不同肥胖测量指标对北京市社区人群动脉僵硬度的评价

Objective The aim of this study was to investigate the relationship between obesity [measured by body mass index(BMI), waist circumference(WC), waist-to-hip ratio(WHR)]and arterial stiffness on community populations in Beijing area. Methods In a cross-sectional study of 2664 subjects(1379 men and 1285 women)aged(53.19 ± 15.73 years, mean±standard deviation), BMI, WC, WHR and other cardiovascular risk factors, were measured and carotidfemoral pulse wave velocity(cfPWV)was measured to assess the arterial stiffness. All the data were analyzed with linear correlation analysis, univariate analysis and stepwise regression method to explore the relationship between obese indexes and arterial stiffness. Results We noticed that a showed the existence of positive correlations between BMI(r=0.0829,P＜0.01)and cfPWV, WC(r=0.2659, P＜0.01)and cfPWV, WHR(r=0.2749, P＜0.01)and cfPWV, in univariate analysis,cfPWV was associated with WC≥85 cm(male)or ≥80 cm(famale)(P＜0.01), WHR≥0.90(male)or≥ 0.85(famale)(P＜ 0.01). Stepwise regression analysis revealed that WC was an independent risk factor of cfPWV, other than age, gender, systolic blood pressure, HDL-C, OGTT2h etc. Conclusion Our findings indicated that obesity was an independent risk factor of cfPWV, which was an early marker of cardiovascular and renal diseases, among community population in Beijing area. There were different relationships between obesity measurement parameters(BMI, WC, WHR)and cfPWV.     

不同肥胖测量指标对北京市社区人群动脉僵硬度的评价

Objective The aim of this study was to investigate the relationship between obesity [measured by body mass index(BMI), waist circumference(WC), waist-to-hip ratio(WHR)]and arterial stiffness on community populations in Beijing area. Methods In a cross-sectional study of 2664 subjects(1379 men and 1285 women)aged(53.19 ± 15.73 years, mean±standard deviation), BMI, WC, WHR and other cardiovascular risk factors, were measured and carotidfemoral pulse wave velocity(cfPWV)was measured to assess the arterial stiffness. All the data were analyzed with linear correlation analysis, univariate analysis and stepwise regression method to explore the relationship between obese indexes and arterial stiffness. Results We noticed that a showed the existence of positive correlations between BMI(r=0.0829,P＜0.01)and cfPWV, WC(r=0.2659, P＜0.01)and cfPWV, WHR(r=0.2749, P＜0.01)and cfPWV, in univariate analysis,cfPWV was associated with WC≥85 cm(male)or ≥80 cm(famale)(P＜0.01), WHR≥0.90(male)or≥ 0.85(famale)(P＜ 0.01). Stepwise regression analysis revealed that WC was an independent risk factor of cfPWV, other than age, gender, systolic blood pressure, HDL-C, OGTT2h etc. Conclusion Our findings indicated that obesity was an independent risk factor of cfPWV, which was an early marker of cardiovascular and renal diseases, among community population in Beijing area. There were different relationships between obesity measurement parameters(BMI, WC, WHR)and cfPWV.     

儿童肥胖对高血压发病率影响的随访研究

目的 探讨儿童肥胖状态及肥胖状态的改变对其高血压发病率的影响.方法 采取前瞻队列研究的方法,抽取2004年北京市儿童青少年代谢综合征队列人群中2189名6～16岁血压正常儿童,于2010年12月对其随访,进行身高、腰围(WC)、体重和血压的测量.分别以体质指数(BMI)和WC作为评价超重、肥胖、腹型肥胖的指标.以不同肥胖状态组设置哑变量,以随访时点是否高血压作为结局变量,进行非条件logistic回归分析,分析基线肥胖状态及肥胖状态的改变与高血压发病率之间的关系,并计算相应的OR值及95%CI值.结果 共完成了1184名在校学生的随访,6年间高血压累积发病率为19.9%(236/1184).男性高血压发病率(23.2%,149/643)高于女性(16.1%,87/541) (χ2=9.257,P=0.002).基线非超重组、超重组、肥胖组随访期间高血压累积发病率分别为8.7%(45/519)、19.3%(35/181)、32.4%(156/484)(χ2=9.332,P<0.001),基线非肥胖组与腹型肥胖组随访期间高血压累积发病率分别为10.3%(63/613)、30.7%(173/567) (χ2=77.753,P<0.001).基线肥胖组的高血压发病危险高于基线非超重组(BMI:OR=4.9,95%CI:3.4～7.0)和基线非肥胖组(WC:OR=3.9,95%CI:2.8～5.3);基线时BMI、WC水平相同时,随访时BMI、WC水平增加,高血压发病危险增加.控制年龄、性别,基线BMI和WC每增加1 kg/m2和1 cm,高血压发病风险分别增加0.21和0.07倍,OR(95%CI)值分别为1.21(1.16～1.26)和1.07(1.05～1.09);随访时BMI和WC改变量每增加1 kg/m2和1 cm,高血压发病风险分别增加0.16和0.05倍,OR(95%CI)值分别为1.16(1.11～1.22) 和1.05(1.03～1.07).结论 儿童肥胖及肥胖水平升高的改变会增加其高血压发病风险.

