肥胖是印度冠状动脉危险因素的主要决定因素：斋浦尔心脏观察研究。

Obesity is major determinant of coronary risk factors in India: Jaipur Heart Watch studies.

作者信息

Gupta Rajeev, Gupta V P, Bhagat Namita, Rastogi Priyanka, Sarna Mukesh, Prakash Hari, Deedwania Prakash C

机构信息

Department of Medicine, Monilek Hospital and Research Centre, Jaipur, India.

出版信息

Indian Heart J. 2008 Jan-Feb;60(1):26-33.

PMID:19212018

Abstract

OBJECTIVE

The impact of rising population-wide obesity on cardiovascular risk factors has not been well studied in low-income countries. To correlate the prevalence of obesity with risk factors we performed epidemiological studies in India.

METHODS

Multiple cross-sectional epidemiological studies, Jaipur Heart Watch (JHW), were performed in India in rural and urban locations. From these cohorts, subjects aged 20-59 years (men 4102, women 2872) were included. Prevalence of various risk factors: smoking/tobacco use, overweight/obesity (body mass index > or = 25 kg/m2) truncal obesity (waist:hip > or = 0.95 men, > or = 0.85 women), hypertension, dyslipidemias, metabolic syndrome and diabetes was determined. Trends were examined using least squares regression.

RESULTS

Smoking/tobacco use was more in rural men (50.0% vs 40.6%) and urban women (8.9% vs 4.5%, p < 0.01). Obesity, truncal obesity, hypertension, hypercholesterolemia, diabetes, and metabolic syndrome were more in urban cohorts (p < 0.001). Age-adjusted prevalence (%) of obesity in various cohorts, rural JHW, and urban JHW-1, JHW-2, JHW-3, and JHW-4 respectively, in men was 9.4, 21.1, 35.6, 54.0, and 50.9 (r2 = 0.92, p = 0.009) and in women 8.9, 15.7, 45.1, 61.5, and 57.7 (r2 = 0.88, p = 0.018). Prevalence of truncal obesity in men was 3.2, 19.6, 39.6, 41.4, and 31.1 (r2 = 0.60, p = 0.124) and in women 10.1, 49.5, 42.1, 51.7, and 50.5 (r2 = 0.56, p = 0.1467). In successive cohorts increasing trends were observed in the prevalence of hypertension (r2 = 0.93, p = 0.008) and metabolic syndrome (r2 = 0.99, p = 0.005) with weaker trends for hypercholesterolemia (r2 = 0.41, p = 0.241) and diabetes (r2 = 0.79, p = 0.299) in men. In women, significant trends were observed for hypertension (r2 = 0.98, p = 0.001) and weaker trends for others. Increase in generalized obesity correlated significantly with hypertension (two-line regression r2, men 0.91, women 0.88), hypercholesterolemia (0.53, 0.44), metabolic syndrome (0.87, 0.94) and diabetes (0.84, 0.93). Truncal obesity correlated less strongly with the risk factors like hypertension (0.50, 0.57), hypercholesterolemia (0.88, 0.61), metabolic syndrome (0.76, 0.33), and diabetes (0.75, 0.33).

CONCLUSIONS

In Asian Indian subjects, escalating population-wide generalized obesity correlates strongly with increasing cardiovascular risk factors.

摘要

目的

在低收入国家，全人群肥胖率上升对心血管危险因素的影响尚未得到充分研究。为了将肥胖患病率与危险因素相关联，我们在印度开展了流行病学研究。

方法

在印度农村和城市地区进行了多项横断面流行病学研究，即斋浦尔心脏观察（JHW）研究。从这些队列中，纳入了年龄在20 - 59岁的受试者（男性4102名，女性2872名）。确定了各种危险因素的患病率：吸烟/使用烟草、超重/肥胖（体重指数≥25 kg/m²）、腹型肥胖（腰臀比：男性≥0.95，女性≥0.85）、高血压、血脂异常、代谢综合征和糖尿病。使用最小二乘法回归分析趋势。

结果

吸烟/使用烟草在农村男性中更为常见（50.0%对40.6%），在城市女性中也更常见（8.9%对4.5%，p < 0.01）。肥胖、腹型肥胖、高血压、高胆固醇血症、糖尿病和代谢综合征在城市队列中更为常见（p < 0.001）。各队列中，农村JHW以及城市JHW - 1、JHW - 2、JHW - 3和JHW - 4队列中，男性年龄调整后的肥胖患病率（%）分别为9.4、21.1、35.6、54.0和50.9（r² = 0.92，p = 0.009），女性分别为8.9、15.7、45.1、61.5和57.7（r² = 0.88，p = 0.018）。男性腹型肥胖患病率分别为3.2、19.6、39.6、41.4和31.1（r² = 0.60，p = 0.124），女性分别为10.1、49.5、42.1、51.7和50.5（r² = 0.56，p = 0.1467）。在连续队列中，观察到男性高血压患病率（r² = 0.93，p = 0.008）和代谢综合征患病率（r² = 0.99，p = 0.005）呈上升趋势，高胆固醇血症（r² = 0.41，p = 0.241）和糖尿病（r² = 0.79，p = 0.299）趋势较弱。在女性中，高血压患病率呈显著趋势（r² = 0.98，p = 0.001），其他因素趋势较弱。全身肥胖的增加与高血压（二线回归r²，男性0.91，女性0.88）、高胆固醇血症（0.53，0.44）、代谢综合征（0.87，0.94）和糖尿病（0.84，0.93）显著相关。腹型肥胖与高血压（0.50，0.57）、高胆固醇血症（0.88，0.61）、代谢综合征（0.76，0.33）和糖尿病（0.75，0.33）等危险因素的相关性较弱。