5种肥胖指标对不同性别及年龄组高血压的预测效果比较

目的 比较不同肥胖指标对不同性别、年龄人群高血压风险的预测价值。方法 基于深圳市龙华区2018年社区居民健康调查数据,对体质指数（BMI）、腰围（WC）、腰围身高比（WHtR）、腰臀比（WHR）和人体肥胖指数（BAI）共5种肥胖指标进行标准化转换,根据Logistic回归分析所得OR值,比较各肥胖指标与高血压的相关性;根据受试者工作特征曲线（ROC）下面积（AUC）,判断各肥胖指标对高血压的预测价值,进而综合评价各肥胖指标对高血压的预测能力。结果 在调整混杂因素后,WC和WHtR与男性和女性高血压的相关性强于其他肥胖指标。WHtR对于男性和女性高血压的预测能力均强于其他肥胖指标,其AUC及95%CI分别为0.694（0.659~0.728）和0.763（0.732~0.794）,其截断值分别为0.51和0.50;女性中各肥胖指标预测高血压的AUC均大于男性,各肥胖指标对女性高血压有更高的预测价值。对男女进行年龄分层后,在男性中除WHR外各肥胖指标对于青年组（18~44岁）高血压的预测价值优于中年组（45~59岁）和老年组（60~80岁）;在女性中各肥胖指标对于高血压的预测价值随着年龄的增长而降低,依次为青年组>中年组>老年组。结论 在综合考虑性别和年龄后,中心型肥胖指标中的WHtR对高血压的预测能力优于WC、BMI、WHR和BAI。

Prediction effect of five obesity indicators for hypertension in differentgender and age

Objective To compare the predictive value of different obesity indicators for hypertension in different gender and age. Methods The study was based on the community health survey in 2018 in Longhua District, Shenzhen. After standardized transformation of five obesity indicators, including body mass index （BMI）, waist circumference （WC）, waist height ratio （WHtR）, waist-to-hip ratio （WHR） and body obesity index （BAI）, the correlation between the obesity indicators and hypertension was compared according to the OR values obtained from the Logistic regression analysis. The predictive value of each obesity indicator for hypertension was estimated by the area under the receiver operating characteristic curve （ROC）. Furthermore, the ability of each obesity indicatorin predicting hypertension wascomprehensively evaluated. Results After adjusting for confounding factors, WC and WHtR were more strongly associated with hypertension in both genders than other obesity indicators. The predictive power of WHtR for hypertension in male and female were stronger than other obesity indicators,the AUC and 95% CI were 0.694 （0.659-0.728） and 0.763 （0.732-0.794）,the cut-off values were 0.51 and 0.50, respectively. Female had higher AUC of hypertension than men, and each obesity indicator had higher predictive value for female hypertension. After stratified by age in both genders, the predictive value of obesity indicators except WHR in the young male group （18-44 years old） was higher than that in the middle-aged group （45-59 years old） and the elderly group （60-80 years old）. In female, the predictive value of obesity indicators for hypertension decreased with age, followed by young group > middle-aged group >elderly group. Conclusion After considering both gender and age, the predictive power of WHtR in central obesity index for hypertension is better than WC, BMI, WHR and BAI.