Urban-rural difference in stroke mortality from a 19-year cohort study of the Japanese general population: NIPPON DATA80

In Japan, cohort studies on stroke have been mainly conducted in rural areas, with few studies comparing stroke mortality between urban and rural areas. We aimed to explore urban-rural difference in stroke mortality throughout Japan using a representative sample of the general Japanese population, the NIPPON DATA80. This study included 9309 subjects (4080 men and 5229 women) aged 30 years or older who were residents of 294 areas in 211 municipalities of Japan in 1980 and followed-up until 1999. Population size of the municipality in which the aforementioned areas were located was used to distinguish between urban and rural areas, because municipalities in Japan are classified as village, town or city principally by population size. We applied a multilevel logistic regression model to take into account the hierarchical data structure of individuals (subjects) (level 1) nested within areas (level 2), and then calculated odds ratios and 95% confidence intervals (CIs) of deaths from total stroke. Statistically significant variance between areas was not observed in men but was in women. Age-adjusted odds ratios of the areas in the medium (population > or = 30,000 and <300,000) and small municipalities (<30,000) compared with the areas in the large municipalities (> or = 300,000) were 1.31 and 1.40 in men, and 1.32 and 1.62 in women, respectively. Multivariate-adjusted odds ratios (adjusted for age, body mass index, total cholesterol, diabetes, hypertension, current smoking, and daily alcohol consumption) of the areas in the medium and small municipalities compared with the areas in the large municipalities were 1.29 and 1.36 in men, and 1.34 and 1.68 in women, respectively. In conclusion, stroke mortality tended to be higher in rural areas than in urban areas in Japan, especially among women.     

中国成年人超重和肥胖与高血压发病关系的随访研究

目的 探讨中国成年人超重和肥胖与高血压发病的关系。方法 研究对象来自中国心血管病流行病学多中心协作研究和中国心血管健康多中心合作研究,两项研究分别于1998年和2000-2001年开展基线调查,并在2007-2008年开展统一的健康状况随访。共纳入13739名研究对象进入最终分析,按照BMI将研究对象分成四组:低体重组(<18.5 kg/m²)、正常体重组(18.5~23.9 kg/m²)、超重组(24.0~27.9 kg/m²)和肥胖组(≥28.0 kg/m²)。计算四组人群年龄标化的高血压累积发病率;并以正常体重组为参照,使用广义线性回归模型计算其他三组高血压发病风险RR值及其95%CI。结果 本研究平均随访8.1年,确诊新发高血压4271例,其中男性2012例,女性2259例。低体重组、正常体重组、超重组和肥胖组的年龄标化高血压累积发病率分别为21.6%、30.6%、42.4%和50.8%,随着BMI的升高而升高(趋势P<0.001)。以正常体重组为参照调整协变量,男性低体重组、超重组和肥胖组的RR值(95%CI)分别为0.78(0.64~0.95)、1.22(1.13~1.30)和1.28(1.16~1.42);女性分别为0.89(0.77~1.03)、1.16(1.09~1.23)和1.28(1.18~1.38)。结论 我国超重和肥胖者的高血压发病风险明显升高,应加强对超重和肥胖人群的高血压防控。     

高血压人群中体质指数与全死因死亡风险的队列研究

目的 探讨高血压队列人群中BMI和全死因死亡风险的关系。方法 研究对象为河南省某农村地区高血压队列人群,应用Cox风险比例回归模型计算基线时不同BMI水平人群随访期间的全死因死亡比例HR值及其95% CI,并采用限制性立方样条模型拟合BMI与全死因死亡风险的剂量-反应关系。结果 5 461名高血压队列人群累积随访31 048.38人年,平均随访6年,随访期间死亡589人。控制潜在的混杂因素后,以基线正常体重组（18.5 kg/m² < BMI < 24.0 kg/m²）为参照,低体重组（BMI<18.5 kg/m²）、超重组（24.0 kg/m² < BMI < 28.0 kg/m²）和肥胖组（BMI≥28 kg/m²）人群发生死亡的HR值（95% CI）分别为0.83（0.37～1.87）、0.81（0.67～0.97）和0.72（0.56～0.91）。限制性立方样条模型分析结果显示,在高血压队列人群中,基线BMI和全死因死亡风险关联强度呈现倒“S”形非线性剂量反应关系（非线性检验P<0.001）。结论 超重和肥胖可能是高血压人群死亡风险的保护因素,与“肥胖悖论”一致。     

Temporal relation between body mass index and renal function in individuals with hypertension and excess body weight

