腰围、腰高比与肱踝脉搏波传导速度的相关性研究

目的 研究腰围和腰高比与肱踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)的关系,探索腹型肥胖对外周动脉弹性的影响。 方法 选取2018年3月—2019年5月在中国医科大学附属第一医院体检中心体检的2 718名体检者,采用动脉硬化测定仪检测双侧肢体的baPWV,根据baPWV值分为正常组和升高组。同时检测其腰围、腰高比、体质指数(body mass index,BMI)、SBP、DBP及生化指标,用t检验比较两组间指标的差异,用多因素logistic回归分析影响baPWV的因素,用ROC曲线判断腰围、腰高比对baPWV的预测价值。 结果 t检验显示baPWV升高组的男性比例、年龄、腰围、腰高比、BMI、SBP、DBP、FBG、TG、TC、HDL-C、UA水平均较正常组高(P＜0.01)。多因素logistic回归分析显示腰围(OR=0.938,95%CI:0.884~0.995)、腰高比(OR=1.605,95%CI:1.486~1.804)、BMI(OR=0.881,95%CI:0.796~0.975)是影响baPWV的独立危险因素。腰围预测baPWV升高的最佳临界值为80.50 cm,ROC曲线下面积为0.725,此时灵敏度0.854,特异度0.483;腰高比预测baPWV升高的最佳临界值为0.495,ROC曲线下面积为0.762,此时灵敏度0.814,特异度0.548。 结论 腰围、腰高比升高是baPWV升高的独立危险因素,可预测外周动脉硬化的发生。

Correlation of waist circumference and waist-to-height ratio with brachial-ankle pulse wave velocity

Objective To study the relationship of waist circumference and waist-to-height ratio with brachial-ankle pulse wave velocity, and to explore the influence of abdominal obesity on peripheral artery elasticity. Methods We selected 2,718 health check-up subjects from Physical Examination Center, the First Affiliated Hospital of China Medical University from March 2018 to May 2019. Arteriosclerosis tester was used to detect baPWV in bilateral limbs. Based on the results of baPWV, they were divided into the normal group and the elevated group. The values of waist circumference, waist-to-height ratio, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and biochemistry indexes were simultaneously detected. t test was used to compare the differences in the above-mentioned indexes between the two groups. Multifactor logistic regression analysis was applied to identifying the factors influencing baPWV, and ROC curve was employed to determine the predictive values of waist circumference and waist-to-height ratio on baPWV. Results t test showed that the values of male ratio, age, waist circumference, waist-to-height ratio, BMI, SBP, DBP, fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and uric acid (UA) in the elevated group were all significantly higher than those in the normal group (all P<0.01). Multifactor logistic regression analysis revealed that waist circumference (OR=0.938, 95%CI: 0.884-0.995), waist-to-height ratio (OR=1.605, 95%CI: 1.486-1.804), BMI (OR=0.881, 95%CI: 0.796-0.975) were the independent factors influencing baPWV. The optimal cut-off point of waist circumference to value increased baPWV was 80.50 cm, and the area under ROC curve was 0.725, with the sensitivity and specificity being 0.854 and 0.483, respectively. The best cut-off point of waist-to-height ratio to value increased baPWV was 0.495, and the area under ROC curve was 0.762, with the sensitivity and specificity being 0.814 and 0.548, respectively. Conclusion The elevated values of waist circumference and waist-to-height ratio were the independent factors influencing elevated baPWV, and could predict the occurrence of peripheral arterial stiffness.