低冠心病患病率女性人群中体质量指数、腰臀比与总胆固醇、三酰甘油、高密度脂蛋白胆固醇、三酰甘油、高密度脂蛋白胆固醇相关性

背景由于危险因素致动脉粥样硬化(atherosclerosisdisease,AS)/冠心病存在协同/交互作用,危险因素常趋向交集(聚集性)及表现以某种组合而导致AS/冠心病,如体质量指数(bodymass index,BMI)及腰臀比的增加与某些危险因素水平的增高相关,但这些结果主要来源于高AS/冠心病患病率的西方人群.目的探讨在低AS、低冠心病患病率女性人群中BMI、腰臀比的线性组合与总胆固醇、三酰甘油、高密度脂蛋白胆固醇(highdensitylipoprotein cholesterol,HDL-C)的线性组合是否存在更高的相关性及相关特征,以便进一步认识AS/冠心病的危险因素.同时初步探讨血脂指标预测BMI、腰臀比的重要性.设计横断面调查研究.地点、对象和方法采用现况研究方法,于1995年对广东省479例女性对象进行调查,所有步骤遵循中澳合作项目研究方案.主要观察指标479例女性研究对象身高、体质量、腰围、臀围及血脂指标总胆固醇、三酰甘油、HDL-C分析结果.结果①BMI、腰臀比、总胆固醇、三酰甘油、HDL-C分别为(21.61±3.39)kg/m2,0.80±0.06,(4.24±0.79),(1.13±0.57),(1.31±0.32)mmol/L.②BMI与总胆固醇、三酰甘油呈正相关(r=0.11265,P＜0.05;r=0.30519,P＜0.01).BMI与HDL-C呈负相关(r=-0.15809,P＜0.01).腰臀比与总胆固醇、三酰甘油呈正相关(r=0.16969,0.40034,P＜0.01).腰臀比与HDL-C呈负相关(r=-0.12936,P＜0.01).③身体测量与血脂两组指标间典型相关系数R1,can=0.451050(F=19.49,P＜0.0001;V1=0.2877×BMI'+0.7914×腰臀比',W1=0.1840×总胆固醇'+0.8818×三酰甘油'-0.4300×HDL-C').④标准逐步回归方程分别为腰臀比=0.41437×三酰甘油'-0.164 68×HDL-C'(P＜0.0001);BMI=0.321 00×三酰甘油'-0.185 45×HDL-C'(P＜0.0001).结论腰臀比可作为一标志反映高危险个体(或人群),及危险因素线性组合可作为AS/冠心病的(预测)测量指标;在低AS、低冠心病患病率女性人群中,高BMI、腰臀比与血脂指标总胆固醇、三酰甘油、HDL-C及两指标组间存在相关性,因此对该危险因素进行预防/干预,特别是针对可控制的危险因素是非常重要的,甚至可在青壮年时期或更早期就对该危险因素进行预防/干预.

Relationship betweenbody mass index,waistline hipline ration and total cholesterol,triglyceride,higy densitylipoprotein cholesterol in the females with low prevalence of coronary heart disease

BACKGROUND:Since the risk factors tend to reinforce/interact with each other in their influence on atherosclerosis (AS) /coronary heart disease (CHD), risk factors tend to aggregate and usually appear in some combinations to cause the diseases.For example, the elevation of body mass index (BMI) and waistline hipline ratio (WHR) are associated with elevated levels of several vardiovascular risk facotrs, but which was based primarily on data from Western populations living with high prevalence of AS/CHD.OBJECTIVE:To explore whether a linear combination of BMI and WHR had stronger association with a linear combination of recognized risk factor serum lipids total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) in the females with low prevalence of ASD/CHD, so to further recognize the risk factors to AS/CHD.We also hoped to determine the relative importance of serum lipids predicting BMI and WHR.DESIGN:Cross sectional study.SETTING, PARTICIP NTS and INTERVENTIONS:With cross sectional study, 479 females were surveyed in 1995 in Guangdong Province,China.All the procedures followed the standards from the China-Australia collaboration program.The main study variables:body measurements height,weight, waistline, hipline of 479 female paricipants; and the serum lipids TC,TG and HDL-C were analyzed.3.39) kg/m2, (0.80±0.06), (4.24±0.79), (1.13±0.57), (1.31±TG(r=0.11265, P ＜0.05; r=0.30519, P ＜0.01).BMI was negatively correlated with HDL-C( r = -0.15809, P ＜ 0.01).WHR was significantly correlated with TC and TG (r =0.16969, 0.40034, P ＜ 0.01) .WHR was canonical correlation coefficient between the body measurements and serum lipids was R1 Can =0.451 050( F = 19.49, P ＜ 0.000 1) between V1 and W1(V1=0.2877×BMI' +0.7914×WHR' andW1= 0.1840×TC' +0.881quation were:WHR =0.414 37 ×TG' -0.164 68 × HDL-C' ( P ＜0.0001);BMI =0.321 00 ×TG' -0.185 45 × HDL-C' (P ＜0.000 1).CONCLUSION:It appeared that WHR could be a marker to identify individuals (or population) at high risk, and the linear combination of the risk factors could behave as a measure of ASD/CHD.These data confirmed that correlation existed between BMI, WHR and blood lipids TC, TG, HDL-C and between body measurement and blood lipids, even in population with low prevalence of ASD/CHD, such as females from Guangdong Province in China.So, it is important to prevent/intervene in these risk factors, especially the modifiable risk factors, even in youths or earlier.