ObjectiveRecent evidence has suggested obesity as an independent risk factor for chronic kidney disease. However, the temporal relation between body mass index (BMI) and early renal dysfunction is unknown. This study aimed at evaluating whether longitudinal variations in BMI would reflect on changes in estimated glomerular filtration rate (GFR) in hypertensive individuals with excess body weight.MethodsThis was a cross-sectional, longitudinal study.ResultsOf the 218 participants who attended the first examination, 150 were available for paired final analyses. At the end of follow-up, GFR decreased by 1.024 mL/min for each 1-kg/m² increment in BMI (P < 0.03). When BMI was analyzed in quartiles, a positive graded relation with GFR changes was observed in quartiles 1 and 2 (individuals who maintained or lost weight), and a negative relation in quartiles 3 and 4 (individuals who gained weight, P = 0.05). A significant difference was observed between the smallest and highest BMI quartiles (P = 0.01). At the end of follow-up, the 76 participants (51%) who gained weight (+4.6 ± 0.4 kg) showed a reduction in GFR (?2.99 ± 1.99 mL/min) of borderline significance (P = 0.06) and a significant increase in fasting plasma glucose and triacylglycerol levels. Conversely, the 74 participants who maintained or lost weight showed no significant change in GFR and in fasting plasma glucose and triacylglycerol levels, although their blood pressure decreased significantly.ConclusionsOur study showed a significant temporal association between changes in BMI and GFR in overweight and obese hypertensive patients.     

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.     

高血压病患者中超重/肥胖与血压负荷及血压变异的关系

目的 探讨超重和肥胖高血压病患者与血压变异性关系。方法 191例原发性高血压患者根据体重指数（BMI）分为正常组，超重组，肥胖组，采用24h动态血压检测方法探讨血压负荷及血压变异的特征。结果 BMI增加血压负荷和血压变异性指数均增加，与正常组相比超重组和肥胖组夜间收缩压变异（nSBPSD)增加14.10%。夜间舒张压变异（nDBPSD)增加13.15%。夜间平均动脉压变异（nMAPSD)增加15.92%。肥胖组增加更明显，分别为20.06%,17.92%,21.63%；但这种血压变异性的差异仅表现在男性。结论 超重和肥胖的高血压病患者不仅加重血压负荷，而且使血压变异性增加；这种血压变异性增加只见于男性病人，且出现在夜间。     

云南少数民族正常高值血压、高血压患病与体重指数和腰围关系的对比分析

摘要:目的　比较分析云南省白族、彝族和布依族的正常高值血压及高血压的流行现状及与体重指数和腰围的关系。方法　采用按比例概率抽样方法从云南省白族、彝族和布依族3个少数民族聚集乡随机抽取1145名≥18岁常住少数民族进行现场问卷调查和体格检查。结果　白族、彝族和布依族的正常高值血压标化率分别为44.4%、37.1%、33.7%,高血压患病标化率分别为24.0%、26.9%、12.9%;3个民族的正常高值血压患病率差异无统计学意义（P＞0.05）,但白族和彝族的高血压患病率高于布依族（P＜0.01）。正常高值血压和高血压患病的危险性均随腰围（WC）的增加而增加,而随体重指数（BMI）的增加仅高血压患病的危险性增加。结论　白族、彝族和布依族的高血压患病率存在明显差异;降低中心性肥胖率有助于减少正常高值血压和高血压的发生。     

天津市宝坻区老年人体质指数、腰围以及腰围身高比与高血压患病率的关联

  目的   探讨天津市宝坻区60岁及以上老年居民的体质指数(body mass index, BMI)、腰围(waist circumference, WC)以及腰围身高比(waist-to-height ratio, WHtR)与高血压患病率的关联。   方法   本研究对2018年4-5月参加天津市宝坻区口东卫生院体检的老年人(≥60岁)进行问卷调查和体格检查。采用分层分析和logistic回归分析BMI与WC(或WHtR)对高血压的联合作用和交互作用。   结果   共邀请1 692人, 1 417人(83.75%)参与本研究。老年人群的高血压患病率为46.36%、BMI超重和肥胖者占66.50%、WC中心型肥胖者占74.66%、WHtR超重和肥胖者占75.38%。与BMI或WC正常相比, BMI超重(OR=1.65, 95% CI:1.19~2.30)和肥胖(OR=3.41, 95% CI:2.23~5.20)及WC中心型肥胖(OR=1.49, 95% CI:1.00~2.23)均增加高血压的患病风险。BMI联合WC超重/肥胖(OR=2.49, 95% CI:1.78~3.46), 或BMI联合WHtR超重/肥胖(WHtR超重: OR=2.05, 95% CI:1.41~2.99;WHtR肥胖: OR=2.37, 95% CI:1.50~3.76)的患病风险高于后者单独作用的风险(WC超重/肥胖: OR=1.39, 95% CI:0.90~2.15;WHtR超重: OR=1.02, 95% CI:0.62~1.66;WHtR肥胖: OR=1.44, 95% CI:0.55~3.81)。   结论   三项指标中, BMI与高血压患病的关联性最强, 且BMI超重/肥胖增强WC(或WHtR)与高血压的关联, 提示控制BMI相关体重指标在正常范围内有助于预防和控制高血压。     

