正常体重指数孕妇孕期体重增长与妊娠结局的关系

目的总结2009年1月至2010年1月我院产检的正常体重指数孕妇妊娠期体重增长的情况,并对其妊娠结局按不同体重增长情况进行分析,得出体重增长与妊娠结局的关系。方法对2009年1月至2010年1月在我院检查及分娩单胎的1382名正常体重指数的孕妇进行分析,按2009年Institute of Medicine(IOM)体重增长指南将孕妇进行分组,分为过少增长、正常增长及过多增长组,并随访妊娠结局。结果 1382名正常体重指数的孕妇体重过少增长、正常增长及过多增长的比率分别为11.43%、37.63%、50.94%。体重增长情况与孕妇受教育程度及社会职务存在相关性,三组妊娠结局进行比较,剖宫产率、妊娠期高血压(PIH)、巨大儿、低体重儿的发生率存在显著性差异,而妊娠期糖尿病(GDM)、产后出血的发生率无显著性差异。结论尽管孕前体重指数正常,仍有超过一半的孕妇体重增长超过标准,且过多或过少的体重增长均会导致不良的妊娠结局,故妊娠期提供正确的体重增长指导对正常孕妇仍很重要。     

腹膜透析患者体重指数与预后的关系

目的初步探讨体重指数(BMI)对腹膜透析(PD)患者预后的影响。方法119例1999年1月起始行PD治疗患者,按BMI分为低体重组(BMI<20kg/m2)、正常体重组(20≤BMI<25kg/m2)及超重肥胖组(BMI≥25kg/m2)。采集这些患者的年龄、性别、RRF、Kt/V、血清白蛋白(SA)、Hb、CRP、心血管并发症以及转归等,并进行回顾性分析。结果与正常体重的PD患者相比,低体重者死亡率较高(42.11%对21.67%,P<0.05),而超重肥胖患者预后更差(52.5%对21.67%,P<0.01)。超重肥胖的PD患者心血管并发症的死亡率明显高于正常体重者(P<0.01)。Pearson相关分析发现,这些PD患者的BMI与其CRP(r=0.79,P<0.01),SA(r=0.58,P<0.01),Hb(r=0.32,P<0.05)呈正相关,而与其Kt/V(r=-0.36,P<0.05)负相关。Cox比例风险模型显示,BMI≥25kg/m2与PD患者死亡率独立相关(风险比例,1.31;95%可信限,1.20￣1.54;P<0.05)。结论低体重、尤其是超重肥胖PD患者预后不佳,BMI≥25kg/m2是值得关注的死亡危险因素。     

体重指数与男性骨质疏松关系的研究

对2003年8月至2005年12月因骨和/或关节疼痛麻木在四川大学华西医院门诊及住院1 207例男性经X线检查判断无骨质增生482人,采用法国DMS公司生产的Challenger双能X线骨密度仪测定L2～4正位骨密度,记录其身高、体重(计算体重指数)、症状、并发症、运动、吸烟等基线状况;测定L2～4骨密度,明确是否骨质疏松;用t检验或2检验比较骨质疏松组和无骨质疏松组基线状况,用逻辑回归分析实验对象中各种可能影响骨质疏松的因素与骨质疏松的相关性。结果显示:骨质疏松和无骨质疏松两组比较:体重指数、运动情况和吸烟比例有显著差异;高血压和糖尿病患病比例、年龄无明显差异;根据多因素分析,体重指数和吸烟是骨质疏松的危险因素,运动是骨质疏松的保护因素。BMI每增加一个单位,男性发生骨质疏松的风险增加0.654倍(P=0.004)。因此,我们认为体重指数是男性骨质疏松的危险因素,可能与体脂分布不同有关。     

