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目的探讨宜昌市夷陵区35岁以上居民体质指数(BMI)、腰臀比(WHR)、腰围(WC)与高血压的关系及其预测价值。方法 2011年7月至2012年9月运用分层整群抽样的方法对宜昌市夷陵区35岁以上居民共9 871人进行身高、体重、WC、臀围、血压测量,并进行问卷调查,采用多因素logistic回归分析、受试者工作特征(receiver operating characteristic,ROC)曲线分析肥胖与高血压的关系及预测价值。结果资料完整者9 849名,有效应答率为99.78%。其中,男性4 066名(41.28%),女性5 783名(58.72%)。男性和女性高血压患病率分别为38.71%和34.20%;男女性居民收缩压(SBP)和舒张压(DBP)水平及高血压患病率在不同BMI分组间差异均有统计学意义(P<0.01)。男女性居民中心性肥胖者其SBP和DBP水平及高血压患病率高于正常体重者,差异均有统计学意义(P<0.01)。校正年龄后,男女性居民肥胖指标罹患高血压风险BMI的OR值最大(男性和女性分别为1.080和1.122)。ROC曲线分析结果显示,在男女性居民中,WC的曲线下面积最大,WHR的曲线下面积最小,但三者的曲线下面积差异无统计学意义(P>0.05)。结论超重、肥胖以及中心性肥胖者更易患高血压,BMI、WHR、WC各指数均能较好地预测高血压风险。
Objective To investigate the relationship between body mass index (BMI), waist-hip ratio (WHR), waist circumference (WC) and hypertension in Yiling District of Yichang City and their predictive value. Methods From July 2011 to September 2012, stratified cluster sampling method was used to measure the height, weight, WC, hip circumference and blood pressure of 9 871 residents over the age of 35 in Yiling District, Yichang City, Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve were used to analyze the relationship between obesity and hypertension and their predictive value. Results The data integrity of 9 849, the effective response rate was 99.78%. Among them, 4 066 (41.28%) were male and 5 783 (58.72%) were female. The prevalence rates of hypertension in males and females were 38.71% and 34.20%, respectively. The SBP and DBP levels and the prevalence of hypertension among men and women were significantly different among different BMI groups (P <0.01). The prevalence of SBP and DBP and the prevalence of hypertension among men and women with central obesity were significantly higher than those with normal weight (P <0.01). After adjusting for age, the odds ratio (OR) of the BMI for hypertension among men and women was the highest (1.080 and 1.122 for males and females respectively). The results of ROC curve analysis showed that under the curves of WC and WC, the area under the curve of WC was the largest and the area under the curve of WHR was the smallest, but there was no significant difference between the three under the curve (P> 0.05). Conclusions Overweight, obesity and central obesity are more likely to be associated with hypertension. The BMI, WHR and WC indices all predict the risk of hypertension.