Life expectancy among Japanese of different smoking status in Japan: NIPPON DATA80

BACKGROUND: The life expectancy is an important measure for describing health status among population. Several studies from the United States and Europe showed the harm of smoking by describing the life expectancies with different smoking status. No such study is examined in Japan, the country with the world's highest life expectancy irrespective of high smoking rate among men. METHODS: The abridged life table method was applied to calculate the life expectancies of men and women among different smoking status from age 40 until age 85. Age-specific mortality rates stratified by different smoking status were obtained from follow-up data from random sample in Japanese population (NIPPON DATA80). RESULTS: Proportion of current smokers was 62.9% in men and 8.8% in women at the baseline survey in 1980. The life expectancies of 40-year-old never smokers, ex-smokers and current smokers were 42.1, 40.4, and 38.6 years in men and 45.6, 45.9, and 43.4 years in women. The life expectancy of 40-year-old men who smoked less than one pack per day was 39.0 and was longer than that of those who smoked one or two packs (38.8) and more than two packs (38.1). CONCLUSION: Life expectancy decreased gradually as the grade of smoking increased in the Japanese population.     

Combining general and central measures of adiposity to identify risk of hypertension: a cross-sectional survey in rural India

AimIn three socioeconomically diverse regions of rural India, we determined the optimal cut-offs for definition of overweight, the prevalence of overweight, and the relationships between measures of overweight and risk of hypertension.Subjects and methodsVillages were randomly sampled within rural Trivandrum, West Godavari, and Rishi Valley. Sampling of individuals was stratified by age group and sex. Cut-offs for measures of adiposity were compared using area under the receiver operating characteristic curve. Associations between hypertension and definitions of overweight were assessed by logistic regression.ResultsOf 11 657 participants (50 % male; median age 45 years), 29.8 % had hypertension. Large proportions were overweight as defined by body mass index (BMI) ≥ 23 kg/m² (47.7 %), waist circumference (WC) ≥ 90 cm for men or ≥ 80 cm for women (39.6 %), waist-hip ratio (WHR) ≥ 0.9 for men or ≥ 0.8 for women (65.6 %), waist-height ratio (WHtR) ≥ 0.5 (62.5 %), or by BMI plus either WHR, WC or WHtR (45.0 %). All definitions of overweight were associated with hypertension, with optimal cut-offs being at, or close to, the World Health Organization (WHO) Asia-Pacific standards. Having overweight according to both BMI and a measure of central adiposity was associated with approximately twice the risk of hypertension than overweight defined by only one measure.ConclusionsOverweight, as assessed by both general and central measures, is prevalent in rural southern India. WHO standard cut-offs are appropriate in this setting for assessing risk of hypertension. However, combining BMI with a measure of central adiposity identifies risk of hypertension better than any single measure. The risk of hypertension is significantly greater in those centrally and generally overweight than those overweight by a single measure.     

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。     

新乡市某高校在职职工高血压和高血脂发病情况

目的了解新乡市某高等院校在职职工高血压和高血脂的发病情况,并分析相关影响因素。方法采用整群抽样的方法,共收集2012年该校1 553名职工的健康检查资料。采用χ2、logistic回归等统计方法对检查资料进行分析。结果在职职工高血压和高血脂的患病率分别为13.52%和26.14%。男职工中36~46岁组高血压患病率为26.85%,女职工随年龄的增长高血压患病率明显升高（P〈0.05）。男性和女性职工高血脂患病率均随年龄的增长而明显升高（P〈0.05）。另外,随着体重指数（BMI）的增加,高血压和高血脂患病率均明显增加（P〈0.05）。高血脂类型以高胆固醇血症和高甘油三酯血症为主。logistic多因素分析可知年龄和BMI均为高血压和高血脂患病的危险因素。结论该校在职职工中高血压和高血脂的发病率不是很高。年龄和BMI为主要危险因素,因而可以针对BMI采取防治措施,进行预防和控制。     