孕前体重指数、孕期增重与糖耐量异常及新生儿出生体重的关系

目的探讨孕妇孕前体重指数及孕期体重增加情况对糖耐量异常及新生儿出生体重的影响。方法测量385例足月单胎初产妇孕前身高、体重和孕期体重增加情况,计算孕前体重指教,并随访糖耐量异常、巨大儿和低体重儿的发生情况。结果（1）孕前肥胖的孕妇糖耐量异常的发生率高于孕前消瘦和理想体重的孕妇（P〈0．05）,而后两组间无差别（P〉0．05）。发生巨大儿和低体重儿的几率3组比较差异无显著性。（2）无论孕前体重指数如何,当孕期体重增加≥18kg时糖耐量异常和巨大儿的发生率明显增高（P〈0．01）,而当孕期体重增加〈9kg时低体重儿的发生率明显增高（P〈0．01）。结论孕前体重指数和孕期增重是孕期发生糖耐量异常的重要影响因素,新生儿出生体重与孕妇孕期体重增加情况密切相关。     

妊娠前不同体重指数与围产结局的关系研究

目的研究妊娠前不同体重指数对围产结局的影响。方法回顾性分析2005~2007年在我院分娩的单胎妇女238例,按妊娠前体重指数(BMI)分为BMI在19.8~23.9的正常BMI组、BMI 24~27的高BMI组和BMI≥27的肥胖组。新生儿体重≥4000g为巨大儿。比较正常BMI组、高BMI组和肥胖组的围产结局。结果全部资料共有238例,其中正常BMI组182例,高BMI组117例,肥胖组56例,巨大儿的发生率分别为10.4%、19.6%、28.6%,妊娠期高血压病、妊娠期糖尿病、羊水过多的风险随妊娠前BMI增加而上升,早产、剖宫产、新生儿病率的发生率亦随妊娠前BMI增加而升高,差异有显著性。结论妊娠前异常的母亲体重指数高度影响巨大儿的发生率;随妊娠前BMI增加不良围产结局的风险增加。     

孕前体重指数、孕期体重增加与新生儿窒息发生率的关系

目的：探讨孕前体重指数、孕期体重增加量与新生儿窒息发生率的关系。方法：对2012年1月至2014年1月在我院参加孕前检查且分娩单胎活产儿的1522例孕产妇,其中新生儿窒息182例(11.96%),按孕前体重指数分为偏瘦组(BMI<18.5)、正常组(18.5≤BMI<24.0)、超重组(24.0≤BMI<28.0)、肥胖组(BMI≥28),按孕期体重增加分为<0.3 kg/周组、0.3~0.5kg/周组、>0.5 kg/周组,回顾性分析新生儿窒息发生率与孕妇孕前体重指数、孕期体重增加的关系。结果：偏瘦组(BMI<18.5)、正常组(18.5≤BMI<24.0)、超重组(24.0≤BMI<28.0)、肥胖组(BMI≥28)的新生儿窒息的发生率分别是10.60%、11.30%、16.10%、26.83%,呈逐渐递增的趋势;孕期增加体重<0.3 kg/周组、0.3~0.5 kg/周组、>0.5 kg/周组的新生儿窒息率分别为17.81%、11.41%、10.36%,随着孕期增重的增加,新生儿窒息率随之下降。结论：孕妇孕前体重指数(BMI)、孕期体重增加是新生儿窒息发生的重要影响因素,临床上应对孕妇孕前体重指数及孕期体重增加量进行监测,充分评估新生儿发生窒息的危险性,并及早行干预措施,降低新生儿窒息发生率,最大程度保障母婴安全。     

孕妇不同体重指数及增长对新生儿出生体重的影响

探讨孕妇不同孕前、分娩前体重指数及体重指数增长对新生儿出生体重的影响.方法对995例单胎初产妇,计算体重指数（BMI）,包括孕前BMI,分娩前BMI,^△BMI（孕期体重指数增长）,按孕前BMI（18.5,18.5≤BMI〈23,BMI≥23;分娩前BMI＜26,26≤BMI〈33, BMI≥33;^ΔBMI〈4.5,4.5≤^ΔBMI〈8,^ΔBMI≥8各分三组,分析不同孕前体重指数,分娩前体重指数,孕期体重指数增长与新生儿出生体重的关系.结果孕妇不同孕前BMI,分娩前BMI,^△BMI与新生儿出生体重有显著相关性,孕前BMI,分娩前BMI,^ΔBMI越大,新生儿出生体重越重. 结论 （1）孕前BMI,分娩前BMI,^△BMI均与新生儿出生体重有重要的影响作用.（2）利用孕妇BMI,进行个体化营养指导,进一步控制新生儿出生体重,使孕妇获得良好的妊娠结局.     

