西藏林芝地区居民高血压患病率调查及与体质量指数的关系探讨

目的通过调查西藏林芝地区居民的高血压患病率及体质量指数(BMI)与高血压患病率之间的关系探讨,为确定高血压与体质量指数的关系及开展相应合理的干预措施和进行健康指导提供科学依据。方法运用整群随机抽样方法于2016年11月1日—2017年5月1日选取西藏林芝地区18~60岁的570名居民,其中18~30岁72人,31~40岁138人,41~50岁195人,51~60岁165人。各人群段分别相对均衡。进行问卷调查,并测量身高、体重与血压指标,以此来了解高血压的患病率及评估BMI与高血压的关系。结果人群高血压总患病率为53.7%,知晓率为79.8%,控制率为29.3%。人群平均血压值以及高血压的患病率随BMI的增加呈现上升趋势;通过将BMI值按<24,24~27.9以及≥28标准划分分析,高血压居民患病率分别为34.1%、66.7%与69.7%。结论高血压患病率明显高于全国平均患病率;高血压患病率与BMI水平呈正相关。合理控制BMI值在正常规定范围内是有效的预防高血压症状的重要举措。     

Association of Body Mass Index and Body Mass Index Change with Mortality in Incident Peritoneal Dialysis Patients

Although high body mass index (BMI) appears to confer a survival advantage in hemodialysis patients, the association of BMI with mortality in continuous ambulatory peritoneal dialysis (CAPD) patients is uncertain. We enrolled incident CAPD patients and BMI was categorized according to World Health Organization classification for Asian population. BMI at baseline and one year after the initiation of peritoneal dialysis (PD) treatment was assessed to calculate the BMI change (∆BMI). Patients were split into four categories according quartiles of ∆BMI. Kaplan-Meier method and Cox regression proportional hazard analysis were performed to assess the association of BMI on outcomes. A total of 1263 CAPD patients were included, with a mean age of 47.8 ± 15.0 years, a mean BMI of 21.58 ± 3.13 kg/m². During a median follow-up of 25.3 months, obesity was associated with increased risk for cardiovascular diseases (CVD) death (adjusted hazard ratio (AHR) 2.01; 95% CI 1.14, 3.54), but not all-cause mortality. Additionally, patients with more BMI decline (>0.80%) during the first year after CAPD initiation had an elevated risk for both all-cause (AHR: 2.21, 95% CI 1.23–3.95) and CVD mortality (AHR 2.31, 95% CI 1.11, 4.84), which was independent of baseline BMI values.     

体质指数对2型糖尿病患者心血管危险因素的影响

目的分析体质指数(BM I)对2型糖尿病(DM)患者心血管危险因素的影响。方法随机选取天津医科大学代谢病医院2型DM患者832例,根据BM I分为体重不足组、体重正常组、超重组、肥胖Ⅰ期组、肥胖Ⅱ期组。检测、比较5组收缩压(SBP)、舒张压(DBP)及空腹血浆甘油三酯(TG)、高密度脂蛋白胆固醇(H DL-C)、血清尿酸(UA)、血浆纤维蛋白原(FIB)、空腹血糖(FPG)、胰岛素(INS),H om a-m odel公式计算胰岛素抵抗指数(IRI)。结果不同BM I的2型DM患者SBP、DBP、TG、H DL-C、UA、FIB和IRI有统计学意义(P<0.01),随着BM I的增加高血压、血脂紊乱、高尿酸血症、高纤维蛋白原血症患者(率)显著增加,有统计学意义(P<0.01～0.05)。Pearson相关分析显示,BM I与IRI、SBP、D BP、TG、U A呈正相关,与H DL-C呈负相关,与FIB无相关性。多元逐步回归分析显示,IRI、SBP、D BP、TG与BM I呈显著正相关,H D L-C与BM I呈显著负相关。结论BM I升高导致2型D M患者多种代谢紊乱加重,心血管疾病的危险性增加。     

