体重指数与不同亚型高血压的关系

目的探讨中国成年人体重指数(BMI)与不同亚型高血压患病率的关系.方法2000-2001年,对年龄35～74岁的中国成年人群中的代表性抽样样本进行横断面调查,分析了资料完整并且未服用降压药的14 124名研究对象的数据.比较男性和女性不同BMI分组的各亚型高血压患病率、比数比(OR值)和归因危险.结果随着BMI水平的增加,男性和女性的收缩压和舒张压均值逐渐增高.男、女性在低体重组、正常体重组、超重组和肥胖组的各亚型高血压患病率和OR值基本上也呈升高趋势.男性超重和肥胖(BMI≥24kg/m2)时患单纯性收缩期高血压(ISH)、单纯性舒张期高血压(IDH)、收缩期和舒张期联合性高血压(SDH)的OR值分别为1.3、2.9和2.4,女性则各为1.6、2.4和2.3(P＜0.05).与非超重者相比,超重和肥胖男性中20%的ISH、65.4%的IDH和57.5%的SDH应归因于BMI≥24 kg/m2,而女性相应有37.9%的ISH、59.0%的IDH和55.8%的SDH由超重和肥胖引起.结论体重指数与各亚型高血压的患病危险有显著正相关.减重和控制肥胖对于预防IDH和SDH的发生起重要作用.     

体重指数与不同亚型高血压的关系

目的探讨中国成年人体重指数(BMI)与不同亚型高血压患病率的关系。方法2000-2001年,对年龄35～74岁的中国成年人群中的代表性抽样样本进行横断面调查,分析了资料完整并且未服用降压药的14124名研究对象的数据。比较男性和女性不同BMI分组的各亚型高血压患病率、比数比(OR值)和归因危险。结果随着BMI水平的增加,男性和女性的收缩压和舒张压均值逐渐增高。男、女性在低体重组、正常体重组、超重组和肥胖组的各亚型高血压患病率和OR值基本上也呈升高趋势。男性超重和肥胖(BMI≥24kg/m2)时患单纯性收缩期高血压(ISH)、单纯性舒张期高血压(IDH)、收缩期和舒张期联合性高血压(SDH)的OR值分别为1.3、2.9和2.4,女性则各为1.6、2.4和2.3(P<0.05)。与非超重者相比,超重和肥胖男性中20%的ISH、65.4%的IDH和57.5%的SDH应归因于BMI≥24kg/m2,而女性相应有37.9%的ISH、59.0%的IDH和55.8%的SDH由超重和肥胖引起。结论体重指数与各亚型高血压的患病危险有显著正相关。减重和控制肥胖对于预防IDH和SDH的发生起重要作用。     

老年人群体质量指数与高血压的相关性

目的调查分析福州市健康体检的老年人体质量指数(BMI)与血压水平及高血压患病率的关系。方法收集2016年1月至12月期间福建省立医院≥60岁的老年人健康体检的资料,回顾性分析该人群血压水平及高血压、超重或肥胖的患病率;按BMI分层,评价不同BMI类型人群的血压水平和高血压发病率。采用SPSS 11.7统计软件进行数据分析,根据数据类型,组间比较采用非配对资料t检验或χ2检验。采用多因素logistic回归分析高血压的影响因素,采用受试者工作特征(ROC)曲线分析BMI与高血压风险的相关性。结果在资料完整的1659例体检者中,高血压患病率为34.2%(568/1659),其中男性患病率为36.2%(363/1003),女性患病率为31.2%(205/656);该人群超重或肥胖患病率为48.1%(798/1659),其中男性患病率为48.4%(485/1003),女性患病率为47.7%(313/656);随着BMI增加,收缩压、舒张压及高血压患病率逐渐增高(BMI18.5,18.5~23.9,24.0~27.9,≥28.0 kg/m~2组的高血压患病率分别为17.0%,27.4%,40.4%,55.5%)。多因素logistic回归分析发现超重或肥胖、空腹血糖高、高尿酸和高甘油三酯血症是高血压的危险因素。高血压风险相关ROC曲线显示,对收缩压性高血压风险,男性BMI的ROC曲线下面积(AUC)最大值为0.601(切点为25.55 kg/m~2),女性BMI的AUC最大值为0.609(切点为25.85 kg/m~2);对舒张性高血压风险,男性BMI的AUC最大值为0.665(切点为25.55 kg/m~2),女性BMI的AUC最大值为0.609(切点为26.35 kg/m~2)。结论随着BMI的增加,收缩压、舒张压及高血压患病率逐渐增高。超重或肥胖、空腹血糖高、高尿酸和高三酰甘油血症是高血压的危险因素,BMI对预测高血压风险有一定价值。     

