深圳市体检人群代谢综合症及其相关危险因素的分析

目的探讨深圳市体检人群不同性别、年龄组代谢综合症（MS）诊断及其相关危险因素流行病学分布特点。方法按照2004年中华医学会推荐诊断标准,对收集到的8884名体检人员的体重、身高、血压、空腹血糖及血脂进行不同性别、年龄组MS诊断及其相关危险因素流行病学分布特点分析。结果 MS患病人数1412,总患病率为15.89%,其中男性患病率为19.98%,女性患病率为11.52%,患病率在50岁之前,男性明显高于女性,61岁以后女性高于男性,差异均有统计学意义（P〈0.05）。高血压患病率男女分别为21.90%、15.17%,高空腹血糖患病率男女分别为7.10%、4.73%,高甘油三酯（TG）患病率男女分别为44.32%、22.10%,高BMI患病率男女分别为39.07%、18.32%,均为男性高于女性,差异有统计学意义（P〈0.05）。高甘油三酯血症、肥胖患病率最高;各代谢危险因素间有相关性（P〈0.001）。结论深圳市体检人群MS患病率高,特别是青年男性、老年女性,主要危险因素为高甘油三酯血症、肥胖。     

延安地区中老年高血压患者的体质量指数及遗传方式研究

目的探讨中老年人体质量指数与高血压发生的关系及其遗传方式。方法标准法测量并计算456名中老年人的身高、血压、体质量指数,按不同分组,分析高血压患病情况及其遗传方式。结果男性肥胖组(BMI≥25)的高血压患病率(48.21%),明显高于正常组(BMI18.5~24.9,29.32%);女性肥胖组患病率(52.38%)明显高于BMI正常组(29.75%)。遗传方式应为多基因遗传。结论肥胖是影响高血压患病率的重要因素,高血压的发生与遗传和环境都有关系。     

糖尿病患者中肥胖与血管并发症的关系

目的：探讨肥胖对糖尿病发生及其并发症的影响。方法：对北京地区,年龄≥25岁的1657人群进行标准口服葡萄糖耐量试验及糖尿病并发症检查。结果：体重指数（BMI）≥25的肥胖者,糖尿病、糖耐量减低的患病率均显著高于BMI＜25者（P＜0．01）。BMI≥25的糖尿病患者高血压、脑卒中患病率亦高于BMI＜25的糖尿病患者,而视网膜病变的患病率低于后者。糖尿病肾病的患病率在肥胖与非肥胖两组相同。结论：肥胖是糖尿病、糖耐量减低及其高血压、脑卒中的重要危险因素,而在微血管并发症的作用有待于进一步探讨。     

瘦素和脂联素在儿童肥胖相关性高血压发病中的作用

目的探讨瘦素和脂联素在儿童肥胖相关性高血压发病中的作用。方法基于北京市儿童青少年代谢综合征研究项目的现况调查结果,非随机选择3502名6-18岁学龄儿童（其中男1784名,女1718名）为研究对象,按照超重（包括肥胖）和高血压状态将研究对象分为4组,正常体重正常血压组（对照组,1497名）、正常体重高血压组（HBP组,125名）、超重但血压正常组（OB组,1349名）和超重合并高血压组（OB＋HBP组,531名）。通过比较4组人群血清瘦素和脂联素水平,以及瘦素和脂联素与血压之间的相关回归分析,探讨其与肥胖和血压之间的关系。结果超重肥胖人群BMI、血压、胰岛素和瘦素水平显著升高,脂联素水平降低。HBP组与对照组BMI、瘦素、脂联素水平差异无统计学意义。OB组和OB＋HBP组与对照组比较,BMI、SBP、DBP、胰岛素和瘦素水平升高,脂联素水平降低,与HBP组比较仍可见BMI、胰岛素和瘦素水平升高,脂联素水平降低。与OB组比较,OB＋HBP组BMI和胰岛素水平及男性的瘦素水平明显升高。血压与年龄、BMI、胰岛素、瘦素均呈显著正相关（r=0.260-0.643,P〈0.01）,与脂联素呈显著负相关（r=-0.171--0.332,P〈0.01）。但在调整胰岛素或BMI后,瘦素、脂联素与血压的相关性减弱或消失。结论超重人群血压、胰岛素及瘦素水平均高于对照人群,脂联素水平低于对照人群。瘦素、脂联素可能通过肥胖或胰岛素抵抗与血压相关。     