Abstract：

Objective To explore the impact of obesity level and the level change in childhood on hypertension incidence.Methods A perspective cohort study was conducted.As part of Beijing Child and Adolescent Metabolic Syndrome Study,2189 aged 6-16 year non-hypertensive children was followed up in December,2010.In this study,height,weight,waist circumference (WC) and blood pressure was measured at follow-up,and body mass index (BMI) and WC was respectively used to assess overweight,obesity and abdominal obesity.Non-conditional logistic regression was used to evaluate the association between baseline obesity status, change of obesity status and hypertension incidence. OR and 95%CI were computed in the model using obese status as dummy variable and hypertension at follow up visit as dependent variable.Results The total hypertension incidence of 1184 subjects during 6 years follow-up was 19.9%(236/1184).The hypertension incidence in male (23.2%,149/643) was higher than that in female (16.1%,87/541) (χ2=9.257,P=0.002).The hypertension incidence of non-overweight,overweight and obese children at baseline was 8.7%(45/519),19.3%(35/181) and 32.4%(156/484)respectively (χ2=9.332,P<0.001),and the incidence of non-obese and abdominal obese children at baseline was respectively 10.3%(63/613) and 30.7%(173/567) (χ2=77.753,P<0.001).Hypertension incidence in the baseline obesity group was higher than the non-overweight (BMI:OR=4.9,95%CI:3.4-7.0) and non-obese group (WC:OR=3.9,95%CI: 2.8-5.3).The hypertension incidence increased with the follow-up BMI/WC level,based on the same baseline level of BMI and WC.The hypertension risk increased to 0.21 and 0.07 times respectively with elevation of baseline BMI level by 1 kg/m2 and WC level by 1 cm,and OR(95%CI) were 1.21(1.16-1.26) and 1.07(1.05-1.09),respectively.Similarly,the hypertension risk increased 0.16 and 0.05 times respectively with the elevation of BMI level change by 1 kg/m2 and 1 cm,and OR (95%CI) were 1.16(1.11-1.22) and 1.05(1.03-1.07),respectively.Conclusion Obesity and increased obesity level change in childhood can increase the risk of incident hypertension.     

北京市成人体质指数、腰围、腰臀比与肾小球滤过率的相关性研究

目的 探讨北京市自然人群体质指数(BMI)、腰围、腰臀比与肾小球滤过率的相关性.方法 2007年9月至2008年10月在北京地区抽样调查了4 510例人群的身高、体重、腰围(WC),计算BMI及腰臀比(WHR);测血肌酐,估算肾小球滤过率(eGFR).采用t检验或单因素方差分析进行组间均值的比较,采用X2检验进行组间率的比较,指标的相关性研究应用直线相关进行统计分析.结果 男性的BMI、WC、WHR水平高于女性(P＜0.05).女性的eGFR水平高于男性(P＜0.05),随着年龄增长,男性和女性的eGFR水平均逐渐降低.超重与肥胖人群eGFR水平低于正常人群,中心性肥胖人群eGFR水平低于非中心性肥胖人群,差别有统计学意义(P＜0.05),肥胖及中心性肥胖人群CKD的检出率高于正常与非中心性肥胖人群(P＜0.05).男性BMI、WC、WHR与eGFR均呈负相关(P＜0.01),女性BMI、WC与eGFR呈负相关(P＜0.01),而WHR与eGFR没有相关性(P=0.85),BMI较WC与eGFR的相关性更强.结论 肥胖和中心性肥胖与肾小球滤过率成呈相关,其中BMI的相关性最强.     

蒙古族人群体重指数、腰围、腰臀比对高血压预测价值的ROC曲线评价

目的 蒙古族人群探讨体重指数(BMI)、腰围(WC)、腰臀比(WHR)与高血压的关系及对高血压的预测价值.方法 采用ROC曲线评价.结果 正常血压组不同性别间的BMI、WC、WHR差异均有统计学意义(P＜0.01),高血压组不同性别间的BMI和WHR差异均有统计差异(P＜0.01),而与WC的差异无统计学差异(P＞0.05);男性各指标对高血压预测价值的大小依次为:WHR＞ WC＞ BMI;女性为:WC＞ WHR＞ BMI.结论BMI、WC、WHR是蒙古族高血压重要的预测因子.     

