323/778)and 35.8%(297/830)for the male and female participants.Significant prediction of hypertension using application of area under ROC curve in predicting hypertension was of statistically significance for the indexes of BMI,WC,WHtR,AVI,PI,BRI and BAI in both male and female participants,with the optimal cut-off values of 25.4 and 25.6 kg/m^2(for male and female)for BMI,83.5 and 86.6 cm for WC,0.50 and 0.53 for WHtR,14.3 and 15.2 cm^2 for AVI,14.6 and 16.1 kg/m^3 for PI,3.4 and 4.1 for BRI,and 25.4 and 32.6 for BAI,respectively.The results of multivariate logistic regression analysis demonstrated that BMI and WHtR were good predictors of hypertension risk;among the males,the risk of hypertension for the participants with the BMI≥25.4 kg/m^2 was 1.53 times higher than those with the BMI<25.4 kg/m^2 and the risk of hypertension for the participants with the WHtR≥0.50 was 1.55 times higher than those with the WHtR<0.50;among the females,the risk of hypertension for the participants with the BMI≥25.6 kg/m^2 was 1.62 times higher than those with the BMI<25.6 kg/m^2 and the risk of hypertension for the participants with the WHtR≥0.53 was 1.81 times higher than those with the WHtR<0.53;the risk of hypertension for the male participants in men with the BMI≥25.4 kg/m^2 and the WHtR≥0.50 was 2.33 times(95%confidence interval[95%CI]:1.63–3.34)higher than the males with the BMI<25.4 kg/m^2 and the WHtR<0.50,while,for the female participants,the risk of hypertension in the females with the BMI≥25.6 kg/m^2 and the WHtR≥0.53 was 2.88 times(95%CI:2.03–4.09)higher than those with the BMI<25.6 kg/m^2 and the WHtR<0.53.Conclusion Body mass index and waist-to-height ratio are good obesity indexes for predicting hypertension risk in elderly community residents and the prediction power could be significantly improved when the two indexes being used jointly.
作者
汪宏莉
韩延柏
陈涛
韩一鸣
王东
耿璐璐
WANG Hong-li;HAN Yan-bai;CHEN Tao(Sport School of Guangxi Normal University,Guilin,Guangxi Zhuang Autonomous Region 541006,China)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2020年第1期105-109,共5页
Chinese Journal of Public Health
基金
2019年度国家社会科学基金（19XTY011）
关键词
老年人
高血压
肥胖指标
风险
预测
older adults
hypertension
obesity index
risk
prediction
作者简介
汪宏莉(1968-),女,辽宁沈阳人,教授,博士,研究方向:体质与健康、运动与健康促进;通讯作者:韩延柏,E-mail:yanbaih0806@163.com。