脐血瘦素水平与胎儿出生体重的关系

目的探讨脐血瘦素水平与胎儿出生体重的关系.方法应用特异放射免疫分析法测定91例正常分娩或剖宫产的新生儿脐血清瘦素水平.根据新生儿出生体重与胎龄的关系将研究对象分成对照组44例,大于胎龄儿(LGA)组28例和小于胎龄儿(SGA)组19例.结果91例新生儿脐血清瘦素范围为1.8-40.5ng/ml,平均为9.9±7.4.男性为1.8-35.5ng/ml,平均为5.3±5.6.女性为2-42.5ng/ml,平均为15.0±8.0.两性新生儿出生体重、体重指数比较无显著差异.脐血清瘦素男性显著低于女性(P=0.011).LGA组、SGA组脐血清瘦素水平、出生体重、体重指数分别与对照组比较差异均有显著性(P＜0.01).新生儿脐血清瘦素水平与出生体重、体重指数均呈正相关.相关系数分别为r=0.59、r=0.37.结论瘦素是胎儿生长调节系统的重要因子,与胎儿出生大小有密切相关性.     

高血压与阿尔茨海默病关系的初步探讨

目的 :探讨高血压与阿尔茨海默病 (AD)的关系 ,以及AD患者患病前后血压的变化。方法 :对 16488名队列人群 16年前的收缩压和舒张压值进行分层后比较不同层人群AD患病率的差别 ,并对 30 1名AD患者患病前后的血压进行比较。结果 :在收缩压不同的四个分层人群中 ,各层AD患病率有显著的差别(χ2 =15 1 9,P =0 0 0 0 ) ,高压组最高 (5 5 1% ) ,低压组最低 (0 5 8% )。在舒张压不同的四个分层中 ,各层AD患病率有显著的差别 (χ2 =10 3 5 ,P =0 0 0 0 ) ,高血压组的患病率最高 (4 72 % ) ,低压组最低(1 0 8% )。对于高血压组的AD患者 ,患病前后收缩压变化无显著性意义 ,而舒张压显著性下降 (P <0 0 1)。结论 :高血压与AD存在密切的联系 ,这种联系机制有待于进一步研究     

孕期体重与妊娠期糖尿病的关系

目的探讨孕期体重与妊娠期糖尿病(GDM)的关系.方法对504名孕妇进行50g葡萄糖激发试验,阳性者再作75 g葡萄糖耐量试验,将504名孕妇分为GDM组16例和正常孕妇组488例.由专人询问孕妇孕前的身高、体重和腰围,计算体重指数(BMI),分娩前测量体重,计算整个孕期体重增加值.对不同孕前BMI孕妇GDM的发病率,以及GDM孕妇与正常孕妇体重特征的不同进行比较.结果 1.504名孕妇发生GDM16例,发病率为3.2%.孕前BMI≥24的肥胖孕妇有30例,发生GDM者4例,而BMI<24的非肥胖孕妇为474例,发生GDM者12例,肥胖组GDM的发病率明显高于非肥胖组,(P<0.01).2.GDM孕妇平均孕前BMI为22.4±2.77,平均孕前腰围为71.9±6.1cm,明显高于正常孕妇,分别为19.9±2.2和67.1±5.3cm,(P<0.05).504名孕妇孕期平均体重增加16.2±4.3kg,GDM孕妇孕期平均体重增加16.8±6.4kg,正常孕妇孕期平均体重增加16.1±4.3kg,两组相比无差别,(P>0.05).结论孕前肥胖是GDM的危险因素,应加强对孕前肥胖孕妇的指导和监护.     