北京市城乡中年人高血压流行情况及危险因素分析

 目的 对比研究北京城市和农村高血压的流行情况及其危险因素。方法 于2005年采用整群抽样的方法,在北京市城市和农村的40～65岁人群中对3268人中进行问卷和体检。诊断标准依据2005年中国高血压防治指南。多因素分析采用Logistic回归方法。结果 农村高血压的患病率为55.58%,显著高于城市的42.91%(P<0.05)。城市男性和女性高血压的患病率为49.54%和38.52%,显著低于农村男性和女性的57.68%和54.17% (P值均小于0.05)。不同性别多因素分析显示,年龄、BMI、腰围、空腹血糖、文化程度为男性的危险因素,年龄、BMI、腰围、职业、甘油三酯为女性的危险因素。结论 农村人群高血压患病率快速上升。主要危险因素有体质指数和腰围。     

广州铁路职工中老年人群脂肪肝的流行特征及影响因素分析

目的掌握广州铁路中老年职工（年龄≥45岁）脂肪肝（FLD）的流行特征及影响因素。方法2007年9月-2008年8月,选择广州铁路地区中老年职工进行问卷调查、体格检查、血生化和肝脏超声检查。结果4974例受检人员中,共检出FLD患者1473人,FLD患病率为29.6%,男性FLD患病率为29.4%,女性为30.3%,差异无统计学意义（P=0.514）;男性及女性均在55～65岁达到峰值。55岁以前男性的患病率高于女性（P=0.028）,55岁后两者患病率差异无统计学意义（P〉0.05）;酒精性脂肪肝患病率为5.4%,非酒精性脂肪肝（NAFLD）患病率为24.2%;多因素Logistic回归分析显示饮酒、高血压、高甘油三酯、高血糖、肥胖、高尿酸血症是广州铁路中老年职工FLD的影响因素。结论广州铁路中老年职工FLD患病率高,主要为NAFLD。饮酒、高血压、高甘油三酯、高血糖、肥胖、高血尿酸等为FLD的影响因素。     

2001年河北省儿童青少年血压及相关因素分析

目的探讨河北省健康儿童青少年的血压分布与性别、年龄、城乡以及生长指标的相关性。方法采用分层不等整群抽样的原则,在河北省的两市、两县中随机抽取检测人群,体检确定为健康的5268名10～18岁的儿童、青少年,进行血压、身高和体重等指标的测定。结果儿童、青少年的血压随着年龄的增长而升高,城市男、女儿童、青少年的血压高于农村(P<0·001),尤其以舒张压更明显;男性和女性的血压偏高率分别为7·5%和6·8%,总血压偏高率为7·2%,高于以往同地区儿童、青少年的血压偏高率;血压偏高者其收缩压(SBP)、舒张压(DBP)、体重和BMI值均显著高于同年龄、同性别的血压正常者(P<0·001);Pearson相关分析显示,男、女学生收缩压和舒张压与年龄、身高、体重、BMI均呈正相关(P<0·001),其中男生血压与身高、体重,女生与体重的相关系数较大。结论河北地区儿童、青少年的血压偏高率高于该地区已报道值;体重偏高或肥胖儿童、青少年应注意控制体重,以降低患原发性高血压的危险性。     

