中山市成人体质指数和腰围与高血压和糖尿病以及血脂异常的关系

目的探讨成人体质指数(BMI)、腰围(WC)与高血压、糖尿病和血脂异常的关系,为中山市居民制定适宜的慢性病综合防治策略和措施提供参考。方法于2016年8—12月采用多阶段的抽样方法抽取中山市24个镇区的6 150名成年居民为研究对象,进行问卷调查、体格检查及血生化指标测定。采用SPSS 20.0软件进行方差分析、χ~2检验、偏相关分析和多因素非条件logistic回归分析。结果调查人群高血压、糖尿病和血脂异常患病率分别为22.9%、10.4%和40.4%。不同BMI、WC组间血压、血糖和血脂差异均有统计学意义(P0.01)。采用偏相关分析校正年龄的影响后发现,BMI、WC与收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯和低密度脂蛋白胆固醇均呈正相关,与高密度脂蛋白胆固醇均呈负相关,均有统计学意义(P0.01)。多因素logistic回归分析结果显示,随着BMI和WC增加,高血压、糖尿病和血脂异常患病风险上升,BMI≥28.0 kg/m2组高血压、糖尿病和血脂异常患病风险分别是BMI 18.5～24.0 kg/m2组的4.899倍(OR=4.899,95%CI:4.056～5.918)、3.237倍(OR=3.237,95%CI:2.540～4.126)和2.483倍(OR=2.483,95%CI:2.098～2.937);WC≥90.0 cm组3种慢性病患病风险分别是WC 75.0～83.0 cm组的3.729倍(OR=3.729,95%CI:3.096～4.492)、3.582倍(OR=3.582,95%CI:2.763～4.642)和2.375倍(OR=2.375,95%CI:2.039～2.767),均有统计学意义(P0.01)。BMI和WC每增加1个标准差,高血压患病风险增加121.1%和88.2%(OR值分别为2.211、1.882),糖尿病患病风险增加84.0%、83.6%(OR值分别为1.840、1.836),血脂异常患病风险增加69.7%、58.5%(OR值分别为1.697、1.585),均有统计学意义(P0.01)。结论中山市成人BMI、WC与高血压、糖尿病和血脂异常密切相关。建议通过健康教育的方式,倡导合理、健康、规律饮食,增强体育锻炼,保持理想体重,从而有效降低慢性病患病带来的疾病负担,提高生存质量。     

江苏省老年人体质指数和腰围与主要慢性病的关系

目的探讨江苏省老年人体质指数(BMI)、腰围(WC)与高血压、血脂异常和糖尿病等常见慢性病的关系。方法利用江苏省2010年成人慢性病及其危险因素监测中≥60岁老年常住居民的数据,运用t检验或方差分析、偏相关分析和非条件logistic回归等方法,分析BMI、WC与血压、血脂和血糖及高血压、血脂异常和糖尿病等常见主要慢性病的关系。结果江苏省老年人肥胖、中心性肥胖和慢性病粗患病率分别为13.5%、54.3%和82.6%,患病率居于前3位的慢性病为高血压、血脂异常和糖尿病。BMI、WC均与收缩压(SBP)、舒张压(DBP)、TC、LDL-C、TG和FPG呈正相关,而与HDL-C呈负相关(P0.05)。肥胖、中心性肥胖、BMI和WC均与高血压、血脂异常和糖尿病显著相关,高血压、血脂异常和糖尿病患病风险随着BMI和WC的增加而不断升高(P0.05)。BMI每增加1个标准差(SD),高血压、血脂异常和糖尿病患病风险分别升高79%(OR=1.79,95%CI:1.61~2.00)、67%(OR=1.67,95%CI:1.52~1.84)和56%(OR=1.56,95%CI:1.38~1.76);WC每增加1个SD,高血压、血脂异常和糖尿病患病风险分别升高63%(OR=1.63,95%CI:1.47~1.80)、74%(OR=1.74,95%CI:1.58~1.91)和66%(OR=1.66,95%CI:1.46~1.89)。结论高血压、血脂异常和糖尿病是江苏省老年人常见主要慢性病。BMI、WC与高血压、血脂异常和糖尿病密切相关。     

