原发性高血压合并微量白蛋白尿患者动态血压观察

目的了解原发性高血压患者微量白蛋白尿(micro-albuminuria,MAU)与动态血压的特征性改变,包括血压变异指数(ABPVs、ABPVd)、血压负荷(BPload)及血压昼夜节律的相关性。方法确诊的141例原发性高血压患者进行24h动态血压和24h尿微量白蛋白检查,分为微量白蛋白尿(MAU)组及尿微量白蛋白正常组(NAU)。结果MAU组血压变异指数及血压负荷较NAU组增大(P<0.05),合并MAU的患者血压昼夜节律不明显。结论微量白蛋白尿的发生与血压变异指数、血压负荷和血压昼夜节律密切相关,有无微量白蛋白尿可一定程度上反映血压控制状况。     

哈萨克族成人6种肥胖评价指标准确性比较

目的 比较身体质量指数（BMI）、腰围（WC）、腰臀比（WHR）、腰围身高比（WHtR）、肥胖指数（BAI）、体脂率（PBF）对哈萨克族肥胖筛查的准确性,并确定6种指标在判断哈萨克族肥胖的最佳切点。方法 采用卡方检验、直线相关分析及受试者工作特征曲线（ROC）分析,比较BMI、WC、WHR、WHtR、BAI、PBF对肥胖预测的准确性,并确定各项指标的最佳切点。结果 经卡方检验分析结果显示,WC与WHtR、BMI与BAI对哈萨克族肥胖判断的结果相近。在直线相关分析中,BMI、WC与身体脂肪含量具有很强的相关性。ROC曲线分析显示,WC的曲线下面积(AUC)最大,其次是BMI。 结论 哈萨克族是超重、肥胖的高发人群,腰围对哈萨克族肥胖筛查的准确性最高,建议使用BMI、WC及WHtR 3项指标共同判定哈萨克族肥胖情况。     

不同糖代谢状态人群的肥胖指标与动脉硬化的相关性

目的研究北京市社区不同糖代谢状态人群的肥胖指标与动脉硬化的相关性。方法用臂-踝脉搏波传导速度(baPWV)反映动脉硬化程度。对北京市石景山区两个社区大于或等于40岁居民进行体格检查,测量体重(weight)、腰围(WC)、体重指数(BMI)、腰臀比(WHR)、腰围升高比(WHtR)及标准化问卷调查、生化和糖化血红蛋白检测、75 g葡萄糖耐量实验及baPWV测量。对数据资料完整及BMI大于或等于18.5 kg/m2的9 080名人员根据75OGTT试验及糖尿病史分为NGT、IGR和DM组,分析BMI、WC、WHR、WHtR与baPWV之间的关系。结果在NGT、IGR、DM组,根据WC、WHR、WHtR分成亚组,中心型肥胖组的baPWV明显高于正常组(P0.01),在DM组内,以BMI作为肥胖标准,baPWV仅在NGT和IGR组内有统计学意义,在DM组无显著差异(P0.05)。在NGT、IGR和DM组内,中心型肥胖指标(WC、WHR、WHtR)与baPWV呈显著正相关(P0.05),BMI仅在NGT组内与baPWV呈正相关,在IGR和DM组内无明显相关(P0.05)。校正年龄、性别、心血管危险因素,通过多元回归分析发现,WHR和WHtR每增加0.1,baPWV则随之升高40.6 cm/s和55.3 cm/s。结论在糖代谢异常人群中,中心性肥胖指标(WC、WHR、WHtR)与动脉硬化呈正相关,较BMI更能反映动脉硬化程度。     

体检人群尿微量白蛋白/肌酐比值参考区间初步分析

目的 探讨并建立体检人群尿微量白蛋白/肌酐比值(UACR)的参考区间.方法 选取北京同仁医院健康体检人群1820例留取的随机中段尿,检测其尿微量白蛋白与尿肌酐并计算尿微量白蛋白与肌酐比值,对其结果进行回顾性分析,观察不同组别结果的分布特征.结果 依性别分组,UACR值男性组明显低于女性组(P<0.01),依年龄分为以下...     

