Chen Zhengming, Smith Margaret, Du Huaidong, Guo Yu, Clarke Robert, Bian Zheng, Collins Rory, Chen Junshi, Qian Yijian, Wang Xiaoping, Chen Xiaofang, Tian Xiaocao, Wang Xiaohuan, Peto Richard, Li Liming
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK,
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Int J Epidemiol. 2015 Aug;44(4):1305-19. doi: 10.1093/ije/dyv012. Epub 2015 Mar 5.
Greater adiposity is associated with higher blood pressure. Substantial uncertainty remains, however, about which measures of adiposity most strongly predict blood pressure and whether these associations differ materially between populations.
We examined cross-sectional data on 500 000 adults recruited from 10 diverse localities across China during 2004-08. Multiple linear regression was used to estimate the effects on systolic blood pressure (SBP) of general adiposity [e.g. body mass index (BMI), body fat percentage, height-adjusted weight] vs central adiposity [e.g. waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR)], before and after adjustment for each other. The main analyses excluded those reported taking any antihypertensive medication, and were adjusted for age, region and education.
The overall mean [standard deviation (SD)] BMI was 23.6 (3.3) kg/m(2) and mean WC was 80.0 (9.5) cm. The differences in SBP (men/women, mmHg) per 1SD higher general adiposity (height-adjusted weight: 6.6/5.6; BMI: 5.5/4.9; body fat percentage: 5.5/5.0) were greater than for central adiposity (WC: 5.0/4.3; HC: 4.8/4.1; WHR: 3.7/3.2), with a 10 kg/m(2) greater BMI being associated on average with 16 (men/women: 17/14) mmHg higher SBP. The associations of blood pressure with measures of general adiposity were not materially altered by adjusting for WC and HC, but those for central adiposity were significantly attenuated after adjusting for BMI (WC: 1.1/0.7; HC: 0.3/-0.2; WHR: 0.6/0.6).
In adult Chinese, blood pressure is more strongly associated with general adiposity than with central adiposity, and the associations with BMI were about 50% stronger than those observed in Western populations.
更高的肥胖程度与更高的血压相关。然而，关于哪种肥胖测量指标最能强烈预测血压以及这些关联在不同人群之间是否存在实质性差异，仍存在很大的不确定性。
我们研究了2004年至2008年期间从中国10个不同地区招募的50万名成年人的横断面数据。使用多元线性回归来估计总体肥胖[如体重指数（BMI）、体脂百分比、身高校正体重]与中心性肥胖[如腰围（WC）、臀围（HC）、腰臀比（WHR）]对收缩压（SBP）的影响，在相互调整前后。主要分析排除了那些报告正在服用任何抗高血压药物的人，并对年龄、地区和教育程度进行了调整。
总体平均[标准差（SD）]BMI为23.6（3.3）kg/m²，平均WC为80.0（9.5）cm。每升高1SD总体肥胖（身高校正体重：6.6/5.6；BMI：5.5/4.9；体脂百分比：5.5/5.0）时SBP的差异（男性/女性，mmHg）大于中心性肥胖（WC：5.0/4.3；HC：4.8/4.1；WHR：3.7/3.2），BMI每增加10kg/m²平均与SBP升高16（男性/女性：17/14）mmHg相关。通过调整WC和HC，血压与总体肥胖测量指标的关联没有实质性改变，但在调整BMI后，中心性肥胖的关联显著减弱（WC：1.1/0.7；HC：0.3/-0.2；WHR：0.6/0.6）。
在成年中国人中，血压与总体肥胖的关联比与中心性肥胖的关联更强，并且与BMI的关联比在西方人群中观察到的要强约50%。