脂质蓄积指数和糖尿病家族史交互作用与糖尿病关系的研究

目的探讨脂质蓄积指数(lipid accumulation product,LAP)和糖尿病家族史交互作用对糖尿病患病风险的影响。方法利用logistic回归和受试者工作特征(receiver operating characteristics,ROC)曲线研究LAP与糖尿病的关系,并用交互作用引起的相对超额风险(the relative excess risk due to interaction, RERI),相互作用比例(attributable proportion due to interaction, AP)和协同指数(synergy index, SI)评价LAP和糖尿病家族史对糖尿病的交互作用。研究对象来源于2015年在安徽省蚌埠市某区进行的"创建省级慢性病管理示范区"项目,通过多阶段随机抽样方法在该区7个社区/街道进行抽样调查,共计纳入1 777名研究对象。结果多因素logistics回归分析显示,LAP升高(OR=3.93, 95%CI:2.47～6.27)是糖尿病发病的重要危险因素。男性中LAP预测糖尿病风险的能力优于BMI(Z=2.37,P=0.02),但与腰围(waist circumference,WC)比较差异无统计学意义(Z=1.23,P=0.22);女性中LAP的AUC与BMI(Z=2.57,P=0.01)和WC (Z=2.33,P=0.02)差异均有统计学意义。LAP和糖尿病家族史对糖尿病风险有交互作用(RERI:2.93, 95%CI:0.33～5.52; AP:0.46, 95%CI:0.21～0.72; SI:2.24, 95%CI:1.21～4.15)。结论 LAP增加与糖尿病发病风险密切相关,且其与糖尿病家族史对糖尿病发病存在交互作用。     

朝鲜族和汉族女性正常范围内GGT与高血压的相关性研究

目的探讨朝鲜族和汉族女性的正常范围内谷氨酰基转移酶(GGT)与高血压的相关性。方法选取2011年5月-2012年2月参加健康体检的20岁以上成年女性3341名,测定身高、体重、血压、血脂、血糖、肝功等指标,分析GGT与各项指标的相关性及不同GGT水平的高血压的患病风险。结果朝鲜族和汉族女性GGT水平与BMI、SBP、DBP、TC、TG、FPG、UA均呈正相关,朝鲜族和汉族女性未调整时GGT上四分位组高血压患病危险分别是下四分位组的2.844倍(95%CI:2.006～4.033)和4.992倍(95%CI:3.280～7.599),调整年龄、BMI、TC、TG、FPG、UA和GFR等因素后上四分位组高血压患病危险是下四分位组的1.811倍(95%CI:1.230～2.666)和2.115倍(95%CI:1.301～3.440);并且不同模型中朝鲜族和汉族女性均随着GGT水平的增加,患高血压的危险增加。结论正常范围内GGT水平的升高可以预测高血压的发生,并且对于汉族女性的预测作用强于朝鲜族。     

女性出生体重与成年期高血压的关联及代际关联研究

目的 分析女性出生体重与成年期血压水平及高血压患病的关联,探讨出生体重及高血压的代际关联。方法 2012年11月～2016年12月期间在上海闵行区11 660名有直系血缘关系的2~4代女性中进行了横断面调查,收集人口学特征、出生信息、生活方式及疾病史等数据。对20岁及以上研究对象行身高、体重、腰臀围、血压测量。采用线性、非线性回归和通径分析方法进行数据分析。结果 出生体重每增加1.0 kg,成年期收缩压、舒张压和脉压分别变化-0.2（95%CI:-0.6～0.7）、-0.3（95%CI:-0.6～0.2）和0.3（95%CI-0.2～0.8）mm Hg（均有P<0.05）。出生体重与成年后高血压患病风险关联差异无统计学意义（OR=0.9,95%CI:0.7～1.0,P=0.140）。与出生体重2.5～kg的女性相比,调整年龄等混杂因素后,出生体重<2.5,3.0~,3.5~kg及≥4.0 kg的女性成年后患高血压的OR（95%CI）值分别为0.8（0.5～1.2）、1.0（0.9～1.2）、0.8（0.6～1.0）和0.7（0.4～1.2）。通径分析结果显示,母女两代人群的出生体重、血压水平及高血压患病状况均相关（均有P<0.05）,但未见母亲出生体重对女儿血压水平影响。结论 女性出生体重与成年期血压水平及高血压患病风险无显著的代际关联。     