常熟市≥35岁人群肥胖测量指标与糖尿病患病关系研究

目的 探讨肥胖测量指标BMI(体质指数)、WC(腰围)、WHR(腰臀比)、WHtR(腰身比)与糖尿病患病的关系.方法 采用多阶段整群随机抽样的方法,随机抽取6个乡镇/街道≥35岁的居民11599名进行问卷调查并体检,分析BMI、WC、WHR、WHtR和糖尿病的关系.结果 常熟市≥35岁成人糖尿病患病率12.18％,空腹血糖平均水平为(5.66±1.32)mmol/L.不同BMI、WC、WHR、WHtR组间空腹血糖水平差异均有统计学意义(P值均＜0.05);BMI、WC、WHR、WHtR与空腹血糖水平呈正相关关系;BMI、WC、WHR、WHtR最高分位组糖尿病患病风险分别是最低分位组的4.40、2.50、2.26、2.13倍(P值均＜0.05).BMI、WC、WHR、WHtR每增加1个标准差,糖尿病患病风险分别增加40.0％、50.4％、52.3％、46.2％.结论 肥胖测量指标BMI、WC、WHR、WHtR与糖尿病关系密切,糖尿病患病风险随着肥胖程度的增加而升高,中心性肥胖指标对糖尿病的筛查价值优于BMI.     

慢性阻塞性肺疾病的炎症反应与营养不良密切相关

Objective To study the relationship between inflammation and malnutrition in patients with stable chronic obstructive pulmonary disease (COPD).Methods A total of 85 patients with stable COPD and 30 healthy subjects were recruited .All patients were divided into the lower body mass index (BMI,BMI<18.5 kg/m~2) group and normal BMI (BMI=18.5-23.9 kg/m~2) group.Lung function,arterial blood gall,cell differenti-als in induced sputum,and the levels of serum C-reactive protein (CRP),interleukin-8(IL-8),interleukin-6 (IL-6),interleukin-10 (IL-10),and tumor necrosis factor-α(TNF-α) were determined.Results The levels of total cell count and neutrophils in induced sputum were significantly higher in lower BMI group than in normal BMI group and healthy subjects (P<0.05).The forced expiratory volume in 1 second percentage,forced expiratory volume in 1 second/forced vital capacity,and arterial oxygen tension were significantly lower in lower BMI group than in normal BMI group,and the arterial carbon dioxide tension was significantly higher in lower BMI group than in normal BMI group (P<0.05).The levels of serum CRP,IL-8,IL-6,and TNF-α were significantly higher in lower BMI group than those in normal BMI group and healthy subjects (P<0.05).In lower BMI group,BMI was negatively correlated with total cell count (r=-0.492,P=0.0038) and neutrophils (r=-0.501,P=0.0032) in induced sputum and the levels of serum CRP (r=-0.473,P=0.0083),IL-8(r=-0.382,P=0.0421),IL-6(r=-0.422,P=0.0147),and TNF-α(r=-0.416,P=0.0156),respectively.Conclu-sion Local and systemic inflammatory reaction is responsible for malnutrition associated with COPD.     

新疆伊犁地区哈萨克族6～13岁儿童超重与肥胖状况及其影响因素

目的 调查新疆伊犁地区6～13岁哈萨克族儿童超重、肥胖状况及其影响因素.方法 在2009年5-6月以新疆伊犁地区哈萨克族6-13岁儿童为调查对象,采取分层整群抽样的方法抽取8所小学,共对2438名儿童测量身高、体重、腰围、臀围、血压,以体质指数(BMI)判定超重、肥胖.分析超重、肥胖的性别、年龄(分为6～7、8、9、10、11、12、13～14岁7个年龄组)、地区(城市、县城、乡村)分布情况.对可能影响超重、肥胖的因素进行非条件logistic回归分析.结果 新疆伊犁地区6～13岁哈萨克族儿童肥胖率为1.64%(40/2438),超重率为5.13%(25/2438);男、女童超重率分别是4.79%(59/1232)、5.47%(66/1206)(x2=0.59,P=0.44),男、女童肥胖率分别为1.62%(20/1232)、1.66%(20/1206)(x2=0.69,P=0.41).6～7岁年龄组儿童肥胖率为3.72%(8/215),12岁儿童为2.30%(10/435),13-14岁年龄组儿童为2.19%(6/274),各年龄组肥胖率差异有统计学意义(x2:14.29,P=0.04).不同地区的超重率由高到低分别是城市8.77%(35/399)、县城6.92%(74/1069)、乡村1.65%(16/970)(x2=42.09,P=0.00);肥胖率由高到低分别是城市2.75%(11/399)、县城2.43%(27/1069)、乡村0.30%(3/970)(X2=18.13,P=0.00).logistic回归分析显示,肥胖家族史(OR=2.73,95%CI:1.42～5.22)、父亲文化程度(OR=1.65,95%CI:0.29～9.25)是超重、肥胖的独立危险因素.腰臀比与血压水平相关(r=0.10,P=0.00),BMI与收缩压(r=0.47,P=0.00)、舒张压相关(r=0.37,P=0.00);腰围(r=0.81,P=0.00)、臀围(r=0.78,P=0.00)与BMI相关.结论 伊犁地区哈萨克族6～13岁儿童超重率、肥胖率没有性别差别,肥胖家族史、父亲文化程度是哈萨克族儿童发生超重、肥胖的影响因素.