某铁路局职工高血压患病状况分析

目的 分析某铁路局职工高血压患病情况,为在本系统内开展高血压健康管理提供依据.方法 选取2015-2019年某铁路局参与健康体检的24 314名在职职工为研究对象,分析高血压患病情况及相关影响因素.结果 该铁路系统职工年龄20～59岁,其中40岁～年龄组人数最多、占在职职工总数的45.0％;以男性居多、占总人数的82.1％;近五年职工高血压总患病率整体呈上升趋势(趋势x2=383.616,P＜0.001),男性患病率(43.1％)高于女性(23.0％),同全人群性别患病情况一致,且不同年龄组男女差异有统计学意义(x2=1 089.942,P＜0.001);与20岁～组相比,其他年龄组患高血压风险性高(OR＞1,P＜0.001),且呈现OR值随年龄增长而上升的趋势;男性高血压患病风险是女性的1.570倍(x2=113.483,P＜0.001);与体重指数(BMI)小于18.5 kg/m2组相比,24.0～27.9 kg/m2及≥28 kg/m2组BMI的OR＞1 (P＜0.001).结论 该铁路系统职工高血压患病率呈上升趋势,男性高于女性;年龄、超重和肥胖仍是职工患高血压病的危险因素.     

湘西少数民族地区健康体检者体质指数、血压特点调查研究

目的以湘西少数民族地区健康体检者为调查对象,探讨湘西少数民族地区体质量指数（BMI）、血压水平及其特点。方法对668例健康体检者进行问卷调查,并测量身高、体质量、腰围（WC）、血压、血脂、血糖等指标。结果湘西少数民族地区健康体检者高血压患病率为28.74%,男性（37.64%）显著高于女性（18.85%）,在不同高血压水平的人群分布比例上,男女也存在差别;本地区超重或肥胖患病率为43.71%,男性（58.03%）高于女性（27.48%）,BMI平均为23.61kg/m2,男性（24.65kg/m2）高于女性（22.43kg/m2）,男性WC亦高于女性;在不同的BMI分层中,血脂异常和高血压患病率均存在明显差异。结论湘西少数民族地区人群高血压、肥胖或超重居于国内中等水平,男性高于女性;本地血脂异常及高血压均与BMI有关。     

机关中青年干部高血压患病及相关危险因素分析

目的了解机关中青年(年龄60岁)干部高血压发病率及与相关危险因素关系。方法入选2012年3月~5月在武警总医院健康医学中心进行体检的机关中青年干部538例,其中男性445例,女性93例。将是否患高血压作为因变量,以性别、年龄、体质指数(BMI)、腰围(WC)、空腹血糖(FPG)、血尿酸(UA)、血脂指标等做为自变量,进行单因素分析及多因素非条件Logistic回归分析。结果机关中青年干部高血压患病率为17.3%。与血压正常组相比,高血压患者男性构成比,BMI、WC、三酰甘油(TG)、低密度脂蛋白(LDL-C)、UA及餐后2 h血糖(2h PBG)明显升高,差异有显著统计学意义(P0.01);高血压组合并超重/肥胖、糖耐量异常、高胆固醇(TC)血症、高UA血症比例明显增高(P0.05)。多因素非条件Logistic回归分析结果表明,男性(OR=4.24,95%CI:1.47~6.36)、BMI(OR=5.16,95%CI:1.36~5.76),2h PBG(OR=2.73,95%CI:1.31~5.69)、TC(OR=2.03,95%CI:1.02~7.31)是高血压的独立危险因素。结论机关中青年干部高血压患病率较高,男性、BMI、TC及2h PBG是高血压的独立危险因素。     

