Kawamoto Ryuichi, Kikuchi Asuka, Akase Taichi, Ninomiya Daisuke, Kumagi Teru
1Department of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Japan.
Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-City, Japan.
Clin Hypertens. 2020 May 15;26:9. doi: 10.1186/s40885-020-00142-2. eCollection 2020.
The incidence of hypertension is increasing worldwide and obesity is one of the most significant risk factors. Obesity can be defined by various anthropometric indices such as body mass index (BMI), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR). This study examined a range of anthropometric indices and their relationships with hypertension.
This study included 768 men aged 70 ± 10 years and 959 women aged 70 ± 8 years from a rural village. The relationship between anthropometric indices (BMI, WHpR, and WHtR) and hypertension was examined using cross-sectional (baseline, = 1727) and cohort data (follow-up, = 419). Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in both genders. Logistic regression models were used to evaluate WHtR as a significant predictor of hypertension.
In the cross-sectional study, WHtR, BMI, and WHpR showed significant predictive abilities for hypertension in both genders, with WHtR showing the strongest predictive ability. Also, in the cohort study, WHtR showed a significant predictive ability for incident hypertension in both genders, and, for women, BMI as well as WHtR had also predictive ability. In the cross-sectional study, the optimal WHtR cutoff values were 0.53 (sensitivity, 44.3%; specificity, 80.2%) for men and 0.54 (sensitivity, 60.9%; specificity, 68.6%) for women. In the cohort study, the optimal WHtR values were 0.47 (sensitivity, 85.4%; specificity, 39.8%) for men and 0.51 (sensitivity, 66.7%; specificity, 58.2%) for women.
The results suggest that WHtR is a useful screening tool for hypertension among Japanese middle-aged and elderly community-dwelling individuals.
高血压的发病率在全球范围内呈上升趋势，肥胖是最重要的危险因素之一。肥胖可以通过各种人体测量指标来定义，如体重指数（BMI）、腰臀比（WHpR）和腰高比（WHtR）。本研究考察了一系列人体测量指标及其与高血压的关系。
本研究纳入了来自一个乡村的768名70±10岁男性和959名70±8岁女性。使用横断面数据（基线，n = 1727）和队列数据（随访，n = 419）研究人体测量指标（BMI、WHpR和WHtR）与高血压之间的关系。采用受试者工作特征（ROC）分析来确定肥胖指标对男女高血压的预测能力。使用逻辑回归模型评估WHtR作为高血压的重要预测指标。
在横断面研究中，WHtR、BMI和WHpR对男女高血压均显示出显著的预测能力，其中WHtR的预测能力最强。此外，在队列研究中，WHtR对男女新发高血压均显示出显著的预测能力，对于女性，BMI以及WHtR也具有预测能力。在横断面研究中，男性的最佳WHtR临界值为0.53（敏感性，44.3%；特异性，80.2%），女性为0.54（敏感性，60.9%；特异性，68.6%）。在队列研究中，男性的最佳WHtR值为0.47（敏感性，85.4%；特异性，39.8%），女性为0.51（敏感性，66.7%；特异性，58.2%）。
结果表明，WHtR是日本社区中老年居民高血压的一种有用筛查工具。