Abstract：

Objective To investigate obesity,overweight and related factors of Kazakh children aged from 6 to 13 years old in Yili,Xinjiang.Methods With stratified cluster sampling method,2438Kazakh children aged 6-13 from eight elementary schools were recruited from the Yili Kazakh autonomy region from May to June in 2009.Height,weight,blood pressure,waist circumference and hip circumference were measured.Body mass index(BMI)value was used to determine overweight or obesity.The overweight and obesity distribution pattern of gender,age(6-7,8,9,10,11,12,13-14 years old group)and region (city,county and countryside)was analyzed.Logistic regression analysis was used to analyze the risk factors of overweight or obesity.Results The prevalence of obesity and overweight in Yili Kazakh aukmomy region was 1.64%(40/2438)(male:1.62%(20/1232),female 1.66%(20/1206)(x2=O.69,P=0.41)),and 5.13%(25/2438)(male:4.79%(59/1232),female 5.47%(66/1206)(x2=0.59,P=0.44)),respectively.The obesity prevalence of 6-7 year-old children was 3.72%(8/215),2.30%(10/435)for 12 year-old group and 2.19%(6/274)for 13-14 year-old group.The difference of obesity and overweight prevalence among different age groups was significant(x2=14.29,P=0.04).The prevelence of overweight was 8.77%(35/399),6.92%(74/1069),1.65%(16/970)(x2=42.09,P=0.00)in city,county and countryside.And the prevalence of obesity was 2.75%(111399),2.43%(27/1069),0.30%(3/970)(x2=18.13,P=0.00)in city,county and countryside.Logistic regression analysis showed that children with family obesity history(OR=2.73,95%CI:1.42-5.22)and culture level of fathers(OR=1.65,95%CI:0.29-9.25)were@independent risk factors of obesity.There was a correlation between blood pressure and waist-to-hip rate(r=0.10,P=0.00).Moreover,the correlation existed between systolic pressure(r=0.47,P=0.00),diastolic blood pressure(r=0.37,P=0.00)and BMI.Correlation existed between waist circumference(r=0.81,P=0.00),hip circumference(r=0.78,P=0.00)and BMT.Conclusion There is no sex difference of overweight and obesitv prevalence in Kazakh children aged from 6 to 13 year-old.Both family history of obesity and culture level of the fathers are factors of obesity and overweight to Kazakh children.     

兔颈动脉损伤后再狭窄与p53蛋白关系的研究

Objective To observe the effect of p53 protein on smooth muscle cell(VSMC)in rabbit artery balloon injury.Methods Restenosis model of carotid artery after balloon injury was established in rabbits.30 rabbits were divided into 2 groups,the sham group(n = 6)and the vascular injury group(n = 24).With H.E.staining and automatic image analysis system,we investigated artery morphology alteration and measured the area of arterial intima and media.The expressions of p53 protein were detected by immunohistochemical analysis.Results With H.E.staining and automatic image analysis and immunohistochemistry,the results showed that the expression of p53 was significantly reduced and the intima area was increased in model group compared with the sham group(P ＜0.01).But the expression of p53 in media was remarkably reduced compared with intima(P ＜ 0.01).Conclusions The possible mechanism of preventing arterial restenosis in the balloon injury might be related with p53,which may be through inhibiting neointimal proliferation in arterial restenosis .     