Association of Body Mass Index with Ischemic and Hemorrhagic Stroke

Data on the association between body mass index (BMI) and stroke are scarce. We aimed to examine the association between BMI and incident stroke (ischemic or hemorrhagic) and to clarify the relationship between underweight, overweight, and obesity and stroke risk stratified by sex. We analyzed the JMDC Claims Database between January 2005 and April 2020 including 2,740,778 healthy individuals (Median (interquartile) age, 45 (38–53) years; 56.2% men; median (interquartile) BMI, 22.3 (20.2–24.8) kg/m²). None of the participants had a history of cardiovascular disease. Each participant was categorized as underweight (BMI <18.5 kg/m²), normal weight (BMI 18.5–24.9 kg/m²), overweight (BMI 25.0–29.9 kg/m²), or obese (BMI ≥ 30 kg/m²). We investigated the association of BMI with incidence stroke in men and women using the Cox regression model. We used restricted cubic spline (RCS) functions to identify the association of BMI as a continuous parameter with incident stroke. The incidence (95% confidence interval) of total stroke, ischemic stroke, and hemorrhagic stroke was 32.5 (32.0–32.9), 28.1 (27.6–28.5), and 5.5 (5.3–5.7) per 10,000 person-years in men, whereas 25.7 (25.1–26.2), 22.5 (22.0–23.0), and 4.0 (3.8–4.2) per 10,000 person-years in women, respectively. Multivariable Cox regression analysis showed that overweight and obesity were associated with a higher incidence of total and ischemic stroke in both men and women. Underweight, overweight, and obesity were associated with a higher hemorrhagic stroke incidence in men, but not in women. Restricted cubic spline showed that the risk of ischemic stroke increased in a BMI dose-dependent manner in both men and women, whereas there was a U-shaped relationship between BMI and the hemorrhagic stroke risk in men. In conclusion, overweight and obesity were associated with a greater incidence of stroke and ischemic stroke in both men and women. Furthermore, underweight, overweight, and obesity were associated with a higher hemorrhagic stroke risk in men. Our results would help in the risk stratification of future stroke based on BMI.     

Disparities in Preventive Care by Body Mass Index Categories Among Women

ABSTRACT

Objective: The present analyses examined the relationship of body mass index (BMI) categories to receiving age-appropriate preventive services among women.

Method: Data from the Medical Expenditure Panel Survey (2003, N = 10,954) were analyzed using multiple logistic regressions. Outcomes were: age-appropriate Pap-test, mammography, colorectal, cholesterol and blood pressure screening, and influenza immunization.

Results: Overall, 3% of participants were underweight, and 26.3% were obese. Obese women were less likely to receive Pap-tests (p < .01), and underweight women less likely to receive mammography (p < .001). Dental care was less likely across all BMI groups outside the normal weight range.

Conclusions: The association between BMI categories and preventive services use varied by type of preventive care.     

冀东油田体检人员体重指数与高血压病、高血脂和糖尿病的相关性分析研究

目的：探讨体重指数与高血压病、高血脂和糖尿病之间的关系。方法：对8760例在本院行健康体检的冀东油田职工,测量身高、体重、血压,测定血脂、血糖,计算体重指数。根据体重指数的诊断标准进行分组,对其与血压、血脂、血糖进行相关性分析研究。结果：本次体检者中男性体检者肥胖发生率是女性体检者的2．8倍,提示该人群不同性别肥胖的发生率存在差异,男性肥胖发病率明显高于女性。研究还显示,冀东油田职工和离退休人员高血压、高血糖、高血脂的患病率随着肥胖程度的不断加重,呈上升趋势。结论：体重超标及肥胖在冀东油田男性职工中发病率已经较高,由肥胖导致的高血压、高血脂、高血糖等慢性病在冀东油田职工中患病率也已经较高,严重影响职工的身心健康,应研究制订行之有效的卫生政策,大力开展健康教育,保障广大职工的身体健康。     

Pre-Pregnancy Body Mass Index and Weight Gain During Pregnancy: Relations with Gestational Diabetes and Hypertension, and Birth Outcomes