血尿酸水平与肥胖相关指数的关系

一项队列前瞻性研究结果显示，在体重指数（BMI）分别妇过25和27的男性和女性中，全因死亡率明显上升。在我国，成人超重率达22．8％，肥胖率达7．1％。随着肥胖人数逐年上升，与肥胖相关的疾病如心脑血管病、糖尿病、高血压、代谢综合征（MS）等的发病率也呈明显增加趋势。高尿酸血症与肥胖、高血压、血脂等的相关性已有较多研究，本文以BMI≥25为切割点，     

农村老年高血压降压治疗现况分析

目的了解农村60岁以上的老年人高血压患病情况及生活方式对高血压的影响。方法2008年9月对江苏泗洪县农村60岁以上570位老年人进行高血压病患病情况进行调查分析。结果调查570人,检出高血压病239人（检出率为42％）,高于全国调查结果。男性患病率高于女性．且饮酒、吸烟、高血脂等高血压危险因素的患病率较女性高,同样冠。病和脑血管病的患病率也高于女性。结论大多农村居民普遍对健康问题不重视．饮食结构不合理,对高血压病知识防治意识差等,是导致高血压发病率升高的主要原因,应该在该人群中开展高血压病健康教育。     

西藏日喀则地区成年僧人体质状况与血压水平的相关性分析

目的:探讨西藏日喀则地区成年僧人体质状况与血压水平的相关性,为高血压的早期预防提供相关依据。方法:采用整群随机抽样的方法,对居住在西藏日喀则地区成年僧人155例的血压(BP)、身高、体质量、腰围(WC)、臀围进行测量,并计算体质指数(BMI)、腰臀比(WHR)和腰身比(WHtR)。结果:155例检测者中高血压的患病率是29%,高血压组在年龄、BMI、WC、WHR和WHtR等方面均高于血压正常组。收缩压和舒张压均随着年龄的增加呈升高趋势;脉压亦随着年龄的增大而增大;高血压的患病率也随着年龄的增加而逐步增大。随着全身性肥胖指标BMI的增加,血压各水平和高血压患病率均升高。各中心性肥胖组的血压水平和高血压患病率均明显高于非肥胖组。Pearson线性相关分析显示,BMI、WC、WH-R和WHtR与收缩压、舒张压和脉压均呈正直线相关。以高血压为因变量进行多因素logistic回归分析,结果显示,BMI、WC和WHtR是血压变化的独立影响因素。结论:西藏日喀则地区成年僧人血压水平与体质状况密切相关,高血压患病率和肥胖率均较高,应予以足够重视,积极控制全身性肥胖和中心性肥胖,从而防治高血压的发生。     

Obesity and regional fat distribution in Kenyan populations: Impact of ethnicity and urbanization

Background: Obesity is increasing rapidly in Africa, and may not be associated with the same changes in body composition among different ethnic groups in Africa.

Objective: To assess abdominal visceral and subcutaneous fat thickness, prevalence of obesity, and differences in body composition in rural and urban Kenya.

Subjects and methods: In a cross-sectional study carried out among Luo, Kamba and Maasai in rural and urban Kenya, abdominal visceral and subcutaneous fat thicknesses were measured by ultrasonography. Height and weight, waist, mid-upper arm circumferences, and triceps skinfold thickness were measured. Body mass index (BMI), arm fat area (AFA) and arm muscle area (AMA) were calculated.

Results: Among 1430 individuals (58.3% females) aged 17–68 years, abdominal visceral and subcutaneous fat, BMI, AFA and waist circumference (WC) increased with age, and were highest in the Maasai and in the urban population. AMA was only higher with increasing age among males. The prevalence of overweight (BMI ≥ 25) (39.8% vs. 15.8%) and obesity (BMI ≥ 30) (15.5% vs. 5.1%) was highest in the urban vs. rural population.

Conclusion: Abdominal visceral and subcutaneous fat thickness was higher with urban residency. A high prevalence of overweight and obesity was found. The Maasai had the highest overall fat accumulation.     