多囊卵巢综合征患者血清Ghrelin水平与胰岛素抵抗关系的研究

目的 探讨多囊卵巢综合征(PCOS)患者血清Ghrehin水平与胰岛素抵抗的关系.方法 选择我院2010年3月到2011年3月期间60例PCOS患者,根据体重指数(BMI)随机分为两组:肥胖组(A组,BMI ≥25 kg/m2)和非肥胖组(B组,BMI ＜25 kg/m2),每组30例.并选取60例健康受试者作为对照组,其中肥胖组(C组,BMI≥25 kg/m2)和非肥胖组(D组,BMI ＜25 kg/m2)各30例.采集以上四组患者空腹静脉血,测定空腹血糖(FBG)、空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-IR);采用酶联免疫吸附法(ELISA)测定血清Ghrelin水平.结果 ①与健康受试者比较,PCOS患者的FINS、HOMA-IR均明显增高(P＜0.05),血清Ghrelin明显降低(P＜0.05),FBG无明显差异(P＞0.05);②在PCOS患者和健康受试者中:与非肥胖组比较,肥胖组的FINS、HOMA-IR均明显增高(P＜0.05),血清Ghrelin明显降低(P＜0.05),FBG无明显差异(P＞0.05);③PCOS患者血清Ghrelin水平与BMI呈显著负相关(r=-0.59,P=0.006),与WHR呈显著负相关(r=-0.24,P =0.021),与HOMA-IR呈显著负相关(r=-0.40,P=0.003).结论 PCOS患者Ghrelin水平降低,并以PCOS肥胖组降低尤为明显;PCOS患者Ghrelin水平与胰岛素抵抗相关.     

不同年龄女性超重和肥胖与动脉僵硬度的相关性研究

目的 探讨女性人群不同体重与臂踝脉搏波速度（baPWV）的关系,评估超重和肥胖女性人群的高动脉僵硬度风险.方法 采用分层整群随机抽样方法,于201 1年3至12月在苏州、无锡、常州地区抽取年龄≥20岁的常住女性人群2 921名.进行问卷调查、人体测量和baPWV检测,用baPWV评估动脉僵硬度.采用Logisitic多元回归模型分析体质指数（BMI）等级变量对高动脉僵硬度的影响;通过受试者工作（ROC）曲线分析BMI对高动脉僵硬度的预测价值.结果 高动脉僵硬度率超重组（37.87％）和肥胖组（47.60％）均高于体重正常组（16.95％）,差异有统计学意义（x2=205.97,P均＜0.01）;BMI与baPWV呈正相关（r=0.310,P＜0.01）.高动脉僵硬度率65岁以上组（79.08％）高于20～40岁组（4.04％）和41～64岁组（24.96％）,差异有统计学意义（x2值分别为677.30和347.26,P均＜0.01）.20～40岁组和41～64岁组超重和肥胖女性的高动脉僵硬度率高于体重正常组,差异有统计学意义（P均＜0.01）.单因素分析显示年龄、静息心率、收缩压、舒张压均与高动脉僵硬度相关（P均＜0.01）.调整年龄、静息心率和血压后,多因素Logisitic回归分析显示以体重正常组为对照,超重组高动脉僵硬度的OR值为2.017（95％CI：1.637～2.486,P＜0.01）,肥胖组高动脉僵硬度的OR值为2.759（95％CI：1.964～3.876,P＜0.01）.BMI预测女性人群高动脉僵硬度的ROC曲线下面积为0.693 （95％CI：0.671～0.715,P＜0.01）,最佳预测切点为23.42 kg/m2.结论 超重和肥胖是女性人群高动脉僵硬度的危险因素,BMI对女性人群高动脉僵硬度的预测界值为23.42 kg/m2.     

体脂分布特征与血脂关系及其预测血脂异常的观察

目的 研究体脂分布特征与血脂关系及其预测血脂异常的价值.方法 采用整群抽样方法抽取北京市郊区居民有效样本784名,测量其身高、体重、腰围(WC)、臀围、身体成分与高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG),并计算体重指数(BMI)与腰臀比(WHR).结果 年龄调整偏相关分析显示WC与HDL-C(r=-0.310)、LDL-C(r =0.204),WHR与TC (r=0.151)、TG (r=0.271)的相关性最好.BMI、WC、WHR、躯干脂肪质量(TFM)分组分析显示WC、WHR、TFM能敏感地反应人体血脂水平的变化;BMI、WC、WHR、TFM能敏感地反应低HDL、高TG及血脂异常的风险.ROC曲线分析显示WC、WHR、BMI、TFM预测血脂异常风险的ROC曲线皆在参考线上方,且男女受试者WHR (0.684、0.630)、WC (0.667、0.616)、TFM(0.661、0.604)的ROC曲线下面积有大于BMI (0.629、0.597)的趋势,但差异均无统计学意义(P＞0.05).结论 体脂分布特征指标如WHR、WC、TFM与BMI相比,在预测血脂异常风险中的应用价值更高;以Youden指数最大值为判定依据预测血脂异常风险,男性理想界值点BMI为24 kg/m2,WHR为0.91,WC为85 cm,TFM为7.5 kg;女性BMI为25 kg/m2,WHR为0.91,WC为87 cm,TFM为9.Skg.由于样本量较少,有待进一步扩大范围的研究.     

