我国成人体重指数和腰围对相关疾病危险因素异常的预测价值: 适宜体重指数和腰围切点的研究

目的 评价辽宁省20～39岁成人的肥胖状况、血压水平及其关联性。 方法 分析2010年和2014年辽宁省国民体质监测点5 313名20～39岁成人的数据资料。 结果 辽宁省20～39岁成人体质指数（BMI）的超重率为28.6 %（男性36.0 % vs女性21.2 %），肥胖率为11.7 %（男性17.7 % vs女性5.9 %）；腰围超标的中心性肥胖率为38.1 %（男性50.3 % vs女性26.1 %）。血压升高率为12.5 %（男性15.3 % vs女性9.8 %），高血压患病率为54.8 %（男性58.9 % vs女性30.8 %）。logistic回归分析表明，与BMI正常组比较，超重、肥胖组的血压升高风险增大（男性1.33倍，女性1.59倍）、（男性2.01倍，女性1.95倍），1级高血压的风险增大（男性2.10倍，女性1.72倍）、（男性3.37倍，女性2.76倍），2级高血压的风险增大（男性2.05倍，女性2.25倍）、（男性6.77倍，女性3.75倍）。男性BMI过低是保护性因素，BMI过低明显降低血压升高（OR = 0.48）、1级高血压（OR = 0.58）和2级高血压（OR = 0.41）的风险。男性的腰围、腰臀比升高增大1级和2级高血压的风险（OR = 1.42～1.79），女性的腰围身高比升高增大2级高血压的风险（OR = 1.81～5.18）。上述均P < 0.05。 结论 20～39岁成人的血压水平升高与超重、肥胖和/或中心性肥胖有关。对于年轻成人，BMI是与血压水平关联性最强的肥胖指标，男性BMI结合腰围和腰臀比、女性BMI结合腰围身高比能够有效提高预测高血压的效果。

Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies

Objective To explore obesity status, blood pressure level and their interrelationship among 20 – 39 years old residents in Liaoning province. Methods We extracted and analyzed the data on 5 313 residents aged 20 – 39 years from the dataset of two waves of National Physical Fitness Surveillance conducted in Liaoning province in 2010 and 2014. Body mass index (BMI) was used for assessment of overweight and obesity and waist circumstance (WC) for central obesity. Results For all the participants, the prevalence rate of overweight was 28.6% (36.0% for the males and 21.2% for the females); the prevalence rate of obesity rate was 11.7% (17.7% for the males and 5.9% for the females); the prevalence rate of central obesity was 38.1% (50.3% for the males and 26.1% for the females); the prevalence rate of elevated blood pressure was 12.5% (15.3% for the males and 9.8% for the females); and the prevalence rate of hypertension was 54.8% (58.9% for the males and 30.8% for the females). Logistic regression analysis revealed that compared to those with normal BMI, the participants with overweight or obesity were at higher risks of elevated blood pressure (1.33 and 1.59 times higher for the overweight males and females, 2.01 and 1.95 times higher for the obese males and females), stageⅠ hypertension (2.10 and 1.72 times higher for the overweight males and females, and 3.37 and 2.76 times higher for the obese males and females) and stageⅡ hypertension (2.05 and 2.25 times higher for the overweight males and females, and 6.77 and 3.75 times higher for the obese males and females); for the male participants, those with low BMI (< 18.5 kg/m²) were at significantly lower risks of elevated blood pressure (odds ratio [OR] = 0.48), stageⅠ hypertension (OR = 0.58) and stageⅡ hypertension (OR = 0.41) in comparison with those with normal BMI; the male participants with increased WC or waist-to-hip ratio were at significantly higher risks of stageⅠ and Ⅱ hypertension (OR = 1.42 – 1.79), while, the female participants with higher waist-to-height ratio were at a significantly higher risk of stageⅡ hypertension (OR = 1.81 – 5.18) (all P < 0.05). Conclusion Overweight, obesity and/or central obesity associate with elevated blood pressure among 20 – 39 years old residents in Liaoning province; for young adults, body mass index is a obesity-related indicator most strongly correlating with blood pressure level and the indicator could effectively predict hypertension among young male adults when combined with waist circumstance and waist-to-hip ratio and among young female adults when combined with waist-to-height ratio.