不同年龄女性超重和肥胖与动脉僵硬度的相关性研究

目的 探讨女性人群不同体重与臂踝脉搏波速度（baPWV）的关系,评估超重和肥胖女性人群的高动脉僵硬度风险.方法 采用分层整群随机抽样方法,于201 1年3至12月在苏州、无锡、常州地区抽取年龄≥20岁的常住女性人群2 921名.进行问卷调查、人体测量和baPWV检测,用baPWV评估动脉僵硬度.采用Logisitic多元回归模型分析体质指数（BMI）等级变量对高动脉僵硬度的影响;通过受试者工作（ROC）曲线分析BMI对高动脉僵硬度的预测价值.结果 高动脉僵硬度率超重组（37.87％）和肥胖组（47.60％）均高于体重正常组（16.95％）,差异有统计学意义（x2=205.97,P均＜0.01）;BMI与baPWV呈正相关（r=0.310,P＜0.01）.高动脉僵硬度率65岁以上组（79.08％）高于20～40岁组（4.04％）和41～64岁组（24.96％）,差异有统计学意义（x2值分别为677.30和347.26,P均＜0.01）.20～40岁组和41～64岁组超重和肥胖女性的高动脉僵硬度率高于体重正常组,差异有统计学意义（P均＜0.01）.单因素分析显示年龄、静息心率、收缩压、舒张压均与高动脉僵硬度相关（P均＜0.01）.调整年龄、静息心率和血压后,多因素Logisitic回归分析显示以体重正常组为对照,超重组高动脉僵硬度的OR值为2.017（95％CI：1.637～2.486,P＜0.01）,肥胖组高动脉僵硬度的OR值为2.759（95％CI：1.964～3.876,P＜0.01）.BMI预测女性人群高动脉僵硬度的ROC曲线下面积为0.693 （95％CI：0.671～0.715,P＜0.01）,最佳预测切点为23.42 kg/m2.结论 超重和肥胖是女性人群高动脉僵硬度的危险因素,BMI对女性人群高动脉僵硬度的预测界值为23.42 kg/m2.

Association of overweight/obesity with arterial stiffness in females

Objective To evaluate the association of body weight with brachial-ankle pulse wave velocity （baPWV） in females.Methods A total of 2 921 residents （≥20 years old） were selected by the stratified cluster random sampling method from March to December 2011.Arterial stiffness was assessed by baPWV.Multivariate logistic regression analysis was used to evaluate the effect of body mass index （BMI） on arteriosclerosis.The predictive value of BMI to evaluate arteriosclerosis was analyzed by using receiver operation characteristic （ROC） curve.Results The prevalence of arteriosclerosis was significantly increased in overweight/obese residents （P＜0.01）.BMI was positively correlated with baPWV （r=0.310,P＜0.01）.The prevalence of increased arterial stiffness in individuals≥65 years older was higher than that in people of 20-40 or 41-64 years old （x2 values were 677.30 and 347.26,respectively; both P＜0.01）.For females of 20-40 or 41-46 years old,the prevalences of increased arterial stiffness in overweight and obese groups were higher than those in normal body weight group （both P＜0.01）.In univariate analysis,age,resting heart rate,systolic blood pressure （SBP） and diastolic blood pressure （DBP） were correlated with arteriosclerosis （all P＜0.01）.The odds ratio for the prevalence of arteriosclerosis in overweight women was 2.017 （95％ confidence interval （CI）：1.637-2.486,P＜0.01） and that in obese women was 2.759 （95％ CI：1.964-3.876,P＜0.01） after adjustment for age,resting heart rate and blood pressure.The area under the ROC curve was 0.693 （95％ CI：0.671-0.715,P＜0.01） to evaluate arteriosclerosis in females and the optimal cut-off point for BMI was 23.42 kg/m2.Conclusions For females,overweight and obesity may be risk factors of arteriosclerosis.The optimal cut-off point for BMI to evaluate arteriosclerosis in women could be 23.42 kg/m2.