老年人肥胖与主要慢性病的关系

目的 分析南京市老年人肥胖与高血压、糖尿病、冠心病、高血脂的关系。方法 2013年4月~12月利用整群随机抽样法抽取南京市某区1 927名60岁及以上的老年人;对其进行问卷调查、体格检查和实验室检测,获取信息,得到完整有效资料1 808份;肥胖用体质指数（body mass index,BMI）和腰围（waist circumference,WC）诊断,采用SPSS 19.0软件进行方差分析、χ2检验、非条件Logistic回归分析,探讨肥胖与血压、血糖、血脂以及主要慢性病的关系。结果 1 808名老年人中慢性病患病人数为1 276（70.6%）人,主要慢性病为高血压、糖尿病、冠心病、高血脂;超重人数为668人,占36.9%,肥胖人数为150人,占8.2%。中心肥胖人数为406人,占比22.5%;肥胖与收缩压、舒张压、空腹血糖、总胆固醇、甘油三脂、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇密切相关（均有P<0.05）;BMI和WC对高血压患病情况有影响（均有P<0.05）。结论 老年人肥胖增加主要慢性病患病风险,肥胖与血压、血糖、血脂密切相关,控制体重是提高老年人健康水平的有效方法。     

体格测量对围绝经期糖尿病患病风险的预测

目的：探讨围绝经期女性人体测量参数对2型糖尿病( T2DM)患病风险的预测价值。方法以2011年1月至2014年12月在广州市妇女儿童医疗中心体检中心参与体检并符合纳入标准的637例围绝经期女性为研究对象,进行T2DM患病筛查,测量身高、体重、腰围( WC )、臀围,计算体质指数( BMI )、腰臀比( WHR )和腰围身高比( WHtR );采用Logistic回归和ROC曲线评估各指标对T2DM患病风险的预测价值。结果有20.3%的调查对象患T2DM;随着BMI(χ2=9.64,P=0.008)、WC(χ2=8.99,P=0.010)、WHR(χ2=18.78,P<0.001)和WHtR(χ2=10.97,P<0.001)反映肥胖程度的增加,T2DM患病率上升,差异均有统计学意义。在控制年龄差异之后的多因素Logistic回归分析结果显示,仅BMI≥28kg/m2( OR=2.61,95%CI：1.22~5.56)和WHR≥0.85(OR=2.35,95%CI：1.43~3.88)与T2DM的发生相关。 ROC测定结果显示,4项指标单独用于预测血糖异常状况的效果均不理想,WHR和WHtR相对较好,ROC曲线下面积(AUC)分别为0.67和0.64,BMI最差,为0.60。结论腹型肥胖指标WHR和WHtR对围绝经期女性T2DM的预测价值优于BMI和WC,其为该时期女性T2DM高危人群的筛查提供了合适的参数。     

