Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China.
Department of Pharmacy, People's Hospital of Zhengzhou, Huanghe Road 33, Zhengzhou, 450003, Henan, China.
J Hum Hypertens. 2021 Jun;35(6):537-545. doi: 10.1038/s41371-020-0368-7. Epub 2020 Jun 24.
This study aimed to identify heterogeneity in BMI trajectories and evaluate the impact of BMI trajectories on the risk of hypertension in middle-aged and elderly Chinese people. After data screening, 28, 706 residents' e-health records from 2010 to 2018, including basic personal information, lifestyle and health, were finally included in this population-based longitudinal study. By latent class growth modeling, we identified 12 BMI trajectories: "underweight-increase I (A1)" and "underweight-increase II (A2)"; "normal weight-stable (B1)", "normal weight-decrease (B2)", "normal weight-increase I (B3)" and "normal weight-increase II (B4)"; "overweight-stable (C1)", "overweight-decrease (C2)" and "overweight-increase (C3)"; and "obese-stable I (D1)", "obese-decrease (D2)" and "obese-stable II (D3)". By Cox proportional hazards models, we found that the risk of hypertension in the BMI stable group was lower than that in the BMI increasing trajectory group and higher than that in the BMI decreasing group. For the underweight and normal weight groups, the risk of hypertension was related not only to the magnitude of BMI growth, but also to the rate of growth. For overweight and obesity groups, the risk of hypertension was higher in the high-level stable BMI group than in the low-level stable BMI group. Therefore, for underweight and normal weight people, weight growth and growth rate should be controlled; for overweight and obese people, health education or targeted weight loss exercise should be taken to reduce weight as much as possible to prevent hypertension.
本研究旨在确定 BMI 轨迹的异质性，并评估 BMI 轨迹对中国中老年人群高血压风险的影响。经过数据筛选，最终纳入了 2010 年至 2018 年 28706 名居民的电子健康记录，包括基本个人信息、生活方式和健康状况。通过潜在类别增长模型，我们确定了 12 种 BMI 轨迹：“消瘦-增长 I（A1）”和“消瘦-增长 II（A2）”；“正常体重-稳定（B1）”，“正常体重-减少（B2）”，“正常体重-增长 I（B3）”和“正常体重-增长 II（B4）”；“超重-稳定（C1）”，“超重-减少（C2）”和“超重-增长（C3）”；以及“肥胖-稳定 I（D1）”，“肥胖-减少（D2）”和“肥胖-稳定 II（D3）”。通过 Cox 比例风险模型，我们发现 BMI 稳定组的高血压风险低于 BMI 增长轨迹组，高于 BMI 减少组。对于消瘦和正常体重组，高血压的风险不仅与 BMI 增长幅度有关，还与增长速度有关。对于超重和肥胖组，高水平稳定 BMI 组的高血压风险高于低水平稳定 BMI 组。因此，对于消瘦和正常体重人群，应控制体重增长和增长速度；对于超重和肥胖人群，应进行健康教育或有针对性的减肥运动，尽可能减轻体重，以预防高血压。
