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中山市体检老年人腹部肥胖指标与高血压患病关系

Associations of abdominal obesity indexes with hypertension in elderly physical examinees in Zhongshan city: a cross-sectional analysis

  • 摘要:
      目的  探讨广东省中山市体检老年人腹部肥胖指标与高血压患病的关系,为高血压的预防控制提供参考依据。
      方法  基于2020年中山市 ≥ 65岁老年人免费体检项目收集2020年6 — 9月在中山市民众镇和火炬开发区参与体检的8318名 ≥ 65岁老年人的体检资料,应用多因素非条件logistic回归模型分析中山市老年人颈围(NC)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)、脂质累积产物(LAP)和中国内脏肥胖指数(CVAI)等腹部肥胖指标与高血压患病的关系,并应用限制性立方样条分析NC与高血压患病风险的剂量 – 反应关系。
      结果  中山市 ≥ 65岁体检老年人的高血压患病率为45.5%,其中男性和女性体检老年人的高血压患病率分别为44.4%和46.4%;男性高血压和非高血压体检老年人的NC、WC、WHR、WHtR、LAP、CVAI平均值分别为(37.29 ± 2.83)cm和(36.41 ± 2.82)cm、(87.90 ± 9.51)cm和(84.40 ± 9.59)cm、(0.93 ± 0.07)和(0.91 ± 0.07)、(0.54 ± 0.06)和(0.52 ± 0.06)、(42.00 ± 38.70)和(32.54 ± 31.22)、(116.19 ± 42.01)和(98.42 ± 42.94),女性高血压和非高血压体检老年人的NC、WC、WHR、WHtR、LAP、CVAI平均值分别为(33.91 ± 2.67)cm和(33.04 ± 2.55)cm、(86.52 ± 9.48)cm和(83.24 ± 9.50)cm、(0.91 ± 0.07)和(0.90 ± 0.07)、(0.57 ± 0.06)和(0.55 ± 0.06)、(58.08 ± 46.96)和(46.98 ± 39.47)、(133.18 ± 30.78)和(119.80 ± 30.25),男性和女性高血压体检老年人的NC、WC、WHR、WHtR、LAP、CVAI平均值均高于非高血压老年人(均P < 0.001);在调整了年龄、文化程度、婚姻状况、家庭人均月收入、吸烟情况、饮酒情况、运动情况、有无咸菜食用习惯、体质指数(BMI)以及空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平等混杂因素后,多因素非条件logistic回归分析结果显示,男性体检老年人NC第三四分位数和最高四分位数高血压患病风险分别为NC最低四分位数的1.314倍(OR = 1.314,95%CI = 1.029~1.676)和1.512倍(OR = 1.512,95%CI = 1.131~2.022),男性体检老年人WHtR第二四分位数高血压患病风险为WHtR最低四分位数的0.636倍(OR = 0.636,95%CI = 0.469~0.863),女性体检老年人NC第二四分位数、第三四分位数和最高四分位数高血压患病风险分别为NC最低四分位数的1.214倍(OR = 1.214,95%CI = 1.009~1.463)、1.289倍(OR = 1.289,95%CI = 1.084~1.532)和1.503倍(OR = 1.503,95%CI = 1.223~1.846);在调整了年龄、文化程度、婚姻状况、家庭人均月收入、吸烟情况、饮酒情况、运动情况、有无咸菜食用习惯、BMI以及FPG、TC、TG、LDL-C和HDL-C水平等混杂因素后,限制性立方样条分析结果显示,男性和女性体检老年人NC与高血压患病风险均存在线性剂量 – 反应关系(χ2 = 94.62和128.22,均P < 0.001)。
      结论  中山市体检老年人NC与高血压患病风险存在正向线性相关关系。

     

    Abstract:
      Objective  To explore the relationship between abdominal obesity index and hypertension among the elderly in Zhongshan city for the prevention and control of hypertension.
      Methods  The data of the analysis were from 8 318 residents aged ≥ 65 years and participating in free physical examination project during June – September 2020 in a town and a district of Zhongshan city, Guangdong province. Multivariate logistic regression model was used to analyze the relationship between abdominal obesity indexes and hypertension among the residents; the abdominal obesity indexes included neck circumference (NC), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), lipid accumulation product (LAP), and China visceral obesity index (CVAI). The dose-response correlation between NC and the risk of hypertension was analyzed with restricted cubic splines.
      Results  The observed prevalence rate of hypertension among the elderly physical examinees was 45.5% (44.4% in the males and 46.3% in the females). Compared to those in the male and female non-hypertensives, significantly higher mean values of NC (37.29 ± 2.83 cm vs. 36.41 ± 2.82 cm and 33.91 ± 2.67 cm vs. 33.04 ± 2.55 cm), WC (87.90 ± 9.51 cm vs. 84.40 ± 9.59 cm and 86.52 ± 9.48 cm vs. 83.24 ± 9.50 cm), WHR (0.93 ± 0.07 vs. 91 ± 0.07 and 0.91 ± 0.07 vs. 0.90 ± 0.07), WHtR (0.54 ± 0.06 vs. 0.52 ± 0.06 and 0.57 ± 0.06 vs. 0.55 ± 0.06), LAP (43.00 ± 38.70 vs. 32.54 ± 31.22 and 46.98 ± 39.47 vs. 58.08 ± 46.96), and CVAI (116.19 ± 42.01 vs. 98.42 ± 42.94 and 133.18 ± 30.78 vs. 119.80 ± 30.25) were measured in the hypertensives (all P < 0.001). After adjusting for age, education, marital status, monthly household income per capita, smoking, alcohol drinking, exercise, salted vegetable consumption habits, body mass index (BMI), fasting blood glucose (FPG), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C), multivariate logistic regression analysis showed that the risk of hypertension increased in the male elderly with higher NC compared to that in those with the NC of the lowest quartile (third quartile: odds ratio OR = 1.314, 95% confidence interval CI: 1.029 – 1.676; the highest quartile: OR = 1.512, 95%CI: 1.131 – 2.022) and in the female elderly with higher WHtR compared to that in those with the WHtR of the lowest quartile (second quartile: OR = 1.214, 95%CI: 1.009 – 1.463; third quartile: OR = 1.289, 95%CI: 1.084 – 1.532; the highest quartile: OR = 1.503, 95%CI: 1.223 – 1.846); the analysis also demonstrated that the risk of hypertension decreased in the male elderly with higher WHtR (the second quartile vs. the lowest quartile: OR = 0.636, 95%CI: 0.469 – 0.863). After adjusting for confounding factors mentioned above, the results of restricted cubic spline analysis revealed a linear dose-response relationship between NC and hypertension risk in both the male and the female elderly (χ2 = 94.62 and 128.22, both P < 0.001).
      Conclusion  There is a positive linear correlation between NC and the risk of hypertension among the elderly in Zhongshan City.

     

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