Correlation of body composition with hypertension and consistency between dual-energy X-ray absorptiometry and bioelectrical impedance in body composition measurement among community adults: a cross-sectional study
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摘要:
目的 探究各体成分与高血压的相关性,分析生物电阻抗法(BIA)与双能X射线吸收法(DXA)的一致性。 方法 于2020年8 — 11月,在北京市招募20岁以上常住居民1 221人,采用DXA作为金标准,同时使用BIA法测量了受试者肌肉量、肌肉率、脂肪量以及体脂率,通过计算Pearson相关系数和Bland-Altman绘图分析探索DXA与BIA法的相关性及一致性,通过logistic回归分析判断各体成分的连续型变量与高血压的关系。 结果 无论使用DXA法还是BIA法(Inbody 770、体成分分析仪)测量,均为女性脂肪量和体脂率高于男性(P < 0.01)。基于DXA法,体脂率与高舒张压发病呈正相关(OR = 1.067,95 % CI = 1.002~1.139),而肌肉率与高舒张压发病呈负相关(OR = 0.936,95 % CI = 0.881~0.997)。当高血压作为结局时也具有类似的趋势,差异具有统计学意义。使用BIA法测量时,较高的体脂率同样会增加高舒张压的风险,而肌肉率与高舒张压呈显著负相关。 结论 BIA法与DXA法测量的相关性及一致性较高。较高的体脂率是高舒张压的主要独立危险因素,而高肌肉率是高舒张压的保护性因素。 Abstract:Objective To explore the correlation of body composition with hypertension and to analyze the consistency between bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). in body composition measurement. Methods Totally 1 221 permanent residents aged over 20 years were recruited at 6 communities in Beijing from August to November, 2020. Using DXA as the gold standard, BIA method was used to measure the participants′ muscle mass, muscle percentage, body fat mass and body fat percentage. The correlation and agreement between DXA and BIA method were analyzed with calculating Pearson correlation coefficient and Bland-Altman plot. Logistic regression analysis was used to determine the associations of continuous variables of each body composition index with hypertension. Results Both measurements of DXA and BIA (Inbody 770, body composition analyzer) revealed significantly higher body fat mass and body fat percentage of the female participants than those of the male participants (P < 0.01 for all). When measured by DXA, high body fat percentage was positively associated with high diastolic blood pressure (odds ratio [OR] = 1.067, 95% confidence interval [95% CI]: 1.002 – 1.139); while high muscle percentage was negatively correlated with high diastolic blood pressure (OR = 0.936, 95% CI: 0.881 – 0.997); similarly, high body fat percentage was associated with increased risk of hypertension but high muscle percentage was correlated with decreased risk of hypertension significantly. When measured with BIA method, higher body fat percentage also increased the risk of high diastolic blood pressure, while muscle percentage was inversely associated with high diastolic blood pressure. Conclusion The correlation and agreement between body composition measurements with BIA and DXA method are relatively high. Higher body fat percentage is a major independent risk factor for high diastolic blood pressure, while high muscle percentage is a protective factor against high diastolic blood pressure. 1) (李晓为本文并列第一作者) -
表 1 DXA与BIA法测量方法的人体成分比较
体成分指标 DXA Inbody 770 体成分分析仪 Bonferroni校正 a 男性 n = 617 n = 617 n = 392 脂肪量(kg) 19.80 ± 7.71 17.90 ± 8.14 17.12 ± 7.82 DXA > Inbody 770; DXA > 体成分分析仪 体脂率(%) 26.87 ± 6.35 24.17 ± 7.06 23.46 ± 6.94 DXA > Inbody 770; DXA > 体成分分析仪 肌肉量(kg) 49.24 ± 6.23 50.62 ± 6.00 50.53 ± 5.95 DXA < Inbody 770; DXA < 体成分分析仪 肌肉率(%) 69.35 ± 6.23 71.62 ± 6.66 72.51 ± 6.61 DXA < Inbody 770; DXA < 体成分分析仪 女性 n = 604 n = 604 n = 237 脂肪量(kg) 22.16 ± 7.80 20.78 ± 8.50 20.74 ± 9.87 DXA > Inbody 770 体脂率(%) 35.71 ± 6.20 33.30 ± 7.47 32.33 ± 8.49 DXA > Inbody 770; DXA > 体成分分析仪 肌肉量(kg) 36.20 ± 5.33 37.27 ± 4.78 38.43 ± 5.16 DXA < Inbody 770; DXA < 体成分分析仪 肌肉率(%) 59.75 ± 9.04 62.64 ± 6.97 64.13 ± 8.03 DXA < Inbody 770; DXA < 体成分分析仪 注:a Bonferroni校正P 值α = 0.017。 表 2 DXA与BIA法测量方法的相关性分析(r)
体成分指标 Pearson相关系数 DXA与Inbody 770 DXA与体成分分析仪 Inbody 770与体成分分析仪 男性 脂肪量 0.98 0.97 0.99 体脂率 0.93 0.92 0.98 肌肉量 0.96 0.96 0.99 肌肉率 0.92 0.91 0.98 女性 脂肪量 0.99 0.99 1.00 体脂率 0.94 0.94 0.98 肌肉量 0.96 0.96 0.99 肌肉率 0.90 0.93 0.99 表 3 DXA与BIA测量体成分与高血压关系的logistic回归分析a
体成分指标 高血压 高舒张压 高收缩压 OR 值 95 % CI OR 值 95 % CI OR 值 95 % CI DXA 体脂率(%) 1.063 1.021~1.106 1.067 1.002~1.139 1.036 0.965~1.112 脂肪量(kg) 1.088 1.027~1.152 1.086 0.989~1.191 1.028 0.929~1.138 肌肉率(%) 0.953 0.916~0.992 0.936 0.881~0.997 0.981
0.914~1.053肌肉量(kg) 0.937 0.886~0.991 0.925 0.844~1.015 0.990 0.895~1.095 Inbody 770 体脂率(%) 1.061 1.023~1.101 1.078 1.016~1.144 1.008 0.946~1.074 脂肪量(kg) 1.077 1.024~1.134 1.095 1.007~1.191 0.992 0.908~1.084 肌肉率(%) 0.941 0.905~0.978 0.925 0.869~0.985 0.992 0.928~1.062 肌肉量(kg) 0.926 0.878~0.978 0.910 0.833~0.995 1.009 0.918~1.109 体成分分析仪 体脂率(%) 1.046 0.996~1.098 1.123 1.028~1.225 0.990 0.910~1.077 脂肪量(kg) 1.059 0.991~1.131 1.183 1.040~1.345 0.990 0.881~1.112 肌肉率(%) 0.959 0.911~1.009 0.892 0.813~0.978 1.014 0.929~1.108 肌肉量(kg) 0.949 0.886~1.017 0.846 0.740~0.968 1.018 0.901~1.149 注:a 模型矫正了年龄、性别、体重以及是否服用高血压药物。 -
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