西藏日喀则地区成年僧人体质状况与血压水平的相关性分析

目的:探讨西藏日喀则地区成年僧人体质状况与血压水平的相关性,为高血压的早期预防提供相关依据。方法:采用整群随机抽样的方法,对居住在西藏日喀则地区成年僧人155例的血压(BP)、身高、体质量、腰围(WC)、臀围进行测量,并计算体质指数(BMI)、腰臀比(WHR)和腰身比(WHtR)。结果:155例检测者中高血压的患病率是29%,高血压组在年龄、BMI、WC、WHR和WHtR等方面均高于血压正常组。收缩压和舒张压均随着年龄的增加呈升高趋势;脉压亦随着年龄的增大而增大;高血压的患病率也随着年龄的增加而逐步增大。随着全身性肥胖指标BMI的增加,血压各水平和高血压患病率均升高。各中心性肥胖组的血压水平和高血压患病率均明显高于非肥胖组。Pearson线性相关分析显示,BMI、WC、WH-R和WHtR与收缩压、舒张压和脉压均呈正直线相关。以高血压为因变量进行多因素logistic回归分析,结果显示,BMI、WC和WHtR是血压变化的独立影响因素。结论:西藏日喀则地区成年僧人血压水平与体质状况密切相关,高血压患病率和肥胖率均较高,应予以足够重视,积极控制全身性肥胖和中心性肥胖,从而防治高血压的发生。     

2型糖尿病患者微量白蛋白尿的相关危险因素分析

目的:研究2型糖尿病(NIDDM)患者微量白蛋白尿(MAU)的危险因素.方法:用放射免疫法测定了112例NIDDM尿白蛋白排泄率(UAER),利用多因素逐步回归分析法分析MAU的危险因素,并显示这些因素独立作用.结果:NIDDM患者UAER与胆固醇、舒张压、空腹血糖、体重指数呈独立正相关;性别、年龄、高密度脂蛋白无明显作用.结论:高血脂、高血压、高血糖、肥胖将导致NIDDM患者发生MAU.     

2型糖尿病患者血清总胆红素水平与白蛋白尿的关系

目的:检测分析2型糖尿病(T2DM)患者血清总胆红素(TBIL)水平变化与其白蛋白尿的关系。方法:选择T2DM患者130例,依其尿微量白蛋白/尿肌酐比值(UACR)分为三组:正常白蛋白尿组(UACR30mg/g,n=66);微量白蛋白尿组(UACR 30—300mg/g,n=39);临床白蛋白尿组(UACR≥300mg/g,n=25);另选体检健康人群作为对照组(n=31)。比较各组TBIL水平差异及T2DM患者TBIL水平与UACR的相关性。结果:T2DM各组血清TBIL水平均低于对照组(P0.05),并随上述UACR分组依次降低,两者呈显著负相关(r=-0.204)。结论:血清TBIL水平可间接反映T2DM患者肾功能损害。     

尿白蛋白排泄率与2型糖尿病微血管病变的相关性分析

研究尿白蛋白排泄率(UAER)与糖尿病肾脏病变(DN)、视网膜病变(DR)之间的关系,并探讨与其有关的相关危险因素. 对465例2型糖尿病患者按UAER分成正常白蛋白尿组(NAU组,UAER＜20μg/min)、微量白蛋白尿组(MAU组,20μg/min ≤UAER＜200μg/min )和临床白蛋白尿组(CAU组,U...     

非酒精性脂肪肝肥胖人群的血尿酸水平分析

目的:分析非酒精性脂肪肝非肥胖及肥胖人群的血尿酸(SUA)水平变化.方法:体检人群筛选出来的非酒精性脂肪肝非肥胖和肥胖者与正常对照组同时检测血尿酸(SUA)、体重指数(BMI)、腰臀比(WHR)及相关生化指标.结果:非酒精性脂肪肝非肥胖组和肥胖组SUA、BMI、WHR、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC...     

尿微量白蛋白与2型糖尿病合并冠心病患者心功能的关系

冠心病（CHD）有很多传统危险因素,其中以糖尿病和高血压最重要。糖尿病人群发生CHD的危险是非糖尿病人群的2～4倍。尿微量白蛋白（MAU）为糖尿病肾病的早期预测指标,但糖尿病合并CHD患者不同心功能分级的MAU水平的分析比较鲜见报道。本文报道不同心功能分级2型糖尿病合并CHD患者治疗前后MAU水平变化。     

Meta-Analysis of the Relationship between Abdominal Obesity and Diabetic Kidney Disease in Type 2 Diabetic Patients

Background and ObjectivesThe meta-analysis aimed to investigate the association of visceral fat area (VFA), waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR) with diabetic kidney disease (DKD) in type 2 diabetic patients.MethodsIncluded studies were searched from Pubmed, Embase, and the Cochrane Library before July 2020. We synthesized the pooled results of the above relationships by meta-analysis.ResultsFourteen cross-sectional studies were enrolled. The pooled results indicated there was a significant difference in continuous VFA, WC and WHR/WHtR between patients with DKD and those without DKD (standard mean difference, SMD, 0.24, 95% confidence interval, CI, 0.13–0.36, p = 0.000). For VFA, patients with DKD had higher VFA levels than those without DKD (SMD 0.27, 95% CI 0.03–0.50). In the WC subgroup, patients with DKD had higher WC levels than those without DKD (SMD 0.17, 95% CI 0.10–0.24); similarly, abdominal obesity (dichotomized WC) was significantly associated with an increase in the odds of DKD (expected shortfall, ES, 1.57, 95% CI 1.32–1.86). However, the association of continuous WHR/WHtR with DKD was not statistically significant (SMD 0.43, 95% CI −0.12 to 0.97), while we found this relationship was statistically significant when analyzed categorically (ES 1.58, 95% CI 1.22–2.06).ConclusionIn this meta-analysis, we found abdominal obesity parameters (continuous VFA, WC) were associated with increased odds of DKD, and type 2 diabetic patients with DKD were more likely to have abdominal obesity (categorized using WC or WHR/WHtR).     