简易体脂参数估测腹内型肥胖的可靠性评价

目的：评价体重指数（BMI）、腰围（WC）、腰臀比（WHR）估测腹内型肥胖的最佳临界点及敏感度、特异度。方法：应用核磁共振（MRI）对690名受试者（男305人，女385人）进行腹内脂肪（VA）测量，同时测量BMI、WC、WHR。以受试者工作特性（ROC）曲线评价简易体脂参数对腹内型肥胖的诊断价值。结果：①经MRI诊断，超重／肥胖者中61．7％，正常体重者中14．2％呈腹内型肥胖（VA≥100cm^2）；②BMI、WC、WHR与腹内脂肪面积呈显著正相关，尤以WC的相关性最好;③简易体脂参数估测腹内脂肪积聚的最佳切割点为BMI：26kg/m^2,WC:90cm,WHR:0.93;④BMI≥28kg/m^2、WC≥95cm时，95％的男性及90％左右的女性呈腹内型肥胖。结论：BMI、WC及WHR都可估测腹内型肥胖，但以腰围的准确率稍高。     

腹型肥胖测量指标与动脉硬化的相关性分析

目的探讨体质指数（BMI）、腰臀比（WHR）、体脂肪率（FAT％）与动脉硬化的相关性。方法2005年1月-2010年5月,以在某医院健康体检中心进行体检并接受人体成分检测及动脉硬化评价的成人26599人为研究对象,其中男性13663例（51．37％）,女性12936例（48．63％）,平均年龄（45．91±8．07）岁,同时进行血脂、血糖、尿酸等指标的检测,用BMI、WHR、FAT％描述性分析人群肥胖的情况,用颈股脉搏波传导速度（cfPWV）、颈桡脉搏波传导速度（crPWV）来评价动脉硬化,用简单相关及多元逐步回归分析各种肥胖指标与动脉硬化的相关性。结果青年男性和女性WHR与cfPWV均相关（r=0．191,P=0．005;r=-0．306,P〈0．001）,女性BMI也与cfPWV相关（r=0．175,P=-0．006）;中年男性和女性WHR与cfPWV均相关（r=0．239,P〈0．001;r=0．189,P〈0．001）,男性FAT％与crPWV相关（r=0．186,P=0．001）,女性FAT％与cfPWV及crPWV相关（r=0．050,P=0．032;r=0．174,P=0．001）;老年男性WHR与cfPWV及crPWV相关（r=0．134,P=0．011;r=0．145,P=0．001）,FAT％与cfPWV相关（r=0．168,P=0．003）,老年女性WHR与cfPWV相关（r=0．093,P=0．017）,FAT％与cfPWV及crPWV相关（r=0．111,P=0．009;r=-0．116,P=0．015）。在调整血压、血脂、血糖、尿酸等因素后,多元逐步回归的结果表明,中年男性WHR与cfPWV独立相关（P〈0．05）,老年男性WHR与cfPWV、erPWV独立相关（P〈0．05）。青年、中年、老年女性的WHR均与cfPWV独立相关（P〈0．05）,老年女性FAT％与crPWV独立相关（P〈0．05）。结论WHR是PWV的独立相关因素,而BMI与PWV无独立相关关系．老年女性的FAT％是crPwV的釉寺相关因素。     