To study the relationship between pre-pregnancy body mass index (BMI) and weight gain during pregnancy with pregnancy and birth outcomes, with a focus on gestational diabetes and hypertension and their role in the association with fetal growth. We studied 1,884 mothers and offspring from the Eden mother–child cohort. Weight before pregnancy (W1) and weight after delivery (W2) were collected and we calculated BMI and net gestational weight gain (netGWG = (W2 − W1)/(weeks of gestation)). Gestational diabetes, hypertension gestational age and birth weight were collected. We used multivariate linear or logistic models to study the association between BMI, netGWG and pregnancy and birth outcomes, adjusting for center, maternal age and height, parity and average number of cigarettes smoked per day during pregnancy. High BMI was more strongly related to the risk of giving birth to a large-for-gestational-age (LGA) baby than high netGWG (odds ratio OR [95% CI] of 3.23 [1.86–5.60] and 1.61 [0.91–2.85], respectively). However, after excluding mothers with gestational diabetes or hypertension the ORs for LGA, respectively weakened (OR 2.57 [1.29–5.13]) for obese women and strengthened for high netGWG (OR 2.08 [1.14–3.80]). Low in comparison to normal netGWG had an OR of 2.18 [1.20–3.99] for pre-term birth, which became stronger after accounting for blood pressure and glucose disorders (OR 2.70 [1.37–5.34]). Higher net gestational weight gain was significantly associated with an increased risk of LGA only after accounting for blood pressure and glucose disorders. High gestational weight gain should not be neglected in regard to risk of LGA in women without apparent risk factors.     

Body Mass Index and Risk of Death in Asian Americans

Objectives. We investigated the association between body mass index (BMI) and mortality among Asian Americans.Methods. We pooled data from prospective cohort studies with 20 672 Asian American adults with no baseline cancer or heart disease history. We estimated hazard ratios and 95% confidence intervals (CIs) with Cox proportional hazards models.Results. A high, but not low, BMI was associated with increased risk of total mortality among individuals aged 35 to 69 years. The BMI was not related to total mortality among individuals aged 70 years and older. With a BMI 22.5 to < 25 as the reference category among never-smokers aged 35 to 69 years, the hazard ratios for total mortality were 0.83 (95% CI = 0.47, 1.47) for BMI 15 to < 18.5; 0.91 (95% CI = 0.62, 1.32) for BMI 18.5 to < 20; 1.08 (95% CI = 0.86, 1.36) for BMI 20 to < 22.5; 1.14 (95% CI = 0.90, 1.44) for BMI 25 to < 27.5; 1.13 (95% CI = 0.79, 1.62) for BMI 27.5 to < 30; 1.82 (95% CI = 1.25, 2.64) for BMI 30 to < 35; and 2.09 (95% CI = 1.06, 4.11) for BMI 35 to 50. Higher BMI was also related to increased cardiovascular disease and cancer mortality.Conclusions. High BMI is associated with increased mortality risk among Asian Americans.During the past 30 years the prevalence of obesity, defined as a body mass index (BMI, defined as weight in kilograms divided by the square of height in meters) of 30 or greater, increased in all racial or ethnic groups in the United States. Historically, obesity has been uncommon among Asian Americans compared with other racial or ethnic groups in the United States, but the prevalence of obesity in this population is rising. Between 1991 and 2008, the prevalence of obesity increased from 13.9% to 28.7% among US-born Asians and from 9.5% to 20.7% among Asian immigrants.1Substantial epidemiological data have defined the dose–response association between BMI and mortality among Whites in the United States,2 and to a lesser degree among US Blacks.3 However, data for Asian Americans, a fast-growing racial group in the United States, are sparse.4 Recently, a pooled analysis among East Asians residing in Asia, including Chinese, Japanese, and Koreans, showed that the association between BMI and total mortality was nonlinear, in that BMIs greater than 25 and less than 22.6 were both associated with increased mortality.5 It was interesting that the increased mortality associated with a high BMI in East Asians was not observed among Indians and Bangladeshis in Asia.5Asian Americans share an environment with US Whites and Blacks, which differs markedly from that of their counterparts in Asia. It is unclear whether this change in context results in different susceptibility to obesity and obesity-related diseases between Asian Americans and Asians residing in Asia, or whether a shared genetic background contributes to a similar association between obesity and disease. To investigate the association between BMI and risk of mortality among Asian Americans in the largest sample to date, we pooled data from 10 prospective cohort studies in the United States.6–15     