Clinical Features of Obstructive Sleep Apnea That Determine Its High Prevalence in Resistant Hypertension

Purpose

Resistant hypertension (HTN) occurs in 15-20% of treated hypertensive patients, and 70-80% of resistant hypertensive patients have obstructive sleep apnea (OSA). The characteristics of resistant HTN that predispose patients to OSA have not been reported. Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA.

Materials and Methods

Hypertensive patients (n=475) who underwent portable polysomnography were enrolled. The patients were categorized into controlled (n=410) and resistant HTN (n=65) groups. The risk factors for the occurrence of OSA in controlled and resistant hypertensive patients were compared, and independent risk factors that are associated with OSA were analyzed.

Results

Out of 475 patients, 359 (75.6%) were diagnosed with OSA. The prevalence of OSA in resistant HTN was 87.7%, which was significantly higher than that in controlled HTN (73.7%). Age, body mass index, neck circumference, waist circumference, and hip circumference were significantly higher in OSA. However, stepwise multivariate analyses revealed that resistant HTN was not an independent risk factor of OSA.

Conclusion

The higher prevalence and severity of OSA in resistant HTN may be due to the association of risk factors that are common to both conditions.     

老年高血压患者抑郁的患病率及与血浆同型半胱氨酸的相关性

目的:分析老年高血压患者抑郁的发病情况,及其与血浆同型半胱氨酸(Hcy)的相关性,为早期干预治疗提供依据。方法:调查2011年1月-2014年6月我院收治的老年高血压患者403例,通过抑郁自评量表(SDS)了解其抑郁发病情况及抑郁程度,并分析其与血浆Hcy水平的相关性。结果:共调查403名老年高血压患者,抑郁的患病率为21.34%,男性患病率(17.23%)显著低于女性(27.27%)(χ2=5.86,P0.05),70岁年龄组抑郁的患病率(27.38%)明显高于60~70岁年龄组(17.02%)(χ2=6.26,P0.05);高血压Ⅲ级患者SDS评分明显高于高血压Ⅰ级、Ⅱ级患者(t=4.51,3.87;P0.05);与轻度抑郁比较,中度、重度抑郁患者Hcy水平(t=4.52,4.72;P0.05)、SDS评分(t=3.91,6.52;P0.05)明显升高,叶酸水平(t=-5.16,-6.40;P0.05)明显下降;抑郁患者中Hcy水平与叶酸水平呈负相关(r=-0.438,P0.05),与SDS评分呈正相关(r=0.587,P0.05)。结论:老年高血压患者抑郁的患病率较高,临床上结合血浆Hcy水平进行治疗,有助于血压的达标,降低心脑血管疾病的风险,改善预后。     

北京市职业人群代谢综合症患病率调查

调查北京市政府机关及企、事业单位人员中代谢综合症 (MS)的患病率。共计调查 2 6 797人 (男 1 6 4 6 0人、女1 0 337人 ) ,年龄 2 0～ 80岁。MS诊断采用美国胆固醇教育计划 (NCEP ATPⅢ )防治指南所提出的建议 ,但其中腹部肥胖的指标 (腰围 )采用“中国肥胖问题工作组”建议的划分界限 ,同时也参考世界卫生组织“MS定义”中的意见以体质指数 (BMI)分别统计患病率。MS患病率在中、老年组中 >2 0 % ,青年组 <7%。年龄标化患病率以腰围计男1 5 1 %、女 1 3 0 % ;以BMI≥ 2 5kg m2 计 ,男 1 5 3%、女 9 9%。MS已是中、老年人中最多见的代谢异常 ,及时治疗MS对心血管病及糖尿病等的防治十分重要     

内蒙古牧区蒙古族体质指数与高血压及血脂相关

目的 了解内蒙古牧区蒙古族体质指数与高血压、血脂的关系.方法 对18岁以上951人蒙古族人群进行体质指数与高血压及血脂的关系进行调查分析.结果 蒙古族人群的超重与肥胖检出率男性大于女性(P＜0.01),高血压和血脂异常患病率随体质指数的增加而增大.超重与肥胖组人群高血压和血脂异常患病率显著高于正常组(P＜0.01).高血压和血脂异常患病率与体质指数呈正相关.结论 蒙古民族体质指数是高血压和血脂异常患者的危险因素.控制体质量可以有效的预防和减少慢性疾病的发生.     