甘肃陇西县35岁及以上人群高血压流行病学现况调查

目的调查甘肃陇西县≥35岁的居民高血压的患病现况,分析其相关危险因素。方法整群分层随机抽取陇西县5个社区≥35岁的居民共12040例,对所选对象进行问卷调查,测量身高、体质量指数(BMI)、腰围、血压,并测定空腹血糖及血脂。计算不同年龄及性别的调查对象高血压及相关疾病的患病率,分析高血压的相关危险因素。结果标化后高血压患病率为26.8%,男性为28.3%,女性为21.4%。Logistic逐步回归分析结果表明,盐摄入量(OR=2.403,95%CI2.066～2.759)、超重(OR=1.566,95%CI1.417～1.730)、高血糖(OR=1.700,95%CI1.303～2.217)、总胆固醇(OR=2.617,95%CI2.294～2.986)、三酰甘油(OR=2.147,95%CI1.960～2.351)、脑力劳动(OR=0.640,95%CI0.490～0.830)、吸烟(烟龄>10年)(OR=1.567,95%CI1.413～1.738)、饮酒(每周>2次)(OR=1.372,95%CI1.340～1.479)是高血压的独立危险因素。结论陇西县35岁以上居民中高血压患病率较高,年龄、男性、高盐饮食、超重及肥胖、高血糖、腰围超标、血脂异常、高三酰甘油是高血压的危险因素。     

40岁以上在职医务人员体质量指数与血脂成份异常的相关性调查

目的:分析40岁以上在职医务人员的BMI与血脂成份异常的相关性,为该人群血脂异常防治提供依据。方法:统计某三甲医院40岁以上人群的2018年体检资料,包括病史、身体测量和血液生化检查结果。依照《中国成人超重和肥胖预防控制指南》中公布的诊断标准,将该人群分成三组(偏瘦者共6例,因例数少,本次不纳入研究):正常BMI(271例)、超重组(201例)和肥胖组(93例)。分析BMI与血脂成份异常的相关性。结果:共纳入人员565例,平均BMI(24.59±2.30)kg/m~2。超重组和肥胖组的TG和LDL-C平均水平均显著高于正常BMI组(P0.01),与BMI呈正相关,而HDL-C则相反;三组高TG(分别为10.3%、29.2%和41.9%)、高LDL-C(分别为23.2%、30.3%和47.3%)和低HDL-C(分别为5.9%、23.4%和30.1%)患病率均随BMI增长而增高(P0.01)。单因素分析显示:高TG危险因素有男性、BMI增长、高血压、糖尿病和吸烟,运动为保护性因素;高LDL-C危险因素有男性、BMI增长和吸烟;低HDL-C危险因素有男性、BMI增长、高血压、糖尿病和吸烟。分别把以上与血脂成份异常相关的因素通过多因素Logistics回归分析发现:高TG危险因素有男性(OR=2.25,95%CI:1.273～3.978,P0.01)、超重(OR=2.579,95%CI:1.522～4.370,P0.01)和肥胖(OR=3.381,95%CI:1.778～6.431,P0.01),运动为保护性因素(OR=0.522,95%CI:0.323～0.844,P0.01);高LDL-C危险因素有超重(OR=1.596,95%CI:1.035～2.460,P0.05)和肥胖(OR=2.976,95%CI:1.749～5.063,P0.01);低HDL-C危险因素有男性(OR=3.753,95%CI:1.959～7.191,P0.01)、超重(OR=2.924,95%CI:1.543～5.543,P0.01)和肥胖(OR=3.111,95%CI:1.457～6.643,P0.01)。结论:血脂成份异常的危险因素均包括超重和肥胖,并且是主要危险因素,危险性与BMI呈正相关。控制该人群BMI增长,是防止血脂成份异常的重要措施。     