Association between Nutrition Policies and Student Body Mass Index

In response to concerns about childhood obesity, many US states have implemented policies to limit the sale of unhealthy foods and beverages (e.g., snacks, desserts, and sugary drinks) sold in competition with school meal programs (i.e., competitive foods) in order to improve the nutritional environment of schools and support student health. This study measured state-level competitive food and beverage policies that require foods and beverages sold in à la carte lines, vending machines, and school stores to meet strong nutrition standards and tested the hypothesis that students living in states with stronger laws would have lower body mass index (BMI)-for-age percentiles. BMI data from a national sample of 1625 students attending 284 schools from the School Nutrition and Meal Cost Study were linked to state laws coded as part of the National Wellness Policy Study. A survey-adjusted linear regression model accounting for student and school-level characteristics showed that stronger state nutrition policies were associated with lower student BMI scores (coefficient: −0.06, 95% CI: −0.12, −0.00). Additional models indicated that stronger state policies were significantly associated with fewer unhealthy foods and beverages available in schools. These findings suggest that strong regulations on competitive foods and beverages may lead to improvements in the nutritional quality of the school environment and student BMI. Thus, current federal standards regulating snacks in US schools (i.e., Smart Snacks) are an important element of a comprehensive strategy to improve the school nutrition environment and reduce rates of childhood obesity.     

The Association of Maternal Pre-pregnancy Body Mass Index with Breastfeeding Initiation

Recent evidence extends the health benefits of breastfeeding to include reduction of maternal body mass index (BMI) and childhood obesity. Since most women decide if they will breastfeed prior to pregnancy, it is important to understand, given the high population prevalence of obesity, if maternal underweight, overweight or obese status is associated with breastfeeding initiation. Population-based study. Florida resident birth certificate records. All live singleton births (2004–2009), excluding observations that lacked the primary outcomes of maternal pre-pregnancy BMI and breastfeeding initiation (final sample of 1,161,949 unique observations). Odds of initiating breastfeeding, adjusted by maternal and infant factors, stratified by pre-pregnancy BMI, categorized as underweight, normal, overweight and obese. Adjusting for the known maternal factors associated with breastfeeding initiation, underweight and obese women were significantly less likely to initiate breastfeeding than women with normal BMI, (adjusted odds ratio 0.87, 95 % confidence interval 0.85–0.89 for underweight women; 0.84, 95 % CI 0.83–0.85 for obese women). The magnitude of these findings did not significantly vary by race or ethnicity. Medicaid status and adherence to the Institute of Medicine’s 2009 pregnancy weight gain recommendations had only minor influences on breastfeeding initiation. Among adolescents, only underweight status predicted breastfeeding initiation; obesity did not. Underweight and obese women have significantly lower rates of breastfeeding initiation compared to women with normal pre-pregnancy BMI. Future studies need to address the health care, social, and physical barriers that interfere with breastfeeding initiation, especially in underweight and obese women, regardless of race, ethnicity or income.     

济南市7岁儿童BMI及体成分与血压水平的相关性分析

目的阐明儿童期BMI及体成分指数与血压水平的相关性,为成年期疾病的早期预防提供相关依据。方法对济南市910名7岁儿童进行身高、体重、血压和皮褶厚度测量,采用回归方程推算体脂比(BF%),计算脂肪组织指数(FMI)和非脂肪组织指数(FFMI)。结果 BMI,BF%,FMI,FFMI与收缩压和舒张压均呈一定程度正相关(P值均0.05),血压与FMI的相关性高于FFMI。高BMI、BF%百分位数组儿童的血压水平均显著高于低百分位数组(P值均0.05)。血压偏高的检出率为肥胖组超重组正常组消瘦组。结论儿童BMI及体成分指数与血压水平有显著的相关性。预防儿童高血压应从控制体脂肪、预防肥胖做起。     