佛山市南海区社区人群体型指数、腰围与高血压的关系

目的采用腰围(WC)、体质指数(BMI)综合评价广东省佛山市南海区成年人中心性肥胖者高血压患病风险。方法采用多阶段分层随机抽样方法抽取南海区2个街道6个镇共17124户中18岁以上常住居民进行调查。采用入户面对面访谈的方法,并进行相关人体测量。采用SPSS13.0统计软件进行多因素Logistic回归分析,比较各BMI组别中心性肥胖者高血压患病的OR值。结果体质指数偏瘦、正常、超重和肥胖组中,男性中心性肥胖者高血压患病率分别为14.6%、23.8%、34.1%和42.7%;女性中心性肥胖者高血压患病率分别为20.3%,24.2%,33.8%和43.5%;除男性体型偏瘦组外,中心性肥胖者高血压患病率均明显高于同组内的正常腰围人群(P0.01);调整混杂因素(年龄、吸烟、饮酒和体育锻炼等)后,与正常腰围人群比较,BMI正常、超重及肥胖组别中男性中心性肥胖者患高血压患病的OR值分别为1.485(1.319~1.672)、1.827(1.536~2.191)、2.849(1.659~4.893);中心性肥胖女性BMI偏瘦、正常、超重及肥胖组高血压患病OR值分别为1.642(1.112~2.425)、1.530(1.363~1.717)、1.644(1.299~2.080)、3.529(2.001~6.225)。结论 BMI与WC两者结合可明显提高高血压风险预测价值;应将腹型肥胖尤其是全身性肥胖合并腹型肥胖的人群作为社区高血压防治的重点干预人群。     

1992至2002年间中国居民超重率和肥胖率的变化

目的 分析我国居民1992至2002年间超重率和肥胖率的变化,为制订肥胖防治策略提供科学依据。方法 利用1992年第三次全国营养调查（78704人）和2002年中国居民营养与健康状况调查（209849人）的资料,比较10年间我国居民超重率和肥胖率的变化。根据1978年世界卫生组织推荐的身高别体重Z评分判定7岁以下儿童的超重和肥胖,采用2003年中国肥胖问题工作组推荐的年龄别性别体重指数标准判定7至17岁人群的超重和肥胖,采用卫生部的《中国成人超重和肥胖症预防控制指南》推荐的标准判定≥18岁成年人的超重和肥胖。结果 10年间我国居民的超重率和肥胖率分别上升了38．6％和80．6％,其中0～6岁、7～17岁、18-44岁、45-59岁和960岁人群的超重率和肥胖率分别上升了31．7％、17．9％、66．7％、45．2％和43．7％。不同性别超重率和肥胖率的增长不同,0～6岁组女孩超重率和肥胖率上升幅度大于男孩,7岁以后各年龄组超重率和肥胖率的增长幅度均为男性大于女性。农村居民男女性的超重和肥胖增长幅度均高于城市居民。10年间估计超重和肥胖患病人数增加了1亿人,其中超重和肥胖的人数分别增加了7000多万和3000多万。结论 我国居民超重和肥胖均呈现迅速上升的趋势,超重和肥胖已经影响到我国近2亿6千万人,21世纪初期是我国肥胖干预的关键时期。     

中国80岁及以上高龄老年人体质指数分布特征

目的研究中国≥80岁高龄老年人体质指数(BMI)水平, 确定高龄老年人主要营养不良问题类型及不同BMI水平人群分布特征。方法共纳入中国老年健康影响因素跟踪调查2017-2018年横断面研究9 481名高龄老年人数据, 通过偏度-中位数-变异系数法、加权均值计算和五分位数分组分析等描述高龄老年人BMI水平及其分布特征。结果研究对象年龄为(91.9±7.7)岁, 加权BMI水平的P50为21.9(95%CI:21.8～22.0)kg/m2。BMI水平随年龄增长总体呈下降趋势, 100岁前下降较快, 之后趋势变得平缓。约30%的高龄老年人存在营养不足问题, 而营养过剩的比例仅约10%。BMI五分位数人群分布特征表明, BMI水平较低的高龄老年人具有的特征:人口社会经济学上, 年龄较大、女性、少数民族、未婚/离异/丧偶、在农村居住、未接受过教育、生活费水平不足、位于华中、华南和西南地区;生活方式上, 吸烟、不锻炼、休闲活动缺乏、膳食多样性差;功能状态上, 咀嚼能力差、日常生活自理能力损伤、认知功能损伤、听力损伤、视力损伤、自评健康状况差;患心脏病、高血压、脑血管疾病和糖尿病的高龄老年人BMI水...     