佛山普君社区老年人体重指数与高血压的关系

目的探讨老年人体重指数与高血压的关系.方法按统一方法对佛山市禅城区普君街道办事处60岁以上常住居民3 382人进行现场问卷调查,同时测量血压、身高、体重等,并计算体重指数(BMI).结果肥胖、超重、体重正常、体重过低者高血压患病率分别为64.12%、49.24%、33.44%、24.16%,随BMI增高,高血压患病率明显增高,同时随BMI水平上升血脂异常患病率亦升高.高血压类型中以单纯收缩期高血压患病率最高.平均BMI为23.0kg/m2,≥24者占37.4%,男性BMI为22.6kg/m2,≥24者占34.0%,女性BMI为23.2 kg/m2,≥24者占40.0%,男女的BMI相比有显著性差异(P＜0.01).随年龄增长BMI稍下降,80岁以后下降明显.结论BMI水平与高血压密切相关,但80岁以后超重率有明显下降.在较高年龄组老年人中进行减肥应慎重.     

泸州市社区老年人群超重、肥胖患病率及特点分析

目的:了解泸州市社区老年人群超重和肥胖的流行特点及其高血压、高血糖、高血脂的患病情况。方法:通过多级抽样方法,对泸州市社区60岁以上居民进行问卷调查、体格检查、生化检测。体质量指数(BMI)≥28.0为肥胖,24.0～27.9为超重。结果:共收集有效资料4 445份,平均BMI为24.1±3.4,男性与女性BMI不同(P<0.001)。样本人群超重和肥胖患病率分别为38.25%、12.78%;各年龄段超重率不同(P<0.05),60～69年龄段超重率最高(P<0.05),随年龄的增长,超重率有下降趋势(P<0.001);男、女性肥胖率分别为10.01%、14.69%(P<0.001),各年龄组肥胖率差异无统计学意义。高血压、高血糖、高三酰甘油等患病率随BMI升高而增加(P<0.05),在超重、肥胖组的患病率高于BMI<24.0组(P<0.05)。结论:被调查人群超重和肥胖患病率超过50%,其高血压、高血糖、高血脂患病率达40%以上;老年人超重、肥胖问题严峻,控制老年超重和肥胖刻不容缓。     

北京部分社区人群肥胖与微量白蛋白尿相关性研究

目的 探讨肥胖及其不同测量指标与微量白蛋白尿(MAU)在普通社区人群中的关系.方法 北京地区参加体检的2080例经知情同意的研究对象(男810例,女1270例),年龄(50.9±13.1)岁,测量身高、体重、腰围、臀围,并计算其BMI、腰臀比(WHR),化验尿白蛋白/肌酐比值(ACR),其结果在30～300 mg/g范围内为MAU,根据ACR结果将测试对象分为无蛋白尿组(NAU组)及MAU组.分析不同肥胖指标(BMI、腰围、WHR)与MAU之间的关系.结果 2080例受试者中,BMI(r=0.1276,P＜0.01)、腰围(r=0.0840,P＜0.01)与ACR呈正相关,WHR与ACR无相关性(P＞0.05).同时显示,BMI≥28 kg/m2(OR=2.02)、腰围≥85 cm(男)或≥80 cm(女)(OR=1.69)在NAU组与MAU组的例数百分比差异有统计学意义(P＜0.05).BMI在24～＜28 kg/m2、WHR≥0.90(男)或≥0.85(女)在NAU组与MAU组的例数百分比差异无统计学意义(P≥0.05).Logistic回归分析显示,BMI(OR=1.06)是MAU的危险因素,独立于年龄(OR=1.01)、性别(OR=1.42)、收缩压(OR=1.01)、TC(OR=1.93)、HDL-C(OR=0.54)等因素存在.结论 北京部分社区人群中肥胖是MAU的～个独立危险因素,其中不同的肥胖测量指标与MAU的相关性不尽相同.