使用腰围身高比检测重庆市成年人正常体重中心肥胖和心血管疾病危险因素

目的 使用腰围身高比(WHR)来探测重庆市成年人正常体重中心肥胖和心血管疾病危险因素.方法 在重庆市"一小时经济圈"内采用整群抽样的方法抽取了20000名18～59岁的在职正常成年人,测量其身高、腰围(WC)、体重,计算体质指数(BMI)和WHR,检测血压、血脂和血糖水平.分析正常体重[18.5≤BMI(kg/m2)＜24]非中心肥胖组(WHR＜0.5)与中心肥胖组(WHR≥0.5)相关指标的差异,用logistic回归分析中心肥胖和心血管各危险因素之间的关系.结果 在11 612名正常体重者中,1801(15.51%)名为正常体重中心肥胖.正常体重非中心肥胖组与中心肥胖组WC水平分别为(73.71±5.91)、(84.47±4.58)cm(F=328.74,P＜0.01);舒张压水平分别为(72.85±10.30)、(78.22±11.90)m Hg(1 mm Hg=0.133 kPa,F=23.62,P＜0.01);甘油三酯分别为(1.22±0.95)、(1. 97±1. 91)mmol/L(F=114.70,P＜0.01);总胆固醇含量分别为(4.66±0.84)、(5.04±0.92)mmol/L(F=13.10,P＜0.01);高密度脂蛋白分别为(1.41±0.31)、(1.25±0.29)mmol/L(F=29.44,P＜0.01);低密度脂蛋白含量分别为(2.65±0.74)、(3.03±0.77)mmol/L(F=9.98,P＜0:01);血糖水平分别为(4.94±0.82)、(5.25±1.37)mmol/L(F=47.21,P＜0.01).logistic 回归分析结果显示,与非中心肥胖组相比,正常体重中心肥胖组的收缩压、舒张压、甘油三酯、高密度脂蛋白、低密度脂蛋白和血糖的OR值(95%CI值)分别是1.28(1.02～1.60)、1.49(1.20～1.84)、2.24(1.92～2.60)、1.77(1.53～2.05)、1.58(1.15～2.16)和1.31(1.06～1.63).结论 WHR能够较有效的分析正常体重中心肥胖和各心血管疾病危险因素;中心肥胖患者心血管疾病风险较高.     

常用人体测量指标对高血糖的筛查价值探讨

目的探讨体质指数(BMI)、腰围(WC)、腰臀比(WHR)、腰围身高比(WHtR)、腰腿比(WTR)与高血糖的关系及其对高血糖的筛查价值。方法 2010年8月整群抽取在北京世纪坛医院健康体检中心体检的某机关工作人员1280名,测量其身高、体重、腰围、臀围、腿围、血压与空腹血糖及生化指标等。结果①此人群空腹高血糖检出率为40.16%,且随着年龄增长高血糖检出率亦增加;高血糖组的WC、BMI、WHtR、WHR、WTR、SBP、DBP、AST、TC、TG、CRE、UA水平均显著高于血糖正常组,而HDL-C水平低于血糖正常组,同时高血糖组脂肪肝的检出率也显著高于血糖正常组。②对于高血糖,WTR的受试者工作特征曲线(ROC)下面积(AUC)为0.716,高于WHtR(0.690)(P<0.001)、WHR(0.682)(P<0.001)、WC(0.682)(P<0.001)、BMI(0.665)(P<0.001);按性别分层后,在男性中,对于高血糖WTR的AUC(0.648)高于WHtR(0.611)(P<0.001)、WHR(0.614)(P<0.001)、WC(0.598)(P<0.001)和BMI(0.587)(P<0.001);在女性中,WTR对于高血糖的AUC为0.758,低于WHtR(0.774)(P<0.001)和WC(0.761)(P<0.001),但高于BMI(0.738)(P<0.001)和WHR(0.732)(P<0.001);在年龄≥35岁的女性中,WTR对于高血糖的AUC为0.725,高于WHtR(0.716)(P<0.001)、WC(0.705)(P<0.001)、WHR(0.676)(P<0.001)和BMI(0.665)(P<0.001);③在调整年龄和性别后,WTR与高血糖的相关性最强(OR=1.70,95%CI 1.37～2.11,每1 SD增量)。结论该机关工作人员空腹高血糖问题较为严重,WTR比其他4个指标能更好地筛查男性高血糖,在年龄大于35岁的女性中,WTR比其他四个能更好地筛查高血糖。     

Waist-hip ratio and waist circumference associated with body mass index in a study with schoolchildren

The objectives of this study were to determine the percentile levels of the anthropometric indices body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) and to verify possible correlations among theses indices in schoolchildren registered at the State Institute of Education, Florianópolis, Santa Catarina State, Brazil. A total of 419 children ages 7 to 9 years were investigated: 215 (51.3%) boys and 204 (48.7%) girls. BMI, WHR, and WC were higher for boys than for girls. However, the differences were only statistically significant for WHR and WC. Prevalence rates were 17.9% for overweight and 6.7% for obesity. The anthropometric indices with the highest correlation were BMI and WC (r = 0.87 and p < 0.01). For overweight, BMI and WC also presented the strongest correlation (r = 0.74). For obesity, WHR and WC showed the best correlation (r = 0.54).     

