体质指数、腰围、血脂水平与高血压的关联分析

【摘要】目的 探讨体质指数(BMI)、腰围(WC)、血脂水平与高血压患病的关系，及BMI、WC 对高血压的预测价值。方法 采用整群随机抽样法，抽取宁波市鄞州区40 岁以上常住居民2 303 例进行问卷调查、体格检查及血脂指标检测，其中高血压患者（高血压组）1 081 例，血压正常者（对照组）1 222 例。WC 分组：男性WC≥85 cm、女性WC≥ 80 cm 为中心性肥胖，其余为正常；BMI 分组：BMI≥24 kg/m2 为超重，BMI＜24 kg/m2 为正常。分别采用非条件Logistic 回归模型分析BMI、WC 和血脂水平对高血压的影响，通过ROC 曲线分析BMI 和WC 对高血压的预测价值。结果 高血压组WC、BMI、总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)均高于对照组（均P＜0.01），且WC、 BMI、TG 及LDL-C 是高血压的影响因素。高血压组中心性肥胖率、超重率均高于对照组（均P＜0.01），超重、中心性肥胖、TG 和LDL-C 异常是患高血压的危险因素。超重伴有中心性肥胖人群高血压患病风险＞超重但腰围正常人群＞单纯性中心性肥胖人群>正常者；男、女性人群的ROC 曲线下面积均为BMI > WC。结论 WC、BMI、TG 和LDL-C 异常是患高血压的危险因素，BMI 比WC 能更好地预测高血压的发生。

Association of Body Mass Index,Waist Circumference and Serum Lipid Levels with Essential Hypertension

Abstract] Objective To explore the relationship of different body mass index, waist circumference and serum lipid levels with essential hypertension among residents of Ningbo. And to explore the predictive value of BMI and WC (Waist Circumference) for hypertension. Methods Adopting cluster sampling, 2 303 people (1 081 cases of hypertension and 1 222 people with normal blood pressure) were collected in the four townships of Ningbo City. We conducted questionnaires, physical examination and blood lipid testing for all of subjects. WC group: WC≥85 cm in male or WC≥80 cm in female is central obesity, and the others are normal. BMI groups: BMI≥24 kg/m2 is overweight, and BMI <24 kg/m2 is normal. The relationship of BMI, WC and serum lipid levels with hypertension was analyzed by multivariate unconditional logistic regression model. The predictive value of BMI and WC for hypertension was analyzed by receiver operating characteristic (ROC) curve. Results WC, BMI, total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in hypertension group were higher than those in control group (P < 0.01). And WC, BMI, TG, LDL-C is the impact factor for hypertension. The overweight rate and central obesity rate in hypertension group were higher than control group (P < 0.01). TG and LDL-C level abnormality, overweight and central obesity were the risk factors of hypertension. As a risk factor of hypertension, overweight with central obesity group is higher than overweight with normal waistline group, simple central obesity group and normal group. In the area under the ROC curve, BMI is higher than WC in both male and female population. Conclusion WC, BMI, TG and LDL-C abnormalities were risk factors for hypertension, and BMI was a better predictive factor for hypertension than WC.