Percentiles of waist–hip ratio and the relationship with blood pressure among children and adolescents in Shandong,China

Background: Anthropometric indices such as waist circumference (WC), waist-to-height ratio (WHtR) and waist–hip ratio (WHR) have been recognized as useful alternatives to visceral fat measurement in epidemiological studies. WHR has been used extensively in adults. However, there are very few published data for WHR among children and adolescents.

Aim: The present study examined the distribution of WHR and the relationship with blood pressure (BP) among children and adolescents in Shandong, PR China.

Subjects and methods: Data for this study were obtained from a large cross-sectional survey of schoolchildren carried out in 2010. A total of 38?822 students (19?456 boys and 19?366 girls) aged 7–17 years participated in this study. WC, Hip circumference (HC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were measured; WHR was calculated as WC divided by HC. Abdominal obesity was defined by previously published WHR references based on Chinese children and adolescents living in Beijing. All subjects were divided into two groups (group 1 with WHR <85th; group 2 with WHR ≥85th) according to the percentiles of WHR and comparisons of the SBP and DBP between the two groups were made.

Results: The WHR levels in Shandong boys and girls were lower than those from German and Pakistani. The overall prevalence of abdominal obesity was 9.53% (95% CI?=?9.12–9.95%) for boys and 9.82% (95% CI?=?9.40–10.24%) for girls, no statistical differences between the two genders were observed (p?>?0.05). In both boys and girls, the Z-scores of SBP and DBP were all significantly lower in group 1 than in group 2 (p?Conclusion: WHR is useful in identifying children and adolescents at risk of developing high BP. These findings, together with the known tracking of BP from adolescence into adulthood, highlight the importance of preventing overweight and obesity among children and adolescents in order to prevent the development of hypertension in adults.     

Central obesity is associated with nonatopic but not atopic asthma in a representative population sample

BACKGROUND: Epidemiologic studies have consistently demonstrated the association between high body mass index (BMI) and asthma, yet the relationship between asthma and the alternative central obesity phenotypes, waist circumference (WC) and waist-to-hip ratio (WHR), has not been assessed in a representative population sample. OBJECTIVE: To determine the strength of the association of WC and WHR with current asthma and whether the association is modified by atopic status in a representative population sample. METHODS: The North West Adelaide Health Study, a biomedical population study of n = 4060, assessed current asthma, respiratory symptoms, and participant demographics by self-completed questionnaire. Clinic assessment included measures of WC and WHR, spirometry, and skin prick tests to a panel of allergens. RESULTS: Logistic regression analysis showed a significant, marginal increased adjusted risk of asthma associated with obese levels of WC and WHR and BMI > or =35.0 kg/m2 in female subjects only. When the association was considered stratified according to atopic status, the relationship between obese levels of WC and WHR with asthma held only for the nonatopic population in both males (WC: odds ratio [OR] 5.7, 95% confidence interval [CI] 1.1-28.8; WHR: OR 6.2, 95% CI, 1.1-32.9) and females (WC: OR 2.3, 95% CI, 1.2-4.4; WHR: OR 3.0, 95% CI, 1.5-5.9). BMI > or =35.0 kg/m2 showed an inconsistent pattern in the association with asthma. CONCLUSION: Central obesity was significantly associated with an increased risk of nonatopic asthma only. The causal pathway is unknown, but this study suggests the involvement of different pathophysiological mechanisms requiring further investigation. CLINICAL IMPLICATIONS: Asthma should be considered in older, nonatopic, centrally obese, symptomatic individuals.     

Central Obesity in Africans: Anthropometric Assessment of Abdominal Adiposity and its Predictors in Urban Nigerians

Objective

To assess the occurrence of central obesity and identify its predictors in urban Africans using anthropometric tools. Another objective was to evaluate the anthropometric indices and their interaction with various cardiovascular risk factors.