延边地区汉族青少年肥胖分布特点

目的分析延边地区汉族青少年肥胖分布特征。方法①选取2008-2009年延边地区安图县4所高中毕业生体检资料,共调查1 658名汉族学生,且均对调查内容知情同意。②采用统一设计的肥胖流行病学调查表收集学生的人口学特征,并测量其身高、体重、腰围和臀围,体格指标均依据《2005年全国学生体质与健康调研检测细则》进行测量。分别计算体质量指数(BMI)、腰围臀围比值(WHR)及腰围身高比值(WHtR)作为评价肥胖的指标。超重及肥胖依据中国肥胖问题工作组制定的"中国学龄儿童青少年BMI超重、肥胖筛查分类标准,WGOC",以BMI(kg/m2)≥24.0为超重和≥28.0为肥胖。结论①男生的身高、体重、腰围、臀围和BMI的平均值均高于女生,其差异均有统计学意义(均P<0.01);男生BMI的P85和P95百分位点分别为23.7及26.2,女生分别为22.7及25.0。②男女生超重检出率分别为11.2%和7.1%,肥胖检出率分别为2.3%和1.4%,超重及肥胖合计检出率分别为13.5%和8.6%,超重及合计检出率性别差异均有统计学意义(均P<0.01)。③BMI与体重、腰围、臀围、WHR及WHtR之间具有正相关关系,偏相关系数分别为0.893、0.548、0.584、0.056及0.555(均P<0.05)。④多因素分析结果表明,本地区青少年超重及肥胖与性别、体重及WHtR密切相关,其OR值分别81.052、1.520及6.457。结果①本地区青少年BMI平均水平明显低于WGOC分类标准,其超重肥胖检出率接近大、中城市汉族。②BMI与体重、腰围、臀围、WHR、WHtR之间具有明显的正相关关系。本地区青少年超重及肥胖患病与性别(女生)、体重(高体重)、WHtR(腹型肥胖)密切相关。     

2型糖尿病患者肥胖状态与肱踝脉搏波传导速度的相关性

  目的  探讨2型糖尿病（type 2 diabetes,T2DM）患者全身性肥胖（overall obesity,OO）、中心性肥胖（abdominal obesity,AO）状态与肱踝脉搏波传导速度（brachial-ankle pulse wave velocity,baPWV）的关联。  方法  以北京某社区T2DM患者为研究对象,收集人口学资料、体格检查数据、血液生化指标及baPWV。采用多元线性回归分析各肥胖指标与baPWV的关联,采用Logistic回归模型探讨肥胖状态与baPWV异常（baPWV≥1700 cm/s）的关联。  结果  共纳入2 048名研究对象,平均年龄（59.2±8.3）岁,baPWV异常率为49.7%。调整年龄、糖尿病病程、高血压等混杂因素后,多元线性回归发现体重指数（body mass index,BMI）与baPWV负相关、腰臀比（waist-to-hip ratio,WHR）与baPWV正相关。Logistic回归分析发现与BMI正常组相比,BMI肥胖组baPWV异常（OR=0.59,95% CI:0.44~0.78,P < 0.001）;与WHR正常组相比,WHR肥胖组baPWV异常（OR=1.46,95%CI:1.07~2.00,P < 0.001）;与既无OO也无AO组患者相比,无OO但有AO组患者baPWV异常（OR=1.67,95%CI:1.19~2.35,P=0.003）。  结论  T2DM患者中,AO与baPWV间存在显著的关联,尤其是BMI不肥胖但WHR肥胖的糖尿病患者需要密切随访动脉僵硬度。     

男性代谢综合征对青春期子代影响的家族聚集性分析

目的 分析男性代谢综合征(MS)患者青春期子代和健康人青春期子代的MS各组分及血清超敏C反应蛋白(hs-CRP)等疾病表型的差异,探讨MS及其相关组分的家族聚集特征.方法 采用遗传流行病学1:3病例对照家系设计,确定26例男性MS作为先证者(病例组)以及78名健康人作为对照组.通过体格检查和实验室检查收集两组研究对象青春期子代的疾病表型信息.测定身高、体重、腰围、臀围、血压,计算BMI、腰臀比和腰围身高比.实验室检测空腹血糖、血脂四项及血清hs-CRP含量.结果 MS病例组青春期子代的肥胖指标(腰围、腰围身高比、腰臀比、DBP值)及hs-CRP值均高于对照组的青春期子代(P＜0.05).病例组青春期子代的MS、中心性肥胖率以及血脂异常率(低HDL-C)均高于对照组子代(P＜0.05).并且病例组子代患MS组分数量显著高于对照组(r=0.231,P＜0.05).结论 病例与对照组青春期子代的疾病表型存在差异;提示MS的家族聚集性在青春期即已体现,主要表现在中心性肥胖、血压升高和炎症表达明显.