Profiles of body mass index and blood pressure among young adults categorised by waist-to-height ratio cut-offs in Shandong,China

Abstract

Background: Waist-to-height ratio (WHtR) is proposed as a valid measure of abdominal obesity and health risks in practice. The present study examined the profiles of weight status and blood pressure (BP) among young adults categorised by WHtR cut-offs.

Methods: A total of 4226 college students (2107 males and 2119 females) aged 19–22?years participated in the study. The body mass index (BMI) cut-offs recommended by the Working Group on Obesity in China (WGOC) were used to define underweight, normal weight, overweight and obesity. The BMI and BP profiles within each WHtR category were examined.

Results: For both males and females, ‘the high WHtR group’ (WHtR ≥ 0.5) had the highest, and ‘the low WHtR group’ (WHtR < 0.4) had the lowest BMI and BP levels. In the WHtR = 0.30–0.34 sub-group, 66.10% of males and 66.67% of females were underweight; in the WHtR ≥ 0.55 sub-group, 91.49% of males and 83.33% of females were obese; in the WHtR = 0.40–0.44 sub-group, 88.88% of males and 89.85% of females were normal weight. The prevalence of high BP in the WHtR < 0.5 group was 9.99% in males and 2.19% in females; the corresponding figures were 28.92% (males) and 14.06% (females) in the WHtR ≥ 0.5 group; the latter is significantly higher than the former (p?<?0.01).

Conclusion: Individuals with low WHtR were underweight and those with high WHtR were obese with high BP. Results from this study support WHtR as a simple and effective screening tool for abdominal obesity and high BP in practice.     

蛋白酪氨酸磷酸酶1B基因位点IVS6＋G82A多态性与肥胖相关性高血压研究

目的探讨PTP1B基因位点IVS6＋G82A多态性与肥胖高血压的相关性。方法选取来自上海、南京地区汉族高血压患者393例（其中男性210例,女性183例;年龄25～70岁,平均年龄56.59岁）和非高血压患者266例（其中男性141例,女性125例;年龄28～72岁,平均年龄57.03岁）,根据体质量指数（BMI）是否≥24kg/m2分为超质量高血压组242例,单纯高血压组151例,超质量对照组116例,正常对照组150例。运用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法测定PTP1B基因位点IVS6＋G82A的多态性。结果超质量高血压组GG基因型及等位基因G频率高于单纯高血压组、超质量对照组和正常对照组。多元逻辑回归分析显示在超质量人群中,位点IVS6＋G82A等位基因G、性别、甘油三酯（TC）、低密度脂蛋白胆固醇（LDL-C）、胰岛素敏感指数是高血压发病的独立相关因素。以AA基因型为参照,GG基因型患肥胖相关性高血压的比值比（OR）为2.29（P〈0.01）。在超质量高血压组中,GG基因型人群血清TC、LDL-C水平高于AA和AG（P〈0.05）基因型人群。结论位点IVS6＋G82A变异与肥胖高血压相关,并与患者脂代谢异常相关。     

Prevalence of parameter indicators of obesity and its relationship with metabolic syndrome in urban Moroccan women

This study aimed to examine the relationship between metabolic syndrome (MS) and different types of obesity in urban Moroccan women. On 213 women aged 25–55 years, Triglycerides (TG), total cholesterol, high‐density lipoprotein cholesterol (HDL‐c), lower‐density lipoprotein cholesterol (LDL‐c), and fasting blood glucose levels were assessed. Body mass index (BMI), waist to hip ratio (WHR), Waist circumference (WC), and blood pressure (BP) were also measured. Globally 36.6% of women were overweight (25 ≤ BMI < 30 m²), 23.9% obese (BMI > 30 m²), 19.7% had WHR > 0.85 and 28.8% had WC ≥ 88 cm. Indicators of obesity increased with age and the prevalence of co‐morbid factors increased with obesity. The women with android obesity (WHR > 0.85) and central obesity (WC ≥ 88 cm) had greater risk compared to those with overweight and general obesity. The prevalence of MS was 17.8% and increased (31.49%) with high BMI and high WHR (50%). MS and its co‐morbidity factors are prevalent among Moroccan women aged 35years and over. The exaggerated influence of obesity in this prevalence suggests that the prevention of obesity could prevent MS and its complications. Am. J. Hum. Biol., 2008. © 2008 Wiley‐Liss, Inc.     