某体检人群血压水平与颈动脉斑块相关性的横断面研究

目的探讨血压水平与颈动脉斑块患病风险的相关性。方法选取2017年在解放军总医院第四医学中心进行颈部超声检查的某单位体检人群为研究对象,采集血压等生理、生化指标。将血压指标按连续变量(收缩压、舒张压和脉压差)和分类变量(是否高血压、血压分级和脉压差四分类)进行分析,采用Logistic回归模型分析该人群血压水平与颈动脉斑块的关联性。结果共纳入研究对象716名,其中男性321名(44.8%),女性395名(55.2%),高血压和颈动脉斑块的患病率分别为40.9%(293例)和40.4%(289例)。≥60岁、糖尿病、高血压以及腰围增加、收缩压、空腹血糖、糖化血红蛋白升高者的颈动脉斑块患病率更高(P<0.05)。随着血压分级和脉压差四分类水平的升高,颈动脉斑块患病风险呈现增高趋势(Ptrend<0.05)。Logistic回归模型分析结果显示,收缩压每升高1 mmHg使颈动脉斑块的患病风险增加了1.4%(95%CI:1.005~1.024);以非高血压人群为对照组,高血压人群的颈动脉斑块的患病风险增加了62.9%(95%CI:1.146~2.316),其中,女性高血压人群的颈动脉斑块患病风险增加106.3%(95%CI:1.242~3.427);以正常血压人群为对照组,正常高值、1级高血压、2和3级高血压的颈动脉斑块的患病风险分别增加了86.8%(95%CI:1.175~2.946)和84.8%(95%CI:1.098~3.110)和119.6%(95%CI:1.165~4.142);以脉压差<60 mmHg(1 mmHg=0.133 kPa)人群为对照组,脉压差≥60 mmHg组的颈动脉斑块的患病风险增加56.2%(95%CI:1.049~2.326),其中女性脉压差≥60 mmHg人群的颈动脉斑块风险增加了73.3%(95%CI:1.007~2.983);以脉压差四分类Q1(≤42 mmHg)人群为对照组,Q3(50~61 mmHg)和Q4(≥62 mmHg)人群颈动脉斑块的患病风险分别增加了92.2%(95%CI:1.173~3.149)和95.0%(95%CI:1.147~3.316)。结论血压和脉压差水平升高与颈动脉斑块患病风险升高相关联,防控血压和脉压差升高可能是防控颈动脉斑块的有效措施之一。     

脂质蓄积指数与缺血性脑卒中发病的相关关系

目的 探讨脂质蓄积指数（LAP）与缺血性脑卒中的关联。方法 选取2018年1月至2020年5月于秦皇岛军工医院住院患者896例,病例组343例包括急性脑梗死、既往脑梗死者,对照组553例为无脑梗死病史者或经头颅核磁证实无脑梗死者。所有患者均测量身高、体重、腰围、血脂等相关指标,比较两组间一般临床资料及LAP的统计学差异,通过二元logistic回归探讨LAP与缺血性脑卒中（IS）发病的关系,并计算受试者工作特征曲线（ROC）探讨LAP预测IS的价值及切点。 结果 脑梗死组LAP高于对照组（Z=-6.052, P<0.001）;以LAP为自变量,是否患有脑梗死为因变量进行二元logistic回归分析,在校正性别、年龄、身高、体重指数（BMI）、吸烟、饮酒、低密度脂蛋白胆固醇（LDLC）、高密度脂蛋白胆固醇（HDLC）、甘油三酯（TG）、总胆固醇（CHOL）、高血压、糖尿病后,LAP每增加一个标准差,脑梗死患病风险增加1.041倍（OR=1.041, 95%CI: 1.030~1.052, P<0.001);LAP的ROC下面积（AUC）为0.620,切点为44.06,敏感性为70.8%,特异性为54.7%。结论 脂质蓄积指数对IS发病有一定预测价值。     

中国成年人中心性肥胖腰围切点值的进一步验证

目的描述中国人群腰围的分布特征,进一步探讨和验证中国成年人中心性肥胖的腰围切点及其对糖尿病患病危险的预测价值.方法利用2002年中国居民营养与健康状况调查的大样本数据,分析中国人群腰围的分布特征、南方和北方人群腰围的分布特征以及身材高大人群的腰围分布特征.分析不同的腰围切点与体重指数（BMI）≥24的诊断一致性.以ROC曲线的最短距离确定适合的腰围切点.用多元logistic回归分析不同腰围水平下调查对象的糖尿病患病相对风险.结果中国人群腰围分布呈正偏态;对腰围进行年龄调整后,男性腰围均值为79.0 cm,女性为74.8 cm.男性腰围均值大于女性;腰围水平随年龄增长而逐渐增加;不论男女,北方人群的腰围均大于南方;身材高大的人腰围水平大于总人群.男性腰围以85 cm、女性80 cm作为切点,与BMI≥24的诊断一致性最好,且ROC曲线的距离最短.男性腰围超过85 cm、女性腰围超过80 cm,患糖尿病的相对危险均增加1.1倍,空腹血糖受损的患病相对危险会增加1.0倍和1.7倍;当男性腰围超过95 cm、女性腰围超过90 cm时,患糖尿病的相对危险就会增加2.6倍和3.0倍,空腹血糖受损的患病相对危险会增加2.2倍和2.3倍.腰围越大,糖尿病的患病风险及空腹血糖受损的患病风险则越大.结论中国卫生部颁发的〈中国成年人超重与肥胖症预防与控制指南〉中推荐的腰围以85 cm和80 cm分别作为诊断男性和女性中心性肥胖的切点,得到了进一步的验证,应在预防中应用.     