Abstract：

Objective To investigate the correlation between microalbuminuria (MAU) and obesity and its indexes, including BMI, waist circumference(WC), and waist-to-hip ratio(WHR) , among partial community population in Beijing. Methods A total of 2080 subjects who took physical examination in Beijing, including 810 men and 1270 women with a mean age of(50. 9 ± 13. 1 )years, were enrolled. The informed consent has been achieved from each patients. BMI and WHR were calculated based on collected data of height, weight, WC, and hipline. Urine albumin-creatinine ratio(ACR) within the range of 30-300mg/g was classified as MAU. The subjects were divided into normal albuminuria ( NAU ) group and MAU group. The correlations between MAU and different obesity indexes including BMI, WC and WHR, were analyzed. Results Among the 2080 subjects, there was a positive correlation between BMI (r = 0. 1276,P＜0.01) and ACR, and WC (r = 0.0840, P ＜0.01) and ACR. WHR and ACR was irrelevant ( P ＞ 0. 05 ). In univariate analysis, there was significant difference in BMI ≥ 28 kg/m2 ( OR = 2. 02 ) and WC ≥85 cm (male) or≥80 cm (female) (OR = 1.69 ) between NAU group and MAU group (P ＜ 0. 05 ).There was no significant difference in BMI 24-＜ 28 kg/m2, and WHR ≥0. 90 (male) or ≥0. 85 (female)between NAU group and MAU group( P≥0. 05 ). Multivariate logistic regression analysis revealed that BMI ( OR = 1.06) was an isolated independent risk factor of MAU from age ( OR = 1.01 ), female ( OR = 1.42),systolic blood pressure (OR=1.01), TC (OR=1.93) and HDL-C (OR=0.54). Conclusions Obesity is an independent risk factor of MAU among partial community population in Beijing. The correlation between different obesity indexes and MAU also differs.     

不同体重指数及腰围2型糖尿病患者甲状腺功能的变化探讨

目的 探讨不同体重指数（BMI）及腰围（WC）2型糖尿病（T2DM）患者促甲状腺激素（TSH）和甲状腺激素（TH）水平的变化及肥胖对TSH、TH的影响。方法 收集住院T2DM患者275例,根据BMI不同将其分为正常组（18.5kg/m²≤BMI＜24kg/m²,88例）、超重组（24kg/m²≤BMI＜28kg/m²,90例）和肥胖组（BMI≥28kg/m²,97例）,比较3组患者的血脂水平及甲状腺功能。再根据性别和WC不同将其分为M1组（男性WC<85cm）、M2组（男性WC≥85cm）、F1组（女性WC<80cm）、F2组（女性WC≥80cm）,比较各组间上述指标。相关性分析采用Spearman相关分析,影响因素分析采用多元线性逐步回归分析。结果 与正常组比较,超重组及肥胖组患者的TSH水平明显增加（P<0.05）。F2组TSH水平明显高于F1组和M2组,游离甲状腺素（FT₄）水平低于M2组（P<0.05）。相关性分析结果显示,T2DM患者BMI与TSH呈正相关(r=0.25,P<0.05),TC与游离三碘甲腺原氨酸（FT₃）呈负相关(r=-0.39,P<0.05),BMI、WC与FT₄(r=-0.31,r=-0.29,P<0.05)呈负相关。多元线性逐步回归分析结果显示,BMI是TSH的独立相关因素,WC是FT₄的独立相关因素（P<0.05）。结论 肥胖T2DM患者TSH水平升高,FT₄下降,女性较男性腹型肥胖者变化更加明显。     

Is waist circumference a useful measure in predicting health outcomes in the elderly?

OBJECTIVE: To examine the effect of age on the relationship between body mass index (BMI) and waist circumference (WC), and the usefulness of BMI, WC and waist-hip ratio (WHR) in predicting mortality and cardiovascular risk in the elderly population. DESIGN: Longitudinal observational study of 36 months duration. SUBJECTS AND METHOD: A stratified random sample of 2,032 Chinese subjects (990 male, 1,033 female) mean age (s.d.) 80.1 (7.5), interviewed and examined at baseline and after 36 months. Deaths and presence of diabetes mellitus and hypertension were documented. A younger data set of 1,010 subjects (500 male, 510 female), mean age (s.d.) 45.5 (11.6), was used for comparison of the BMI-WC relationship between younger and older subjects. In predicting outcomes using different values of BMI, WC and WHR, receiver operating characteristic curve analysis was used to derive cut-off values with optimal sensitivity and specificity, and the likelihood ratios for mortality, diabetes and hypertension for different anthropometric values were plotted. RESULTS: The waist circumference values corresponding to BMI values of 25 and 30 kg/m(2) were higher in elderly (92 and 103 cm for men; 88 and 99 cm for women) compared with younger subjects (85 and 97 cm for men; 78 and 88 cm for women). BMI and WC are inversely associated with mortality, in both men and women, positively associated with diabetes in men but not in women. WC was positively associated with hypertension in men and women. WHR was not associated with any outcome measures. The anthropometric measurement at the point of intersection of the likelihood curves for mortality and diabetes may be considered the optimum value, being BMI=21 kg/m(2) for men and 25 kg/m(2) for women, WC between 80 and 85 cm, and WHR 0.88-0.90. CONCLUSION: Waist measurement values for predicting health outcomes in elderly people aged 70 y and over are different compared with younger subjects, and have similar predictive accuracy compared with body mass index. Waist-hip ratio is not a useful predictor.     

Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity

OBJECTIVE: To test the validity of internationally accepted waist circumference (WC) action levels for adult Asian Indians. DESIGN: Analysis of data from multisite cross-sectional epidemiological studies in north India.Subjects:In all, 2050 adult subjects >18 years of age (883 male and 1167 female subjects). MEASUREMENTS: Body mass index (BMI), WC, waist-to-hip circumference ratio, blood pressure, and fasting samples for blood glucose, total cholesterol, serum triglycerides, and high-density lipoprotein cholesterol. RESULTS: In male subjects, a WC cutoff point of 78 cm (sensitivity 74.3%, specificity 68.0%), and in female subjects, a cutoff point of 72 cm (sensitivity 68.7%, specificity 71.8%) were appropriate in identifying those with at least one cardiovascular risk factor and for identifying those with a BMI >21 kg/m(2). WC levels of > or =90 and > or =80 cm for men and women, respectively, identified high odds ratio for cardiovascular risk factor(s) and BMI level of > or =25 kg/m(2). The current internationally accepted WC cutoff points (102 cm in men and 88 cm in women) showed lower sensitivity and lower correct classification as compared to the WC cutoff points generated in the present study. CONCLUSION: We propose the following WC action levels for adult Asian Indians: action level 1: men, > or =78 cm, women, >/=72 cm; and action level 2: men, > or =90 cm, women, > or =80 cm.     

Body mass index and waist circumference as determinants of coronary artery disease in Taiwanese adults with type 2 diabetes mellitus

OBJECTIVE: This study examined the association between body mass index (BMI) and waist circumference (WC) and coronary artery disease (CAD) in Taiwanese type 2 diabetic patients. METHODS: A total of 1183 (558 men and 625 women) patients aged 62.4+/-11.6 years were studied. CAD was diagnosed by history or an electrocardiogram by Minnesota codes. RESULTS: The respective cutoffs of BMI and WC as determined by the receiver operating characteristic curves were 24.5 kg/m2 and 90 cm for men, and 25 kg/m2 and 80 cm for women. Distributions of CAD prevalence and multivariate-adjusted odds ratio (MAOR) for BMI cutoffs of 24.5 and 25 kg/m2 were quite similar in men. MAOR for WC above the respective cutoffs for men and women was 1.832 (1.267-2.648) and 1.450 (0.956-2.200, 0.05 or = 25 kg/m2 was 1.759 (1.213-2.551) and 1.471 (1.052-2.058) for men and women, respectively. Patients with BMI> or = 25 kg/m2 and WC > or = 90 cm for men or > or = 80 cm for women had the highest risk of CAD when compared to those without either risk factor, with respective MAOR of 2.053 (1.352-3.118) and 1.698 (1.071-2.691). CONCLUSION: The recommended BMI and WC cutoffs for obesity for Asian adults are associated with CAD in Taiwanese T2DM.     