Association of Perceived Neighborhood Safety on Body Mass Index

Objectives. We sought to determine whether there is an association between perceived neighborhood safety and body mass index (BMI), accounting for endogeneity.Methods. A random sample of 2255 adults from the Los Angeles Family and Neighborhood Survey 2000–2001 was analyzed using instrumental variables. The main outcome was BMI using self-reported height and weight, and the main independent variable was residents’ report of their neighborhood safety.Results. In adjusted analyses, individuals who perceived their neighborhoods as unsafe had a BMI that was 2.81 kg/m² (95% confidence interval [CI] = 0.11, 5.52) higher than did those who perceived their neighborhoods as safe.Conclusions. Our results suggest that clinical and public health interventions aimed at reducing rates of obesity may be enhanced by strategies to modify the physical and social environment that incorporate residents’ perceptions of their communities.Obesity is a major public health problem^1–5 that contributes to poor quality of life; increased incidence of diabetes, cardiovascular disease, and other chronic conditions; and higher mortality rates.⁵ During the last decade, population-based strategies to reduce obesity have emphasized modification of physical and social environments, which may be particularly important in disadvantaged communities. Low neighborhood socioeconomic status (SES),⁶ a higher proportion of Black and Latino residents,^7–10 barriers in the built environment (e.g., fewer places to walk),^11,12 lack of access to supermarkets or fresh fruits and vegetables,^6,13,14 and a higher density of fast food restaurants¹⁵ are all characteristics of residential environments associated with obesity. Research also suggests that low levels of collective efficacy (a perception of mutual trust and willingness to help each other)¹⁶ are associated with adolescent obesity. However, the mechanisms through which neighborhood social, economic, and physical characteristics lead to weight gain and obesity are not well characterized.Perceived neighborhood safety is a mechanism through which neighborhood characteristics may influence obesity. Residence in a neighborhood perceived as unsafe may contribute to obesity in a number of ways, including increased secretion of stress hormones,^17–19 lower rates of walking or other outdoor physical activity,^20–28 and higher rates of stress-related eating.^29–32 Perceived safety may reflect the physical, social, and resource characteristics of neighborhoods. For example, residents may perceive a neighborhood to be unsafe if supermarkets and retailers that sell fresh fruits and vegetables are unwilling to locate in their neighborhoods, or if fast food restaurants and stores that sell low-cost, calorie-dense foods tend to locate in their neighborhoods.^33–35 Yet, the limited literature on relations between perceived safety and body weight is mixed. One study found that mothers with young children, residing in large cities, and perceiving their neighborhoods as unsafe were more likely to be obese,³⁶ and another study found no association between perceived safety and obesity.³⁷ Similarly, in the larger body of literature on neighborhood safety and physical activity, some studies found an association of perceived neighborhood safety with physical activity levels,^20–26 although other analyses showed no such relationship,^38–42 suggesting a more complex etiology.We hypothesized that 1 reason for the inconsistent findings in these previous analyses—all of which were cross-sectional—is endogeneity bias, that is, the possibility that the findings from these studies may have been influenced by either reverse causality^36,43 or unmeasured neighborhood or individual characteristics influencing both perceived neighborhood safety and obesity. For example, reverse causality may occur if larger individuals, believing nobody would attack them because of their size, feel safer, or if larger individuals, being less agile and less physically fit and believing they cannot protect themselves, feel less safe. To address the possibility of endogeneity from reverse causality or unmeasured neighborhood or individual characteristics, we studied the association between perceived neighborhood safety and obesity in a population-based, geographically sampled cohort of residents in Los Angeles County, California. We used 2-stage least squares regression, a special case of an instrumental variables analysis that is a method developed to produce statistically consistent estimates when the covariate of interest is potentially endogenous. To our knowledge, no studies to date have used instrumental variables analysis to assess the relationship between neighborhood safety and obesity.     

体重指数、腰围与高血压患病率关系的分析

目的探讨体重指数(BMI)和腰围(WC)对人群高血压患病率的影响。方法采用集中调查和入户调查相结合的方式,对社区35岁以上常住居民进行问卷调查和体格检查。结果该地区高血压患病率29.96%,全身性肥胖患病率为12.52%,中心性肥胖患病率33.26%。全身性肥胖和中心性肥胖患者中高血压患病率分别为57.87%和51.80%,中心性肥胖人群患高血压的风险是腰围正常人群的4.56倍,超重和肥胖人群患高血压的风险分别是体重正常人群的3.17倍和6.76倍,超重且中心性肥胖者患高血压的风险是体重正常腰围也正常人群的7.01倍。结论该地区超重和肥胖患病形势严峻,超重肥胖人群患高血压的风险显著增高,控制体重对高血压等慢性病的防治具有重要意义。     

