社区居民中超重、肥胖与动脉僵硬度之间的关联

Huang Hui-ming, Li Sen, Xu Hao

Jiangsu Research Institute of Sports Science, Nanjing 210033, China.

Zhonghua Xin Xue Guan Bing Za Zhi. 2011 Oct;39(10):950-4.

OBJECTIVE

To evaluate the relationship between overweight, obesity and arterial stiffness in community residents.

METHODS

A total of 4585 community-dwelling adults in Jiangsu province, China were surveyed with the method of stratified and cluster sampling from 2007 to 2009. Overweight and obesity were defined by body mass index (BMI) and arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). Statistical analysis of arteriosclerosis included multivariate logistic regression testing among which BMI was viewed as continuous variable (1 kg/m(2) increasing to BMI) and categorical variables (underweight, normal, overweight and obesity) respectively. Odds ratio, population attributable risk percent and the optimal cut-off points for BMI to evaluate arteriosclerosis were analyzed using receiver operator characteristic (ROC) curve.

RESULTS

(1) After age control, BMI of male or female were positively correlated with baPWV (r = 0.213, P < 0.01; r = 0.186, P < 0.01). baPWV and prevalence of arteriosclerosis were significantly higher in obese residents compared with normal body weight group (all P < 0.01). (2) As a continuous variable, the odds ratio value of BMI on predicting arteriosclerosis was 1.146 (95%CI: 1.117 - 1.175, P < 0.01) after adjusting of age, gender and hypertension. As categorical variables, the odds ratio value of BMI was 0.369 (95%CI: 0.141 - 0.962, P < 0.05) for underweight group, 1.576 (95%CI: 1.333 - 1.863) for overweight group and 2.087 (95%CI: 1.615 - 2.698) for obesity group (all P < 0.01). (3) The population attributable arteriosclerosis risk was 19.1% and 11.6% in overweight and obesity groups, respectively. The area under the ROC curve was 0.661 (95%CI: 0.645 - 0.678, P < 0.01) and the optimal cut-off point for BMI to evaluate arteriosclerosis was 24.25 kg/m(2).

CONCLUSIONS

Overweight and obese residents faced higher risk for arteriosclerosis than normal population. Overweight and obesity are independent risk factors for arteriosclerosis after adjusting for age, gender and hypertension.

目的

评估社区居民中超重、肥胖与动脉僵硬度之间的关系。

方法

2007年至2009年，采用分层整群抽样方法对中国江苏省4585名社区成年居民进行了调查。超重和肥胖通过体重指数（BMI）定义，动脉僵硬度通过臂踝脉搏波速度（baPWV）评估。动脉硬化的统计分析包括多因素逻辑回归检验，其中BMI分别被视为连续变量（BMI每增加1 kg/m²）和分类变量（体重过轻、正常、超重和肥胖）。使用受试者工作特征（ROC）曲线分析评估动脉硬化的BMI的比值比、人群归因风险百分比和最佳切点。

结果

（1）在控制年龄后，男性或女性的BMI与baPWV呈正相关（r = 0.213，P < 0.01；r = 0.186，P < 0.01）。与正常体重组相比，肥胖居民的baPWV和动脉硬化患病率显著更高（均P < 0.01）。（2）作为连续变量，在调整年龄、性别和高血压后，BMI预测动脉硬化的比值比为1.146（95%CI：1.117 - 1.175，P < 0.01）。作为分类变量，体重过轻组BMI的比值比为0.369（95%CI：0.141 - 0.962，P < 0.05），超重组为1.576（95%CI：1.333 - 1.863），肥胖组为2.087（95%CI：1.615 - 2.698）（均P < 0.01）。（3）超重和肥胖组的人群归因动脉硬化风险分别为19.1%和11.6%。ROC曲线下面积为0.661（95%CI：0.645 - 0.678，P < 0.01），评估动脉硬化的BMI最佳切点为24.25 kg/m²。