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中国农村人群内脏脂肪指数与未经治疗的高血压之间的剂量反应关系:农村糖尿病研究

Dose-response relationship between visceral fat index and untreated hypertension in Chinese rural population: the RuralDiab study.

作者信息

Tian Zhongyan, Li Yuqian, Li Linlin, Liu Xiaotian, Shi Yuanyuan, Yang Kaili, Liu Ruihua, Zhang Honglei, Qian Xinling, Yin Lei, Zhao Jingzhi, Wang Chongjian

机构信息

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.

Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China.

出版信息

J Am Soc Hypertens. 2018 Jun;12(6):448-456.e1. doi: 10.1016/j.jash.2018.03.009. Epub 2018 Mar 29.

Abstract

The study aimed to explore the association of visceral fat index (VFI) with untreated hypertension in different genders and evaluate the practicability of VFI as a marker for discriminating untreated hypertension in Chinese rural population. A total of 12,536 eligible participants aged 35 years and older were derived from the RuralDiab study in China. VFI was assessed with bioelectrical impendence methods and divided into sex-specific quartiles. Logistic regression and restricted cubic spline regression were performed. Receiver operating characteristic curve was applied to analyze the discriminating performance of VFI. Meanwhile, a meta-analysis was conducted to validate the result of this study. Compared with the lowest VFI quartile, the adjusted odds ratios (ORs) and 95% confidence interval (95% CI) in the highest VFI quartile were 3.68 (2.91-4.66) in male and 2.63 (2.12-3.25) in female (P < .01). Nonlinear increasing trends about the risk of untreated hypertension were observed with the continuously increasing VFI in both genders (P < .01). The sensitivity and specificity in the optimal cutoff values for VFI were 58.37% and 62.26% in male, and 49.09% and 66.67% in female. The area under the curves (95% CI) were 0.64 (0.63-0.66) in male and 0.61 (0.60-0.62) in female. Meta-analysis results displayed the pooled odds ratios (95% CI) of 2.65 (1.79-3.93) in male and 2.27 (1.74-2.95) in female. VFI was significantly positively correlated with the risk of untreated hypertension, and dose-response relationships were observed in both genders in Chinese rural population. However, VFI as a marker had limited potential for discriminating untreated hypertension.

摘要

该研究旨在探讨内脏脂肪指数(VFI)与不同性别未经治疗的高血压之间的关联,并评估VFI作为中国农村人群未经治疗高血压判别标志物的实用性。共有12536名35岁及以上的合格参与者来自中国的农村糖尿病研究(RuralDiab study)。采用生物电阻抗法评估VFI,并将其分为按性别划分的四分位数。进行了逻辑回归和限制性立方样条回归分析。应用受试者工作特征曲线分析VFI的判别性能。同时,进行了荟萃分析以验证本研究结果。与最低VFI四分位数相比,最高VFI四分位数中男性的校正比值比(OR)和95%置信区间(95%CI)为3.68(2.91 - 4.66),女性为2.63(2.12 - 3.25)(P < 0.01)。随着VFI在两性中持续增加,观察到未经治疗高血压风险呈非线性增加趋势(P < 0.01)。VFI最佳截断值时的敏感性和特异性在男性中分别为58.37%和62.26%,在女性中分别为49.09%和66.67%。曲线下面积(95%CI)在男性中为0.64(0.63 - 0.66),在女性中为0.61(0.60 - 0.62)。荟萃分析结果显示男性的合并比值比(95%CI)为2.65(1.79 - 3.93),女性为2.27(1.74 - 2.95)。VFI与未经治疗高血压的风险显著正相关,在中国农村人群的两性中均观察到剂量反应关系。然而,VFI作为一种标志物,在判别未经治疗高血压方面的潜力有限。

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