Relationship between obesity and structural brain abnormality: Accumulated evidence from observational studies

We aimed to evaluate the relationship between obesity and structural brain abnormalities assessed by magnetic resonance imaging using data from 45 observational epidemiological studies, where five articles reported prospective longitudinal results. In cross-sectional studies’ analyses, the pooled weighted mean difference for total brain volume (TBV) and gray matter volume (GMV) in obese/overweight participants was -11.59 (95 % CI: -23.17 to -0.02) and -10.98 (95 % CI: -20.78 to -1.18), respectively. TBV was adversely associated with BMI and WC, GMV with BMI, and hippocampal volume with BMI, WC, and WHR. WC/WHR are associated with a risk of lacunar and white matter hyperintensity (WMH). In longitudinal studies’ analyses, BMI was not statistically associated with the overall structural brain abnormalities (for continuous BMI: RR = 1.02, 95 % CI: 0.94–1.12; for categorial BMI: RR = 1.18, 95 % CI: 0.75–1.85). Small sample size of prospective longitudinal studies limited the power of its pooled estimates. A higher BMI is associated with lower brain volume while greater WC/WHR, but not BMI, is related to a risk of lacunar infarct and WMH. Future longitudinal research is needed to further elucidate the specific causal relationships and explore preventive measures.     

Body Composition,Sarcopenia, and Suicidal Ideation in Elderly Koreans: Hallym Aging Study

This study was conducted to assess the relationship between body composition and suicidal ideation among the Korean elderly population (n = 302; ≥ 65 years) who participated in the Hallym Aging Study in 2010. Body composition was measured using dual-energy X-ray absorptiometry, and obesity was measured by the indices of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body fat percentage. Sarcopenia was defined as presence of both low muscle mass and low muscle function. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. We found no differences in body composition measures between subjects with suicidal ideation and those without. In the logistic regression analyses, there were no significant relationships for suicidal ideation according to body composition measures, including BMI, WC, WHR, WHtR, and body fat percentage in both sexes. After adjusting for age, smoking status, alcohol drinking, regular exercise, medical comorbidities, monthly income, education level, and presence of depressive symptoms, the odds ratio (OR) of suicidal ideation was higher in elderly men with sarcopenia compared to those without, whereas no significant relationships were observed in elderly women (OR 8.28, 95% confidence interval [CI] 1.20–61.34 in men; OR 0.79, 95% CI 0.07–8.43 in women). Sarcopenia is closely associated with an increased risk of suicidal ideation in elderly men.     

红细胞分布宽度与未经治疗的2型糖尿病患者肾功能关系

目的:探讨红细胞分布宽度(red cell distribution width,RDW)与未经治疗的糖尿病患者肾功能关系.方法:收集河南省郑州市第三人民医院2015年8-10月335例未经治疗的原发性糖尿病病人,按照尿微量白蛋白量分为对照组(215例)和病例组(120例),收集生理及实验室检查数据,比较两组各项指标的差异.结果:病例组的RDW要显著高于对照组,两组在吸烟、腰围、空腹血糖和尿酸水平差异均有统计学意义(P＜0.05).RDW预测血压形态的受试者工作特征曲线(receiver operatingcharacteristic curve,ROC)下面积为0.74(95％CI 0.69～0.78),灵敏度为78.1％,特异度为64.1％,多元logistic回归显示RDW的比值比为2.75(95％CI 1.45～4.33,P＜0.001).结论:在未经治疗的糖尿病人群中,RDW可能是预测糖尿病早期肾功能损害一个有价值的指标.     

2型糖尿病患者尿白蛋白排泄率与心自主神经病变的关系

目的 观察2型糖尿病心自主神经病变的患病率及其与尿白蛋白排泄率的相关性.方法 选取T2DM患者200例,根据尿蛋白排泄率分为正常蛋白尿组(80例)、微量蛋白尿组(66例)和大量蛋白尿组(54例);采集临床资料,测定收缩压、舒张压、空腹血糖、糖化血红蛋白及血脂等指标;行心血管反射试验检查,结合临床症状评价糖尿病患者心自主神经病变.结果 三组患者在糖尿病病程、收缩压、甘油三酯、空腹血糖、糖化血红蛋白和心自主神经病变之间的差异有统计学意义.心自主神经病变者分别占1.3％、9.1％、22.2％(两两比较,P均＜0.05).尿蛋白排泄率与糖尿病病程、空腹血糖、糖化血红蛋白、收缩压、甘油三酯、低密度脂蛋白-胆固醇、心自主神经病变呈正相关(P均＜0.05).多元回归分析显示收缩压(X1)、甘油三酯(X2)、心自主神经病变(X3)、糖尿病病程(X4)是UACR的影响因素,回归方程为Y=-398.454+2.789X1 +49.092X2+147.969X3 +5.659X4.结论 随着蛋白尿程度加重,合并心自主神经病变的患病率增加;收缩压、甘油三酯、心自主神经病变、糖尿病病程是尿蛋白排泄率的独立影响因素.