Fourteen year changes in adiposity and blood pressure in American Samoan adults

A cohort of 194 American Samoan adults with no history of antihypertensive treatment was seen at two times, 14 years apart, 1976 and 1990. Anthropometric and blood pressure (BP) data in 1976 and 1990, and the chages, were described and correlated within age (<40 and ?40 years) and sex groups. These Samoans are characterized by massive adiposity and body mass, as well as high prevalence and incidence of overweight and hypertension. The younger group had a notable mean increase in the body mass index (BMI) and fatness over 14 years, whereas only younger females had BP increases. Among older females there were small negative mean chages, and in older males small positive mean changes in BMI and skinfolds. In both older males and females, systolic BP increased markedly with little mean change in diastolic BP. There was substantial heterogeneity around the mean chages in all sex-age groups. Adiposity in 1976, assessed by the BMI and skinfolds, was positively related to follow-up BP in all groups except older males. Chages in adiposity were positively related to chages in BP in all groups. Multiple regression analyses showed that change in BMI and age were positively related to 1990 BP after adjustment for baseline BP. © 1995 Wiley-Liss, Inc.     

原发性高血压病患者TNF-α与IR的关联分析

目的：探讨原发性高血压病患者肿瘤坏死因子-α（TNF-α）与胰岛素抵抗（IR）的关联。方法：应用放免法测定41例原发性高血压病患者和38例正常对照组的血清TNF-α及胰岛素（fINS）水平,用胰岛素抵抗指数（HOMA-IR）评价IR程度。结果：高血压组病血清TNF-α水平显著高于正常对照组（P〈0.001）;HOMA-IR显著高于正常对照组（P〈0.001）,相关分析显示,在高血压病组及正常对照组中,TNF-α与BMI、HOMA-IR、收缩压（SBP）呈正相关（P〈0.05）。结论：高血压病患者血清TNF-α升高,且与肥胖及IR呈正相关。     

正常成年人椎体氢质子磁共振波谱与个体因素的初步研究

目的应用氢质子磁共振波谱(1H-MRS)技术,探讨正常成年人腰椎(L1~L4)椎体的脂水比(LWR)和脂肪含量(FF%)与性别、年龄及体质量指数(BMI)之间的关系。方法选择100例MRI检查正常的成年人,其中男性52例(52%),女性48例(48%);年龄18~79岁,平均年龄46.77岁;平均BMI为22.85。按性别、年龄及BMI进行分组:男性组52例,女性组48例:青年组(≤44岁)44例,中年组(45~59岁)33例,老年组(≥60岁)22例;正常组(18.5BMI24.0)69例,超质量肥胖组(BMI≥24)31例。所有纳入对象行MRI常规扫描及L1~L4椎体的1H-MRS扫描,测量并记录椎体的LWR及FF%,采用SPSS13.0对所有数据按组别进行统计学分析。结果 L1~L4椎体的平均LWR及FF%分别为1.20±0.75、1.41±0.93、1.57±1.05、1.58±1.09和0.50±0.15、0.53±0.15、0.56±0.15、0.56±0.15,LWR及FF%在性别及年龄组间的差异具有统计学意义(P0.05),而BMI组间差异不具有统计学意义(P0.05);相关性分析结果显示,L1~L4椎体的LWR和FF%与年龄呈正相关(P0.05,相关系数为0.47~0.54),但与BMI没有相关性(P0.05)。结论 L1~L4各椎体的LWR和FF%均存在性别差异(男性高于女性),并随着年龄的增加而增大。