安庆地区农村人群腰高比与脑卒中发病关系的研究

目的探讨农村人群中腹部肥胖指标——腰高比（waist—to—heightratio，WHR）与脑卒中的发病关系。方法对安庆及其周边地区在1995—2005年间参加前期流行病学研究的队列人群进行健康回访。采用COX比例风险模型来探讨腰高比与脑卒中的发病关系。结果纳入分析18963人，中位随访时间为6．3年，共发生371例脑卒中，经年龄、性别（分析总人群时）、吸烟、饮酒多变量调整后，总人群中腰高比每增加0．1，发生脑卒中、脑梗死和脑出血的风险比（hazardratio，HR）分别为1．75（95％CI：1．47—2．09）、2．18（95％CI：1．59～2．99）和1．67（95％CI：1．20～2．30），男性中对应的HR分别为1．69（95％CI：1．32—2．16）、2．35（95％CI：1．50～3．68）和1．60（95％CI：1．03—2．48），女性中对应的HR分别为1．86（95％CI：1．45—2．38）、2．09（95％CI：1．34～3．26）和1．82（95％CI：1．12～2．97）；进一步调整收缩压和舒张压之后，在总人群中，腰高比每增加0．1仍能增加50％的脑梗死发病风险，对应的HR值为1．50（95％CI：1．08—2．09）；而分别在男女性别中，腰高比与脑卒中发病风险的关联无统计学意义。结论农村人群中，腰高比的升高增加脑卒中及其亚型的发病风险，但是这种关系在一定程度上受到血压的影响，在总人群中腰高比是脑梗死的独立危险因素。

The study of waist-to-height ratio and risk of stroke in Anqing rural areas

Objective To investigate the relationship between waist-to-height ratio（WHtR） and stroke in Anqing rural areas. Methods The participants who were enrolled from 1995 to 2005 at baseline studies in Anqing and the sur- rounding communities were investigated. Cox＇ s proportional hazard model was used to investigate the association between waist-to-height ratio and stroke. Results 18 963 participants were selected into the analysis. During a median of 6. 3 years follow-up, 371 participants developed stroke events. In the total study population, the multivariate-adjusted hazard ratios（95% CI） for each 0. 1 increased in WHtR were 1.75（95% CI：1. 47-2. 09） for total stroke, 2. 18（95% CI： 1.59- 2. 99） for ischemic stroke and 1.67 （95% CI： 1.20-2. 30） for cerebral hemorrhage stroke. Among men, the corresponding HRs were 1.69 （95 % CI： 1.32-2. 16） for total stroke, 2. 35 （95 % CI：1. 50-3.68 ） for ischemic stroke and 1.60 （95 % CI： 1.03-2.48 ） for cerebral hemorrhage stroke. Among women, the corresponding HRs were 1.86 （95 % CI ： 1.45-2. 38 ） for to- tal stroke, 2. 09（95% CI：I. 34-3.26） for ischemic stroke and 1.82（95% CI： 1.12-2. 97） for cerebral hemorrhage stroke. Additional adjusted for systolic pressure and diastolic pressure, WHtR could significantly increase the ischemic stroke risk in total study population, the HR was 1.50 （95% CI： 1.08-2. 09 ） ; in men and women, no significant association between WHtR and stroke was observed. Conclusions In rural areas population, WHtR can increase the risk of stroke and sub- types, but the relationships were highly modified by systolic pressure and diastolic pressure in certain degree. WHtR is an independent risk factor for ischemic stroke in total population.