上海市社区居民中心性肥胖与打鼾对血脂异常的交互作用

目的 探讨上海市社区居民中心性肥胖与打鼾对血脂异常的交互作用。方法 利用2017年上海市慢性病及其危险因素监测数据（SHCR-2017），通过多阶段分层抽样,合计纳入研究对象20 259人，应用多因素logistic回归评价中心性肥胖与打鼾对血脂异常患病的影响。采用相乘交互、相加交互作用模型评估中心性肥胖和打鼾对血脂异常患病的交互作用。结果 上海市血脂异常检出率为35.5%，高甘油三酯血症（18.2%）和低高密度脂蛋白胆固醇血症（15.8%）为主要特征。经混杂因素调整后，中心性肥胖（OR=1.74,95%CI:1.63～1.85)与打鼾（OR=1.16,95%CI:1.09～1.24）均与血脂异常相关。交互作用分析表明，中心性肥胖与打鼾对血脂异常患病无显著相乘交互作用（OR=0.98,95%CI:0.87～1.11）。两者对血脂异常患病存在相加交互作用（RERI=2.21,95%CI:1.61～2.81;SI=3.40,95%CI:3.07～3.78;AP=0.54,95%CI:0.49～0.58）。血脂异常四种临床类型中，研究对象对高甘油三酯血症、低高密度脂蛋白胆固醇血症患病的相加交...

Interaction of central obesity and snoring on dyslipidemia in Shanghai: a cross-sectional study

Objective To explore the interaction effect of central obesity and snoring on dyslipidemia in Shanghai community dwelling residents. Methods A total of 20 259 subjects were included in the study based on the surveillance data of the chronic disease and their risk factors in Shanghai 2017 (SHCR-2017). The investigation was performed by questionnaire, physical measurements, and laboratory tests. Multivariate logistic regression was performed to estimate the effect of central obesity and snoring on dyslipidemia. Additive models and multiplicative interaction models were used to estimate the interaction between central obesity and snoring on dyslipidemia. Results The dyslipidemia rate was 35.5% in Shanghai, and HTG (18.2%) and LHDL (15.8%) were main characteristics. Multivariate logistic regression showed that after adjusting the confounding factors, central obesity (OR=1.71, 95%CI: 1.46-2.01) and snoring (OR=1.99, 95% CI: 1.68-2.36) were related to the high risk of dyslipidemia. Interaction analysis showed that central obesity and snoring had no significant multiplicative interaction effect on dyslipidemia (OR=0.98, 95%CI: 0.87-1.11). Both had additive interaction effect on dyslipidemia (RERI=2.21, 95%CI: 1.61-2.81; SI=3.40, 95%CI: 3.07-3.78; AP=0.54, 95%CI: 0.49-0.58). Among the four clinical types of dyslipidemia, significant additive interaction between hypertriglyceridemia and low high density lipoprotein cholesterol was found. Compared with overweight and obese people, there was a significant interaction between central obesity and snoring on dyslipidemia in normal BMI people. Conclusion Central obesity and snoring may have a synergistic effect on dyslipidemia. Strengthening the control of waist circumference in snorers is beneficial for the prevention of dyslipidemia, especially hypertriglyceridemia and low high density lipoprotein cholesterol.