脂质蓄积指数和体重指数与糖尿病关系比较的前瞻性研究

目的 探讨基线脂质蓄积指数(LAP)与体重指数(BMI)不同水平与随访糖尿病(DM)发病的关系.方法 运用前瞻性研究方法 ,以江苏省多代谢异常和代谢综合征(MS)防治队列研究人群为研究对象,分析并比较基线LAP和BMI不同水平与DM的关系,计算LAP、BMI、腰围(WC)、腰臀比(WHR)对预测随访DM的ROC曲线下面积.结果与BMI相比,不论男女DM发病人数及累计患病率随LAP水平增高而增加的趋势更为明显;调整年龄、DM一般危险因素后,相对危险度(RR)分别随BMI水平和LAP水平增加而增高,但后者更具有统计学意义(P<0.05);4种肥胖指标中,预测随访DM的ROC曲线下面积从大到小依次为LAP、WHR、WC、BMI.结论 高LAP比高BMI更容易导致DM;相对于体重增加,DM的形成可能与体内脂质蓄积关系更为密切.     

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

OBJECTIVES: To evaluate waist circumference (WC) as a screening tool for obesity in a Caribbean population. To identify risk groups with a high prevalence of (central) obesity in a Caribbean population, and to evaluate associations between (central) obesity and self-reported hypertension and diabetes mellitus. DESIGN: Cross-sectional. SETTING: Population-based study. SUBJECTS: A random sample of adults (18 y or older) was selected from the Population Registries of three islands of the Netherlands Antilles. Response was over 80%. Complete data were available for 2025 subjects. INTERVENTION: A questionnaire and measurements of weight, height, waist and hip. MAIN OUTCOME MEASUREMENT: Central obesity indicator (WC > or =102 cm men, > or =88 cm women). RESULTS: WC was positively associated with age (65-74 y vs 18-24 y) in men (OR=7.7, 95% CI 3.4-17.4) and women (OR=6.4, 95% CI 3.2-12.7). Women with a low education had a higher prevalence of central obesity than women with a high education (OR=0.5, 95% CI 0.3-0.7). However, men with a high income had a higher prevalence of a central obesity than men with a low income (OR=1.7, 95% CI=1.1-2.6). WC was the strongest independent obesity indicator associated with self-reported hypertension (OR=1.7, 95% CI 1.4-2.0) and diabetes mellitus (OR=1.6, 95% CI 1.3-1.9). CONCLUSIONS: The identified risk groups were women aged 55-74 y, women with a low educational level and men with a high income. WC appears to be the major obesity indicator associated with hypertension and diabetes mellitus. SPONSORSHIP: Island Governments of Saba, St Eustatius and Bonaire, the Federal Government of the Netherlands Antilles, Dutch Directorate for Kingdom relationships.     

脂质蓄积指数与糖尿病患病风险的关系

目的 探讨脂质蓄积指数(lipid accumulation product,LAP)与糖尿病患病风险的关系,并比较不同肥胖评价指标对糖尿病患病风险的预测价值.方法 2016年6月-2017年12月,采取多阶段分层整群抽样的方法,选择上海市松江区4个社区20～74岁常住居民作为研究对象,对其进行问卷调查及体格、生化检查...     