Association between different measurements of obesity and the incidence of hypertension

BACKGROUND: Obesity is a risk factor for the incidence of hypertension, but it is still unclear whether this risk can be better estimated by body mass index (BMI) or waist circumference (WC). METHODS: In the baseline evaluation of a population-based cohort, 1089 adults answered a pretested questionnaire and had their baseline blood pressure (BP) and anthropometric measurements assessed according to standardized recommendations. Excluding the individuals with hypertension at baseline, and those deceased or lost during the follow-up, 592 individuals (80.5% of those eligible) were visited again. Obesity was defined as BMI >/=30 kg/m(2) for both genders, and WC >/=102 cm for men and WC >/=88 cm for women. Incident cases of hypertension were characterized by BP >/=140/90 mm Hg or use of BP medication in the follow-up visit. RESULTS: After a mean follow-up of 5.6 +/- 1.1 years, 127 incident cases of hypertension were identified. The hazard ratios (Cox model), adjusted for age and baseline systolic BP (95% CI and P), for BMI higher than 30 kg/m(2) were 1.08 (0.52-2.24, P =.82) in men and 1.74 (0.93-3.26, P =.08) in women. The corresponding figures were 1.78 (0.76-4.09, P =.18) for men with WC >/=102, and 1.72 (1.09-2.73, P =.02) for women with WC >/=88 cm. CONCLUSIONS: We conclude that the risk for hypertension may be better identified by obesity defined by higher WC than higher BMI.     

Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993-2009

The objective of this study is to examine the trends in body mass index (BMI), waist circumference (WC) and prevalence of overweight (BMI 25-27.49 kg m(-2) ), general obesity (BMI ≥ 27.5 kg m(-2) ) and abdominal obesity (WC ≥ 90 cm for men and ≥80 cm for women) among Chinese adults from 1993 to 2009. Data were obtained from the China Health and Nutrition Survey, which was conducted from 1993 to 2009 and included a total of 52,621 Chinese adults. During the period of 1993-2009, mean BMI values increased by 1.6 kg m(-2) among men and 0.8 kg m(-2) among women; mean WC values increased by 7.0 cm among men and 4.7 cm among women. The prevalence of overweight increased from 8.0 to 17.1% among men (P < 0.001) and from 10.7 to 14.4% among women (P < 0.001); the prevalence of general obesity increased from 2.9 to 11.4% among men (P < 0.001) and from 5.0 to 10.1% among women (P < 0.001); the prevalence of abdominal obesity increased from 8.5 to 27.8% among men (P < 0.001) and from 27.8 to 45.9% among women (P < 0.001). Similar significant trends were observed in nearly all age groups and regions for both men and women. The prevalence of overweight, general obesity and abdominal obesity among Chinese adults has increased greatly during the past 17 years.     

Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease

AIM: To study the effect of regular aerobic exercise on insulin resistance, serum aminotransferase and liver histology in nonalcoholic fatty liver disease (NAFLD) patients. METHODS: Sixty (mean age 40.0 ± 8.5 years, 75% male) NAFLD patients were included in the study. After baseline anthropometric measurement i.e., body mass index (BMI), waist circumference (WC); all patients were advised regular aerobic exercise for 30 min/d, for at least 5 d/wk and trained to achieve around 70% of his maximal heart rate. In addition, moderately energy restricted diet was advised to patients with high BMI (> 25 kg/m 2 ). Monthly follow up was done by measuring BMI, WC, aspartate aminotransferase, and alanine aminotransferase (ALT). Insulin resistance was calculated using homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) model, at baseline and after 6mo. Insulin resistance was arbitrarily considered altered when it was ≥ 2. Liver biopsy was done in a section of patients at baseline and after 6 mo. RESULTS: Seventy percent (42/60) patients were overweight or obese; 95% (57/60) had central obesity (WC > 90 cm in men, > 80 cm in women). In the 45 exercise compliant patients insulin resistance decreased from 6.4 ± 6.1 to 1.3 ± 1.0, BMI from 26.7 ± 3.3 kg/m 2 to 25.0 ± 3.3 kg/m 2 , WC from 95.7 ± 8.9 cm to 90.8 ± 7.3 cm and ALT from 84.8 ± 43.5 U/L to 41.3 ± 18.2 U/L (P < 0.01). In 15 exercise noncompliant patient’s insulin resistance, BMI, WC and ALT did not show significant change at 6 mo follow up. Six of 8 patients in compliant group on repeat liver biopsy showed significant change in steatosis and necroinflammation. Nonalcoholic steatohepatitis scores improved form 5.3 ± 1.5 to 3.35 ± 1.5. The decline in insulin resistance correlated with decline in ALT (P = 0.01, r s = 0.90) and liver histology (P = 0.03, r s = 0.73). CONCLUSION: Life style modification improves insulin resistance resulting in improvement in ALT and liver histology in NAFLD patients.     

