中国老年人的体重指数和甘油三酯水平与血压的关联和交互作用分析。
Association and Interaction Analysis of Body Mass Index and Triglycerides Level with Blood Pressure in Elderly Individuals in China.
机构信息
Department of Community Nursing, School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District Jinzhou City, Liaoning Province, China.
Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China.
出版信息
Biomed Res Int. 2018 Nov 22;2018:8934534. doi: 10.1155/2018/8934534. eCollection 2018.
OBJECTIVES
To assess the extent of interaction between body mass index (BMI) and triglyceride (TG) level and its effects on blood pressure (BP) in elderly individuals in China.
DESIGN
Cross-sectional study.
SETTING
Data were taken from a cross-sectional study called the China Health and Retirement Longitudinal Study.
PARTICIPANTS
The analytic sample included 3629 subjects aged 45 to 96 years.
MAIN OUTCOME MEASUREMENTS
Data were obtained from the China Health and Retirement Longitudinal Study, which is a cross-sectional study. Age-adjusted partial Pearson's correlation test was used to compare various characteristics and BP. Adjusted associations were first used as linear regression models, as appropriate. Then, general linear models adjusted for related potential confounders were used to examine the synergistic effects of BMI and TG level on BP. Finally, a binary logistic regression model adjusted for confounding factors was used to examine the association between BMI or TG level and hypertension.
RESULTS
Age-adjusted partial Pearson's correlation coefficient showed that the TG level was positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both men and women with BMI < 24.0 kg/m; however, TG level was positively correlated with DBP in women with BMI ≥ 24.0 kg/m but not with DBP in men with BMI ≥ 24.0 kg/m. Multiple linear regression analysis showed that BMI level was significantly and positively associated with both SBP and DBP in men and women with BMI < 24.0 kg/m, and TG level was significantly and positively associated with SBP in women with BMI < 24.0 kg/m, independent of other confounding factors. A general linear model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, eating habits, taking activities, antidiabetic medication, antihypertensive therapy, fasting plasma glucose [FPG], low-density lipoprotein cholesterol [LDL-C], estimated glomerular filtration rate [eGFR], and serum uric acid [SUA]) showed no interaction between BMI and TG level and SBP (men, = 0.572, = 0.845; women, = 0.122, = 0.923) and DBP (men, = -0.373, = 0.810; women, = 0.272, = 0.828). A binary logistic regression model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, drinking, eating habits, taking activities, major accidental injury, physical activity, history of cardiovascular disease, history of liver disease, antilipidemic medication, antidiabetic medication, antihypertensive therapy, FPG, LDL-C, high-density lipoprotein cholesterol [HDL-C], eGFR, and SUA) showed that overweight and obese men and women were more likely to have hypertension (men: odds ratio [OR] = 1.781, 95% confidence interval [CI] = 1.393-2.277; women: OR = 1.653, 95% CI = 1.330-2.055) and women with high TG were more likely to have hypertension (OR = 1.558, 95% CI = 1.219-1.992).
CONCLUSION
An interactive effect of BMI and TG level on BP was not observed in either men or women; however, independent effects of BMI on BP were observed in both men and women, and an association between TG level and hypertension was observed in women.
目的
评估中国老年人的体重指数(BMI)和甘油三酯(TG)水平之间的相互作用程度及其对血压(BP)的影响。
设计
横断面研究。
地点
数据来自一项名为中国健康与退休纵向研究的横断面研究。
参与者
分析样本包括 3629 名年龄在 45 岁至 96 岁之间的受试者。
主要观察指标
数据来自中国健康与退休纵向研究,这是一项横断面研究。采用年龄调整后的部分 Pearson 相关系数检验来比较各种特征和 BP。首先使用调整后的关联作为线性回归模型,视情况而定。然后,使用调整了相关潜在混杂因素的一般线性模型来检查 BMI 和 TG 水平对 BP 的协同作用。最后,使用调整混杂因素的二元逻辑回归模型来检查 BMI 或 TG 水平与高血压之间的关联。
结果
年龄调整后的部分 Pearson 相关系数显示,在 BMI<24.0kg/m2 的男性和女性中,TG 水平与收缩压(SBP)和舒张压(DBP)均呈正相关;然而,在 BMI≥24.0kg/m2 的女性中,TG 水平与 DBP 呈正相关,但在 BMI≥24.0kg/m2 的男性中与 DBP 无关。多元线性回归分析显示,在 BMI<24.0kg/m2 的男性和女性中,BMI 水平与 SBP 和 DBP 均呈显著正相关,而在 BMI<24.0kg/m2 的女性中,TG 水平与 SBP 呈显著正相关,且不受其他混杂因素的影响。在调整混杂因素(年龄、教育程度、婚姻状况、当前居住地、吸烟、饮食习惯、活动、降糖药、降压治疗、空腹血糖[FPG]、低密度脂蛋白胆固醇[LDL-C]、估算肾小球滤过率[eGFR]和血清尿酸[SUA])的一般线性模型分析中,BMI 和 TG 水平与 SBP(男性,=0.572,=0.845;女性,=0.122,=0.923)和 DBP(男性,=0.373,=0.810;女性,=0.272,=0.828)之间无交互作用。在调整混杂因素(年龄、教育程度、婚姻状况、当前居住地、吸烟、饮酒、饮食习惯、活动、主要意外伤害、体力活动、心血管疾病史、肝病史、降脂药、降糖药、降压治疗、FPG、LDL-C、高密度脂蛋白胆固醇[HDL-C]、eGFR 和 SUA)的二元逻辑回归模型分析中,超重和肥胖的男性和女性更有可能患有高血压(男性:比值比[OR]=1.781,95%置信区间[CI]=1.393-2.277;女性:OR=1.653,95%CI=1.330-2.055),而高 TG 的女性更有可能患有高血压(OR=1.558,95%CI=1.219-1.992)。
结论
在男性或女性中均未观察到 BMI 和 TG 水平对 BP 的交互作用;然而,在男性和女性中均观察到 BMI 对 BP 的独立作用,在女性中观察到 TG 水平与高血压之间的关联。