Maternal plasma ascorbic Acid (vitamin C) and risk of gestational diabetes mellitus

BACKGROUND: Antioxidants, particularly vitamin C (ascorbic acid), have the capacity to influence glucose tolerance. Modification of diet could reduce the likelihood of developing gestational diabetes mellitus. METHODS: In a prospective cohort study of pregnant women, we studied the association of maternal plasma ascorbic acid concentrations, measured at an average of 13 weeks' gestation, with subsequent risk of gestational diabetes. Maternal plasma ascorbic acid concentrations were determined using automated enzymatic procedures. Dietary vitamin C intake during the periconceptional period and early pregnancy was ascertained using a semiquantitative food frequency questionnaire. We fitted generalized linear models to derive estimates of relative risks and 95% confidence intervals (CIs). RESULTS: Approximately 4% (n = 33) of 755 women who completed pregnancy developed gestational diabetes mellitus. Plasma ascorbic acid concentrations were inversely associated with the risk of gestational diabetes (P for trend = 0.023). After adjusting for maternal age, race, prepregnancy adiposity, parity, family history of type 2 diabetes, and household income, women with plasma ascorbic acid <55.9 micromol/L (lowest quartile) experienced a 3.1-fold increased risk of gestational diabetes (95% CI = 1.0 - 9.7) compared with women whose concentrations were > or = 74.6 micromol/L (upper quartile). Women who consumed <70 mg vitamin C daily experienced a 1.8-fold increased risk of gestational diabetes compared with women who consumed higher amounts (95% CI = 0.8 - 4.4). CONCLUSIONS: If confirmed, our results raise the possibility that current efforts to encourage populations to consume diets rich in antioxidants, including vitamin C, could reduce the occurrence of gestational diabetes mellitus.     

Cigarette smoking and risk of type 2 diabetes mellitus among middle-aged and elderly Japanese men and women

For examination of sex- and age-specific relations between smoking and risk of type 2 diabetes mellitus, 39,528 nondiabetic men and 88,613 nondiabetic women aged 40-79 years who underwent health checkups in Ibaraki-ken, Japan, in 1993 were followed through 2002. Risk ratios for diabetes according to smoking habits were calculated using a Cox proportional hazards model. Compared with never smokers, the risk ratio for diabetes among current smokers, after adjustment for age, systolic blood pressure, antihypertensive mediation use, alcohol intake, parental history of diabetes, body mass index, fasting status, blood glucose concentration, total and high density lipoprotein cholesterol levels, and log-transformed triglyceride level, was 1.27 (95% confidence interval (CI): 1.16, 1.38) in men and 1.39 (95% CI: 1.20, 1.61) in women. The excess risk was more pronounced among men with a parental history of diabetes than among men without one. The excess risk among current smokers was observed in both age subgroups (40-59 and 60-79 years). Respective multivariate risk ratios for the age subgroups were 1.37 (95% CI: 1.18, 1.60) and 1.20 (95% CI: 1.08, 1.34) in men and 1.45 (95% CI: 1.18, 1.79) and 1.34 (95% CI: 1.09, 1.66) in women. Smoking was independently associated with increased risk of type 2 diabetes among both middle-aged and elderly men and women.     