广东省2002年成人超重、肥胖流行病学特征分析

目的 了解广东省成年人超重肥胖的流行特征,确定预防控制的重点人群和地区。方法 运用多阶段随机整群抽样方法,抽取大城市、中小城市、2类农村各3个区(县)、1类农村4个县,每个县(区)抽取2个街道(乡)、6个居委,共540户,用面对面询问调查获得≥18岁居民个人基本情况,体检获取体重、身高数据。结果 共调查≥18岁成年人15 130人,体重指数均值为22.03±3.38,男性(22.06±3.37)与女性(21.98±3.40)比较差异无统计学意义,城市(23.06±3.53)与农村(21 08±2.94)比较差异有统计学意义。超重、肥胖的粗患病率分别为16 8％和1.8％,年龄标化患病率分别为15.0％和1 7％。超重粗患病率城市(24 8％)高于农村(9.4％),男性(17 5％)高于女性(16 2％);肥胖粗患病率城市(3.1％)明显高于农村(0 7％),男性(1 8％)与女性(1.7％)之间差异无统汁学意义。超重、肥胖的影响因素主要为体力活动、家庭收入、性别、年龄、吸烟与城乡。结论 广东省超过六分之一成年居民超重和肥胖,已经成为一个重要的公共卫生问题,必须采取平衡膳食、增加体力活动与健康教育等措施进行综合防治。     

北京市55岁以上人群体重指数与高血压及全死因死亡率的关系

目的：探索老年人体重指数（BMI）与高血压和死亡的关系。方法：1992年在北京市区和近郊山区，各随机抽取1个区／县，在所抽取的区／县采取分层、分段及整群抽样的方法抽取55岁以上人群2086名进行队列研究。结果：BMI随年龄的上升而下降，高血压患病率则随BMI和年龄的增高而上升。BMI与全死因死亡率呈负相关关系，BMI≥25．0和20．0－24．9组老人的死亡危险分别比BMI＜20．0组老人低62％（HR＝0．38，95，CI：0．29－0．49）和39％（HR＝0．61，95％；CI：0．49－0．75）；Cox多因素分析表明，在控制年龄、性别、地区（城乡）、高血压患病史、认知功能、健康自评等因素后，上述关系依然存在。结论；在老年人群不应过分强调减肥，但结果有待于进一步深入研究和证实。     

北京市1985—2005年中小学生肥胖的变化趋势

目的 了解北京市1985-2005年中小学生肥胖的流行情况及其变化趋势.方法 应用流行病学现况研究方法分析1985-2005年间四次全国学生体质健康调查中北京市7～18岁学生形态发育数据,计算人群的肥胖检出率,并描述其在不同亚人群的分布特点及变化趋势.结果 北京市的7～18岁学生1985-2005年间四次肥胖检出率分别为0.65%、3.40%、5.23%和8.53%,呈明显的增长趋势,且增幅逐渐加大.2005年调查表明,不同特征学生群体的肥胖检出率存在明显差异,男生(11.11%)高于女生(5.98%),10～12岁年龄段最高,达到11.63%;此外,城镇检出率(10.38%)高于农村(6.60%),而地区社会经济水平与肥胖检出率呈负相关.结论 20年间,北京市中小学生肥胖由散发到流行,并将进一步扩散;其流行兼具有发达国家和发展中国家的双重特点.     

安庆农村社区高血压人群中甘油三酯与体质指数相关性分析

目的描述安庆农村社区高血压人群不同体质指数（BMI）分层中甘油三酯（TG）的分布情况,并探讨不同BMI分层TG异常代谢表型的聚集,为从多重因素防制心脑血管疾病提供科学依据。方法从2008年5～10月,采用流行病学现况调查方法 ,用整群抽样抽取安庆农村社区45～75岁原发性高血压患者进行问卷调查、体格检查以及相关的实验室检测。结果研究纳入分析的对象共8562人,其中男3540人,女5022人;TG水平（-x±s）为男性（1.17±0.69）mmol/L,女性（1.43±0.72）mmol/L;女性的TG水平高于男性,差异具有统计学意义（P〈0.01）。女性的高TG患病率为9.7%,高于男性（5.8%）,差异有统计学意义（P〈0.01）。人群的TG水平随着BMI的增加而增加。校正相关变量后,随着BMI的增加,高TG的患病率也增加;BMI每增加1kg/m^2,男性和女性患高TG的风险分别增加31%（OR=1.31,95%CI：1.24～1.37）和16%（OR=1.16,95%CI：1.12～1.19）。结论甘油三酯代谢异常在不同BMI分组存在明显差异,控制体重是预防和控制血脂代谢异常的重要措施。