The Association Between Body Mass Index in Adolescence and Obesity in Adulthood

PURPOSE: This study used data from the National Longitudinal Study of Youth 1979 to examine the association between body mass index (BMI) in adolescence and obesity in adulthood. METHODS: Measurements of height and weight from 1981 and 2002 were used to calculate BMI for a cohort of 1309 adolescents at baseline and during adulthood. Associations between BMI at age 16/17 and obesity (BMI > or =30) at age 37/38 were analyzed using logistic regression analysis. RESULTS: When the predicted probability of adult obesity equaled 0.5, the point on the adolescent BMI distribution was close to the 85th percentile for both sexes (83rd percentile for females and 86th percentile for males). Among adolescents with a BMI in the 85th-<95th percentile, 62% of the males and 73% of the females became obese adults. Among those with a BMI > or =95th percentile, 80% of the males and 92% of the females became obese adults. Versus those with a BMI <85th percentile, those with a BMI in the 85th-<95th percentile were more likely to be obese (odds ratio = 7 for males, 11 for females) as adults, and those with a BMI > or =95th percentile were most likely to be obese (odds ratio = 18 for males, 49 for females) as adults. CONCLUSION: Adolescents with a BMI > or =85th percentile are at elevated risk for obesity in adulthood. To prevent the development of obesity and its associated health risks, population-based efforts combined with targeted interventions for these high-risk adolescents are needed.     

Association Between Second-Generation Antipsychotics and Changes in Body Mass Index in Adolescents

PurposeTo assess the association of second-generation antipsychotics (SGAs) with changes in body mass index (BMI) among adolescents compared with a matched untreated comparison group.MethodsA retrospective cohort study was conducted using an electronic medical record database between January 2004 and July 2009. Adolescents (12–19 years old), newly initiated on SGAs formed the exposure group and untreated adolescents formed the comparison group matched (3:1) to the antipsychotic group based on age, gender, and month of index SGA. Both the exposure and comparison groups were followed for slightly more than a year (395 days). Baseline and follow-up BMI were evaluated for both groups and percentage change from baseline BMI to follow-up BMI was calculated. Multivariate linear regression was conducted to assess the impact of SGAs on percent change in follow-up BMI from baseline controlling for demographic characteristics, baseline medications, comorbidities, and other covariates.ResultsThe mean percentage increase in follow-up BMI from baseline for antipsychotic group was significantly higher than the comparison group (p < .01). After adjusting for covariates, adolescents on olanzapine had the highest percentage increase in follow-up BMI from baseline (5.84%, 95% confidence interval [CI], 4.07–7.61) followed by aripiprazole (4.36%; 95% CI, 3.08–5.64), risperidone (3.65%; 95% CI, 2.61–4.68), and quetiapine (1.53%; 95% CI, .53–2.52) compared with the comparison group.ConclusionThis study further validates a growing concern of increased BMI in adolescents on SGA therapy.     

Association Between Body Mass Index and Adenocarcinoma of the Esophagus and Gastric Cardia

Obesity is an increasing problem for industrialized nations. The incidence of adenocarcinoma of the esophagus and gastric cardia has also risen during the past two decades. A recently published population-based study attempted to relate this rise to increases in obesity or body mass index. Obesity may not only increase the risk for adenocarcinoma of the upper gastrointestinal tract, but it may also increase the risk of colon cancer and overall mortality. More research is needed to understand obesity's health impact and ways to control this epidemic.     

713名船员体重指数与高血压的相关性分析

目的 探讨交通员工中体重指数(BMI)与高血压患病率的关系.方法 对713名航行于港澳小型船舶的员工的体重、身高和血压进行统计分析.结果 在该部分人群里属偏瘦型的为14.59%,属正常型的为60.73%,属于肥胖型(Ⅰ+Ⅱ)的为24.68%;高血压的患病率于偏瘦型中占8.65%,正常型中占10.85%,Ⅰ度肥胖型中占22.01%;Ⅱ度肥胖占29.41%,经统计学分析,在偏瘦正常型与肥胖型间有显著性差异(X2=17.2,P＜0.01).结论 高血压率是伴随BMI上升而升高的,两者均有随年龄的增长而上升之特点.