河北涞源县贫困人口高血压患病现况及影响因素分析

目的探讨河北涞源县贫困人口高血压的患病现况和该地区高血压发病的主要危险因素。方法研究对象均来自河北省保定市银坊镇下属21个行政村在册的贫困人口,随机抽取150人(男/女:59/91)参与调查。排除认知功能异常不能配合完成问卷调查及生化检查缺项的居民,共141人(男/女:54/87)纳入研究,年龄44~92岁。研究对象均完成完整的问卷调查、体格检查及血生化检查。按照高血压与非高血压分为两组,年龄、体重指数、性别与是否吸烟等进行亚组分析。结果高血压患病率为48.2%。体重、BMI、TC、LDL-C、吸烟者占比高血压组明显高于非高血压组,差异有统计学意义(P<0.05)。<65岁贫困居民高血压患病率(77.5%)明显高于≥65岁老年人(36.6%,OR=5.96,95%CI:2.56-13.88,P<0.001)。BMI≥28 kg/m^2组高血压患病率为65.5%,显著高于BMI<24kg/m^2组,(OR=2.43,95%CI:1.04-5.73,P<0.05)。男性吸烟组高血压患病率为50%,非吸烟组25%,两者比较差异无统计学意义(P>0.05)。Logistic回归分析男性、年龄≥65岁、不吸烟为高血压患病的保护因素。结论该地区贫困人口高血压患病率为48.2%,体重、BMI、总胆固醇、低密度脂蛋白、吸烟率高血压组明显高于非高血压组。BMI≥28 kg/m^2是高血压患病的危险因素,男性、≥65岁、非吸烟是高血压患病的保护因素。     

炎性肠病患者发生非酒精性脂肪性肝病的危险因素

目的探讨炎症肠病(inflammatory bowel disease,IBD)患者非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患病情况及相关危险因素。方法以2017年1月至2019年10月新疆军区总医院收治的409例IBD患者为研究对象,应用腹部超声筛查NAFLD,根据是否合并NAFLD分为NAFLD组(131例)和对照组(278例),比较两组患者年龄、性别、体重指数(body mass index,BMI)、腹围、病程及并发症(高血压、糖尿病、吸烟)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、γ-谷氨酰转移酶(gamma-glutamyltransferase,GGT)、白蛋白、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、血肌酐、估算肾小球滤过率(estimated glomerular filtration rate,eGFR)和C-反应蛋白(C-reactive protein,CRP)等的差异。采用Logistic回归分析IBD患者发生NAFLD的独立危险因素。结果IBD患者NAFLD的患病率为32.03%(131/409)。NAFLD组患者年龄[(50.24±12.83)岁vs(38.74±10.91)岁]、BMI[(28.24±4.90)kg/m2 vs(23.52±3.73)kg/m2]、腹围[(93.10±11.52)cm vs(85.52±10.06)cm]、病程[(8.52±1.84)年vs(5.84±1.28)年]、高血压比例[20.61%(27/131)vs 4.68%(13/278)]、糖尿病比例[9.92%(13/131)vs 1.80%(5/278)]、吸烟比例[50.38%(66/131)vs 38.13%(106/278)]、GGT[(26.57±8.19)U/L vs(18.46±4.36)U/L]和HbA1c[(6.65±2.17)%vs(3.64±1.05)%]水平均显著高于对照组,差异有统计学意义(P均<0.05)。多因素Logistic回归分析表明年龄(OR=1.33,95%CI:1.15~1.82,P=0.018)、BMI(OR=1.80,95%CI:1.25~3.27,P=0.002)、病程(OR=2.60,95%CI:1.10~3.26,P=0.010)和糖尿病(OR=1.77,95%CI:1.23~4.79,P=0.006)是IBD患者发生NAFLD的独立危险因素。结论IBD患者NAFLD的患病率高,年龄、BMI、病程和糖尿病均是IBD患者发生NAFLD的独立危险因素,可通过促进健康生活方式进行代谢干预,以减少NAFLD的发生。