社区人群吸烟和肥胖交互作用与高血压的关联分析

目的:探讨体重异常?腹型肥胖?吸烟与高血压之间的关联以及两者之间的交互作用对高血压的影响?方法:调查对象资料来自2012年常州市钟楼区社区诊断资料,共7 437例18岁以上对象被纳入本研究?运用Logistic回归模型分析腰围(WC)?体质指数(BMI)和吸烟及其交互作用与高血压发病的关系,采用Andersson等编制的Excel表计算相对超额危险度比(RERI)?归因比(AP)和交互作用指数(SI)等相加交互作用指标,并估计可信区间?结果:调整性别?年龄?饮酒?高血压家族史?职业?饮食等因素后,与BMI正常组相比,BMI异常组发生高血压的OR(95%CI)分别为2.75(2.46~3.12);腹型肥胖人群发生高血压的OR(95%CI)为2.41(2.13~2.71);与不吸烟人群相比,吸烟人群发生高血压的OR(95%CI)为1.37(1.16~1.63)?交互作用分析中,与不吸烟的非腹型肥胖人群相比,吸烟的腹型肥胖人群发生高血压的OR(95%CI)为3.66(3.07~4.36),不吸烟的腹型肥胖人群发生高血压的OR(95%CI)为2.01(1.78~2.03),吸烟的非腹型肥胖人群发生高血压的OR(95%CI)为1.47(1.26~1.71)?交互作用指数SI为1.80(1.35~2.38),RERI为1.18(0.57~1.79),AP为0.322?结论:吸烟人群患高血压的风险显著高于非吸烟人群;另外,吸烟与腹型肥胖之间存在显著的交互作用?

Association analysis of smoking and abdominal obesity on hypertension risk in community population

Objective:To investigate the independent and combined effects of smoking status,overall obesity and abdominal obesity on risk of hypertension. Methods:Participants were recruited under the framework of the community diagnosis investigation from Zhonglou district of Changzhou in 2012. In this investigation,a total of 7 437 subjects aged above 18 years were included in this study. Logistic regression model was performed to analyze WC,BMI and smoking as well as the relationship between their interaction and hypertension. We tested an interaction on an additive scale by using an Excel spreadsheet set up by Andersson to calculate relative excess risk due to interaction(RERI),attributable proportion due to interaction(AP),the synergy index(SI),and then estimate the confidence interval(CI). Results:After adjustment for sex,age,alcohol consumption,family history of high blood pressure,occupation,diet and etc,hypertension OR (95%CI) was 2.75 (2.46~3.12) in overweight or obese subjects,and 2.41 (2.13~2.71) in abdominal obese subjects,compared with normal subjects. OR(95%CI) was 1.37 (1.16~1.63) for smokers compared to never smoking subjects. Compared to never smoking and non-abdominal obese subjects,OR (95%CI) was 3.66 (3.07~4.36) in abdominal obese smokers,2.01 (1.78~2.03) in never smoking and abdominal obese subjects,and 1.47 (1.26~1.71) in non-abdominal obese smokers. RERI was 1.18(0.57~1.79),AP was 0.322 and SI was 1.80(1.35~2.38). Conclusion:Smokers have a significantly higher hypertension risk than never smoking subjects. Moreover,this study further demonstrates an additive interaction of smoking and abdominal obesity on hypertension risk.