Validity of BMI as a measure of obesity in Australian white Caucasian and Australian Sri Lankan children

Background: Body mass index (BMI) is used to diagnose obesity. However, its ability to predict the percentage fat mass (%FM) reliably is doubtful. Therefore validity of BMI as a diagnostic tool of obesity is questioned. Aim: This study is focused on determining the ability of BMI-based cut-off values in diagnosing obesity among Australian children of white Caucasian and Sri Lankan origin. Subjects and methods: Height and weight was measured and BMI (W/H²) calculated. Total body water was determined by deuterium dilution technique and fat free mass and hence fat mass derived using age- and gender-specific constants. A %FM of 30% for girls and 20% for boys was considered as the criterion cut-off level for obesity. BMI-based obesity cut-offs described by the International Obesity Task Force (IOTF), CDC/NCHS centile charts and BMI-Z were validated against the criterion method. Results: There were 96 white Caucasian and 42 Sri Lankan children. Of the white Caucasians, 19 (36%) girls and 29 (66%) boys, and of the Sri Lankans 7 (46%) girls and 16 (63%) boys, were obese based on %FM. The FM and BMI were closely associated in both Caucasians (r?=?0.81, P<0.001) and Sri Lankans (r?=?0.92, P<0.001). Percentage FM and BMI also had a lower but significant association. Obesity cut-off values recommended by IOTF failed to detect a single case of obesity in either group. However, NCHS and BMI-Z cut-offs detected cases of obesity with low sensitivity. Conclusions: BMI is a poor indicator of percentage fat and the commonly used cut-off values were not sensitive enough to detect cases of childhood obesity in this study. In order to improve the diagnosis of obesity, either BMI cut-off values should be revised to increase the sensitivity or the possibility of using other indirect methods of estimating the %FM should be explored.     

Genetic and Shared Environmental Influences on Adolescent BMI: Interactions with Race and Sex

The present study uses a behavioral genetic design to investigate the genetic and environmental influences on variation in adolescent body mass index (BMI) and to determine whether the relative influences of genetic and environmental factors on variation in BMI are similar across racial groups and sexes. Data for the present study come from the National Longitudinal Study on Adolescent Health (Add Health), a large, nationally representative study of adolescent health and health-related behaviors. The Add Health sample contains a subset of sibling pairs that differs in levels of genetic relatedness, making it well suited for behavioral genetics analyses. The present study examines whether genetic and environmental influences on adolescent BMI are the same for males and females and for Black and White adolescents. Results indicate that genetic factors contribute substantially to individual differences in adolescent BMI, explaining between 45 and 85% of the variance in BMI. Furthermore, based on an analysis of opposite-sex sibling pairs, the genes that influence variation in adolescent BMI are similar for males and females. However, the relative importance of genetic and environmental influences on variation in BMI differs for males and females and for Blacks and Whites. Although parameter estimates could be constrained to be equal for Black and White males, they could not be constrained to be equal for Black and White females. Moreover, the best-fitting model for Black females was an ADE model, for White females it was an ACE model, and for males it was an AE model. Thus, shared environmental influences are significant for White female adolescents, but not for Black females or males. Likewise, nonadditive genetic influences are indicated for Black females, but not for White females or males. Implications of these results are discussed.     