中国中老年人群和高个成年人中心型肥胖的腰围界值点验证

目的 探讨中国中老年人群和高个成年人的适宜腰围界值点及其对糖尿病患病危险的预测价值.方法 利用2002年中国居民营养与健康状况调查数据,分析≥45岁人群和身高在全人群第85百分位数(P85)以上成年人的腰围分布特征,分析不同的腰同界值点与体重指数(BMI:kg/m2)≥24的诊断一致性,采用多元logistic回归分析不同腰围水平的调查对象患糖尿病和空腹血糖受损的相对风险,并以ROC曲线最短距离确定上述人群的适宜腰围界值点.结果 中国中老年人腰围男性均值为80.8 cm,女性均值为79.4 cm;高个男性腰围均值为84.1 cm,女性为77.9 cm.中老年人腰围以男性85 cm、女性80 cm作为界值点,与BMI≥24的诊断一致性最好,预测糖尿病的ROC曲线距离最短.与腰围<85 cm组相比,85 cm～组、90 cm～组和95 cm～组的中老年男性患糖尿病[OR值分别为2.1(95%CI:1.6～2.8)、3.0(95%CI:2.3～4.0)和4.5(95%CI:3.4～5.8)]和空腹血糖受损[OR值分别为1.6(95%CI:1.2～2.2)、2.6(95%CI:1.9～3.5)和3.5(95%CI:2.6～4.6)]的相对风险明显增加.与腰围<80 cm组相比,80 cm～组、85 cm～组和90 cm～组中老年女性患糖尿病[OR值分别为1.9(95% CI:1.4-2.6)、3.2(95%CI:2.4～4.3)和4.8(95%CI:3.7～6.1)]和空腹血糖受损[OR值分别为2.5(95%CI:1.8～3.4)、3.2(95%CI:2.4～4.4)和4.2(95%CI:3.2～5.6)]的相对风险明显增高.高个成年人腰围以男性90 cm、女性85 cm作为界值点,预测糖尿病患病的ROC曲线距离最短.与腰围<85 cm组相比,95cm～组高个男性患糖尿病和空腹血糖受损的相对风险明显增高[OR值分别为3.6(95%CI:2.1～6.4)和5.5(95%CI:3.0～10.1)].与腰围<80cm组相比,85 cm～、90 cm～组高个女性患糖尿病的相对风险明显升高[OR值分别为5.0(95%CI:2.7～9.4)和8.0(95%CI:4.6～14.1)],90 cm～组患空腹血糖受损的相对风险OR=3.7(95%CI:2.0～6.9).结论 男性85 cm和女性80 cm是中老年人群的适宜腰围界值点;对于高个成年人,此腰围界值点对于空腹血糖受损有预测价值;人群中心型肥胖预防指标建议使用男性85 cm和女性80 cm作为腰围界值点.     

Cardiovascular disease risk factors prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in a community of older adults

Cardiovascular disease risk factors were measured 10-15 years (mean, 11.9 years) prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in Rancho Bernardo, California. There were 1,847 men and women aged 40-79 years who had no known diabetes or fasting hyperglycemia at baseline (1972-1974). At the follow-up examination (1984-1987), 1,115 men and women (60.4%) had normal glucose tolerance, 513 (27.8%) had impaired glucose tolerance, and 219 (11.9%) had non-insulin-dependent diabetes mellitus as defined by World Health Organization criteria. Rates of impaired glucose tolerance and non-insulin-dependent diabetes mellitus increased with age, and impaired glucose tolerance was approximately twice as common as non-insulin-dependent diabetes mellitus. Those with non-insulin-dependent diabetes mellitus were older and more overweight and had higher levels of blood pressure, fasting plasma glucose, and triglyceride at baseline than those whose glucose tolerance remained normal; those with impaired glucose tolerance generally had intermediate levels of the same risk factors. When it was examined in a prospective fashion, in general, the age-adjusted risk of non-insulin-dependent diabetes mellitus increased with increasing quartile of each risk factor, and the risk of non-insulin-dependent diabetes mellitus in a given quartile was greater than that for impaired glucose tolerance. Logistic regression analyses showed these factors to be positively associated with a subsequent diagnosis of impaired glucose tolerance as well as non-insulin-dependent diabetes mellitus in women, and to a lesser degree in men, independent of baseline age and body mass index (weight (kg)/height (m)2). These data illustrate that a less favorable cardiovascular risk factor profile precedes the diagnosis of both non-insulin-dependent diabetes mellitus and impaired glucose tolerance.     

Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers

We examined the association of serum uric acid (SUA) with development of hypertension (blood pressure 140/90 mmHg and/or medication for hypertension) and impaired fasting glucose (IFG) (a fasting plasma glucose level 6.1–6.9 mmol/l) or Type II (non-insulin-dependent) diabetes (a fasting plasma glucose level 7.0 mmol/l and/or medication for diabetes) over a 6-year follow-up among 2310 Japanese male office workers aged 35–59 years who did not have hypertension, IFG, Type II diabetes, or past history of cardiovascular disease at study entry. After controlling for potential predictors of hypertension and diabetes, the relative risk for hypertension compared with quintile 1 of SUA level was 1.27 [95% confidence interval (CI): 1.00–1.62] for quintile 2, 1.34 (95% CI: 1.08–1.74) for quintile 3, 1.48 (95% CI: 1.18–1.89) for quintile 4, and 1.58 (95% CI: 1.26–1.99) for quintile 5 (p for trend <0.001). The respective multivariate-adjusted relative risks for IFG or Type II diabetes compared with quintile 1 of SUA level were 1.55 (95% CI: 0.95–2.63), 1.62 (95% CI: 0.98–2.67), 1.61 (95% CI: 1.01–2.58), and 1.78 (95% CI: 1.11–2.85) (p for trend = 0.030). The association between SUA level and risk for hypertension and IFG or Type II diabetes was stronger among men with a body mass index (BMI) <24.2 kg/m² than among men with a BMI 24.2 kg/m², although the absolute risk was greater in more obese men. These results indicate that SUA level is closely associated with an increased risk for hypertension and IFG or Type II diabetes.     

Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds

BACKGROUND: Waist circumference (WC) is strongly linked to obesity-associated risks. However, currently proposed WC risk thresholds are not based on associations with obesity-related risk factors but rather with body mass index (BMI; in kg/m(2)). OBJECTIVE: The objective was to determine the relations of WC to obesity-associated risk factors in a representative sample of US whites and to derive comparable risk thresholds for WC and BMI. DESIGN: Data on 9019 white participants of the third National Health and Nutrition Examination Survey were divided into 2 groups according to the presence of >or= 1 of 4 obesity-associated risk factors: low HDL cholesterol, high LDL cholesterol, high blood pressure, and high glucose. Odds ratio (OR) equations were derived from logistic regression models for WC and BMI with the use of the 25th percentile in the study population as the reference. Receiver operating characteristic curves for identifying risk factors were computed for WC and BMI. RESULTS: At BMIs of 25 and 30, ORs were 1.19 (95% CI: 1.06, 1.35) and 2.37 (95% CI: 1.33, 4.22) for men and 1.56 (95% CI: 1.29, 1.91) and 3.16 (95% CI: 1.94, 5.28) for women, respectively. The corresponding ORs for WC were at 90 and 100 cm for men and at 83 and 93 cm for women. Minima on the receiver operating characteristic curves for men were at 96 cm for WC and at 26 for BMI and for women were at 86 cm for WC and 25 for BMI. CONCLUSION: WC is more closely linked to cardiovascular disease risk factors than is BMI.     

北京市朝阳区成年人体质指数和腰围与高血压的关系

目的 探讨北京市朝阳区成人体质指数（body mass index, BMI）、腰围（waist circumference,WC）与高血压的关系。方法 采用多阶段分层随机抽样方法,抽取北京市朝阳区18～79岁32668名成年居民作为研究对象。调查内容包括一般人口学特征、生活方式、行为习惯、慢性疾病病史资料等,也进行体格测量。通过方差分析、偏相关分析和非条件logistic回归模型研究BMI、WC与高血压的关系。结果 调查人群新检出高血压患病率为19.80%（标化率为16.30%）;不同性别人群BMI、WC组间血压水平差异均有统计学意义（P＜0.050）;不同性别人群BMI、WC与收缩压和舒张压呈正相关（P＜0.050）;随着BMI、WC增加,男女人群的高血压患病危险性均上升,且BMI和WC每增加一个标准差,男性人群高血压患病危险性分别增加0.66（OR=1.66,95% CI:1.57～1.75）和0.56（OR=1.56,95% CI:1.48～1.65）,女性人群分别增加0.50 （OR=1.50,95% CI:1.42～1.57）和0.57（OR=1.57,95% CI:1.49～1.66）。结论 BMI、WC与高血压患病危险性密切相关,且BMI对男性人群患病危险性影响更大,WC对女性的影响更大。