摘要
目的探讨山东省济南地区35~75岁人群肥胖类型与血脂促动脉硬化指数的相关性。方法 2011年6月—2013年7月,采用整群随机抽样方法抽取山东省济南地区35~75岁人群10 079人,测量受试者腰围、身高、体重、颈-股动脉的脉搏波速度(cf PWV)及空腹血脂指标,并计算体质指数(BMI)及血脂促动脉硬化指数(PAI)。结果 BMI<28 kg/m^2+非腹型肥胖组cf PWV及PAI分别为(9.15±1.62)m/s和(2.27±0.96),BM I<28 kg/m^2+腹型肥胖组分别为(9.82±1.78)m/s和(2.56±1.18),BM I≥28 kg/m^2+非腹型肥胖组分别为(9.45±1.82)m/s和(2.44±1.19),BM I≥28 kg/m^2+腹型肥胖组分别为(10.99±1.91)m/s和(3.21±1.71)。与BM I<28 kg/m^2+非腹型肥胖组比较,其余各组cf PWV及PAI明显升高(P<0.05)。与BM I<28 kg/m^2+腹型肥胖组比较,BMI≥28 kg/m^2+非腹型肥胖组cf PWV明显升高(P<0.05)。与BM I≥28 kg/m^2+非腹型肥胖组比较,BM I≥28 kg/m^2+腹型肥胖组cf PWV及PAI明显升高(P<0.05)。BM I及腰围对cf PWV及PAI共同效应有统计学意义(F=61.366、42.682,P<0.001)。以BMI<28kg/m^2非腹型肥胖组为参照,在校正年龄、性别、收缩压、舒张压、FPG等因素后,BM I≥28 kg/m^2非腹型肥胖组PAI>4及cf PWV>10m/s的OR值分别为1.649(95%CI=1.154~2.144)和1.551(95%CI=1.117~1.985),P均<0.001;BM I<28kg/m^2腹型肥胖组OR值分别为1.764(95%CI=1.370~2.158)和1.577(95%CI=1.264~1.890),P均<0.001;BM I≥28 kg/m^2腹型肥胖组OR值分别为5.666(95%CI=3.726~7.606)和4.631(95%CI=2.615~6.647),P均<0.001。结论在山东济南地区35~75岁人群中,单纯性肥胖及腹型肥胖均是动脉硬化的独立危险因素,腰围及BMI增加在致动脉硬化中具有协同作用。
Objective To investigate obesity type and the association of obesity with arterial stiffness in community populations aged 35-70 years in Ji＇nan area,Shandong province.Methods From June 2011 to July 2013,10 079 permanent residents aged 35-70 years were recruited from 24 communities in Ji＇nan area of Shandong province using random cluster sampling.Waist circumference （WC）,height,weight,carotid-femoral pulse wave velocity （cfPWV）,and fasting blood lipids were measured in all the participants and body mass index （BMI） and plasma induced arterial stiffness index （PAI） were calculated.Results The values of cfPWV and PAI were 9.15±1.62 m/s and 2.27±0.96 for the participants with BMI〈28 kg/m2 and non-abdominal obesity （AO）,9.82±1.78 m/s and 2.56±1.18 for those with BMI〈28 kg/m2 and AO,9.45±1.82 m/s and 2.44±1.19 for BMI≥28 kg/m2 and non-AO,and 10.99±1.91 m/s and 3.21±1.71 for BMI≥28 kg/m2 and AO,respectively.Compared to those with BMI〈28 kg/m2 and non-AO,the cfPWV and PAI were significantly increased in the participants with BMI〈28 kg/m2 and AO,BMI≥28 kg/m2 and non-AO,and BMI≥28 kg/m2 and AO （P〈0.05 for all）.Compared to those with BMI〈28 kg/m2 and AO,the cfPWV was significantly increased in the participants with BMI≥28 kg/m2 and non-AO （P〈0.05）.Compared to those with BMI≥28 kg/m2 and non-AO,the cfPWV and PAI were significantly increased in the participants with BMI≥28 kg/m2 and AO （both P〈0.05）.Significant joint effect of WC and BMI on cfPWV and PAI were observed （F=61.366 and 42.682,both P〈0.001）.Compared to those with BMI〈28 kg/m2 and non-AO,the participants with BMI≥28 kg/m2 and non-AO presented significantly increased risks of PAI〉4 （odd ratios[OR]=1.649,95% confidence interval[95% CI]：1.154-2.144） and cfPWV〉10m/s （OR=1.551,95% CI：1.117-1.985）（both P〈0.001）;the participants with BMI〈28 kg/m2 and AO had significantly increased risks of PAI〉4 （OR=1.764,95% CI：1.370-2.158） and cfPWV〉10m/s （OR=1.577,95% CI：1.264-1.890）（both P〈0.001）;and the participants with BMI≥28 kg/m2 and AO had significantly increased risks of PAI〉4 （OR=5.666,95% CI：3.726-7.606） and cfPWV〉10m/s （OR=4.631,95% CI：2.615-6.647）（both P〈0.001）,after adjusting for age,gender,systolic blood pressure,diastolic blood pressure,and fasting plasma glucose.Conclusion Both simple obesity and abdominal obesity are independent risk factors for arterial stiffness and there is a synergistic effect of WC and BMI on arterial stiffness in populations aged 35-70 years in Ji＇nan area of Shandong province.
作者
王娟
庄严
巩会平
刘振东
杜贻萌
WANG Juan ZHUANG Yan GONG Hui-ping et al(Department of Cardiology, The Second Hospital of Shandong University, Ji＇ nan, Shandong Province 250033, Chin)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2017年第3期444-447,共4页
Chinese Journal of Public Health
基金
国家自然科学基金(81500232)
山东省自然科学基金(ZR2014HM098
ZR2013HQ065)
山东省医药卫生科技发展计划项目(2014WS0155)
山东省科技重大专项和重点研发计划(2015GSF118078)
关键词
肥胖
动脉僵硬度
协同作用
obesity
arterial stiffness
synergistic interaction