体质指数对超重与肥胖青少年血压的影响

目的探讨体质指数对超重与肥胖青少年高血压的影响。方法测量郴州市6所学校部分12～15岁青少年体重、身高、血压。结果 2566名在校学生血压偏高率为20.7%,其中血压偏高在非超重组、超重组和肥胖组检出率分别为19.15%、34.55%和39.29%,非超重组、超重组和肥胖组儿童血压偏高检出率组间差异有统计学意义（P〈0.05）。结论青少年血压偏高检出率随体质指数增加而明显增高。     

神经性厌食症患者体重指数的对照分析

目的 :探讨神经性厌食症患者体重指数 (BMI)的特点及疾病的临床特征。方法 :采用进食障碍调查问卷 (EDI-1)对 3 0名神经性厌食症患者和 3 0名正常对照者进行评定 ,计算EDI -1量表分、BMI。结果 :根据期望BMI和目前BMI的差值 ,厌食症患者可分为追求更瘦组和不追求更瘦组。不追求更瘦组的目前BMI最低 ,追求更瘦组的目前BMI次之 ,正常对照组目前BMI最高 ,差异具有显著性 (F =5 4 15 ,P <0 0 1) ;两病例组间期望BMI没有差异 (P >0 0 5 ) ,但都低于正常对照组。追求更瘦组EDI -1量表总分最高、不追求更瘦组次之、对照组最低 ,差异具有显著性 (P <0 0 1)。结论 :体重过低的厌食症患者可能希望体重增加。但无论患者是否希望体重增加 ,期望体重指数都低于正常 ,实际上都是怕胖的。追求更瘦的患者可能预后较差 ,这可能与患者较严重的认知偏差以及某些心理特征有关。     

Association between measured BMI and self-perceived body size in Mexican adults

Aim: The study examined the association between perceived body size (through self-selection of Stunkard's body shape silhouettes) and measured body mass index (BMI) in Mexican Mestiso adult men and women, and determined the BMI values that corresponded to each silhouette.

Subjects: A sample of 1092 men and 1247 women, apparently healthy, aged 20–69, was studied.

Methods: Participants were asked to identify the silhouette that most accurately represented his/her body size. Weight and height were measured in duplicate to calculate BMI. A simple linear regression analysis was used to adjust BMI values to silhouette categories by gender. Areas under the receiver operating characteristic curves (AUC) were calculated to assess accuracy.

Results: Gender-specific BMI values for each silhouette were obtained. Correlation coefficients between silhouette ratings and BMI were 0.702 in males and 0.766 in females. Overweight ranged from silhouette 4 to 6 and obesity from silhouette 6 to 9, in both men and women. In the regression models, 49.3% of BMI variance in males and 58.7% in females were explained statistically by silhouette self-selection. AUC were higher than 0.8 for overweight and obesity in males and females.

Conclusions: Both male and female models had a good fit, indicating that BMI can be associated with body shape silhouettes. Silhouettes can be useful for defining overweight and obesity in settings such as schools or worksites, or where scales and stadiometers might not be available. They can also be used to provide health advice to the public.     

National reference centiles of anthropometric indices and BMI cut-off values in a child population in Nepal

Background: There is a need for national- or ethnicity-specific growth reference values in developing countries like Nepal, where rapid urbanisation and consequential nutritional transition is taking place.

Aim: To establish national growth reference percentiles for anthropometric indices and to propose body mass index (BMI) cut-off values for Nepalese schoolchildren.

Methods: This study comprised 1135 Nepalese schoolchildren of four World Health Organization (WHO) indexed age groups (5-, 6-, 12- and 15-year-olds). The age- and gender-specific smoothed percentile curves for anthropometric indices (height, weight, BMI, waist circumference, waist-to-hip-ratio and waist-to-height-ratio) were constructed using LMS method and the corresponding Z-scores were computed. The Receiver Operating Characteristic analysis was used to determine BMI cut-off values based on the International Obesity Taskforce (IOTF) and the WHO growth references.

Results: The age- and gender-specified smoothed percentile values of anthropometric indices at 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles were computed. The BMI cut-off values for thinness (?1.2 SDS/12th percentile), overweight (+1.2 SDS/88th percentile) and obesity (+2.1 SDS/98th percentile) had high discriminating power, and high sensitivity and specificity.

Conclusion: The Nepali anthropometric cut-off values proposed here can be recommended to be applied into research, and to identify public health risks in Nepal among these age groups.