Ding Yanan, Gu Dongfeng, Zhang Yanxuan, Han Wenjie, Liu Hengliang, Qu Qingshan
Division of Cardiovascular Medicine, The People's Hospital of Zhengzhou, Affiliated with Southern Medical University, Zhengzhou, P.R. China.
Department of Nephrology and Transplantation Center, The People's Hospital of Zhengzhou, Affiliated with Southern Medical University, Zhengzhou, P.R. China.
PLoS One. 2015 Apr 10;10(4):e0123414. doi: 10.1371/journal.pone.0123414. eCollection 2015.
The prevalence of prehypertension has increased in China, and prehypertension frequently progress to hypertension over a short time period; both have become public health problems. Therefore, this study was conducted to determine the relationship between the Visceral Adiposity Index (VAI) and blood pressure (BP) in China.
A cross-sectional epidemiological survey was conducted in China using a stratified random cluster sampling method. Sex-specific VAI quartile cut-off points were used as follows: 0.88, 1.41, 2.45 in males and 0.85, 1.33, 2.22 in females. Prehypertension and hypertension were each defined according to The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines. A multivariate logistic analysis was conducted to analyze the relationship among VAI, prehypertension and hypertension.
The ORs for prehypertension and hypertension in the upper quartiles of the VAI were 1.514 (1.074-2.133), P=0.018 and 1.660 (1.084-2.542), P=0.020, in males, after adjusting for age, education, smoking habits, alcohol consumption, physical activity, serum creatinine, fasting glucose, and plasma insulin. Following further adjustments for the above confounders, chronic kidney disease, and diabetes, the ORs for prehypertension and hypertension in the upper quartile of the VAI were 1.660 1.533 (1.086-2.165), P=0.015, and 1.743 (1.133-2.680), P=0.011, in males. The ORs for prehypertension and hypertension in the upper quartile of the VAI were 1.691 (1.223-2.338), P=0.001, and 1.682 (1.162-2.435), P=0.006, in females, after adjusting for age, education, smoking habits, alcohol consumption, physical activity, serum creatinine, fasting glucose, and plasma insulin. Following further adjustments for the above confounders, chronic kidney disease, and diabetes, the ORs for prehypertension and hypertension in the upper quartile of the VAI were 1.688 (1.220-2.334), P=0.002, and 1.657 (1.141-2.406), P=0.008, in females.
A higher VAI was positively associated with both prehypertension and hypertension in both males and females. It is both essential and urgent that clinicians take steps to control and prevent visceral adiposity.
中国高血压前期的患病率有所上升，且高血压前期常于短时间内进展为高血压；二者均已成为公共卫生问题。因此，开展本研究以确定中国内脏脂肪指数（VAI）与血压（BP）之间的关系。
在中国采用分层随机整群抽样方法进行横断面流行病学调查。按性别划分的VAI四分位数切点如下：男性为0.88、1.41、2.45，女性为0.85、1.33、2.22。高血压前期和高血压均根据美国预防、检测、评估与治疗高血压联合委员会第七次报告（JNC 7）指南进行定义。进行多因素逻辑分析以分析VAI、高血压前期和高血压之间的关系。
在男性中，校正年龄、教育程度、吸烟习惯、饮酒量、身体活动、血清肌酐、空腹血糖和血浆胰岛素后，VAI上四分位数人群患高血压前期和高血压的比值比（OR）分别为1.514（1.074 - 2.133），P = 0.018和1.660（1.084 - 2.542），P = 0.020。在进一步校正上述混杂因素、慢性肾病和糖尿病后，男性VAI上四分位数人群患高血压前期和高血压的OR分别为1.533（1.086 - 2.165），P = 0.015和1.743（1.133 - 2.680），P = 0.011。在女性中，校正年龄、教育程度、吸烟习惯、饮酒量、身体活动、血清肌酐、空腹血糖和血浆胰岛素后，VAI上四分位数人群患高血压前期和高血压的OR分别为1.691（1.223 - 2.338），P = 0.001和1.682（1.162 - 2.435），P = 0.006。在进一步校正上述混杂因素、慢性肾病和糖尿病后，女性VAI上四分位数人群患高血压前期和高血压的OR分别为1.688（1.220 - 2.334），P = 0.002和1.657（1.141 - 2.406），P = 0.008。
较高的VAI与男性和女性的高血压前期及高血压均呈正相关。临床医生采取措施控制和预防内脏肥胖既至关重要又刻不容缓。
