Department of Cardiology, Beijing Jishuitan Hospital, No. 31 East Street, Xinjiekou, XiCheng District, Beijing, 100035, China.
Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, 737 N. Michigan Ave, 16th Floor, Chicago, USA.
Biol Sex Differ. 2020 Jul 17;11(1):38. doi: 10.1186/s13293-020-00317-4.
There are inconsistent interpretations of the interrelationship of adiposity, anthropometric indices, and blood pressure (BP) in hypertensive patients. Additionally, whether these relationships differ between sexes is unknown. We aimed to elucidate the associations of adiposity indices measured using quantitative computed tomography (QCT) with BP and hypertension and to determine the effect of sex on the interrelationship of these parameters in a Chinese population.
Abdominal adipose fat, including the visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area, was measured by QCT in 1488 patients (514 men, 974 women). Body mass index (BMI), waist circumference (WC), hip circumference (HC), and systolic (SBP) and diastolic BP (DBP) were measured. Pearson correlation coefficients, multivariate analyses, and receiver operating characteristic (ROC) curves were used to assess the relationship and potential of adiposity indices to BP and risk of hypertension within sex groups.
Men had significantly greater VAT area but less SAT area than women in hypertensive group. VAT, SAT, and WC were more highly correlated with SBP in men than in women. After controlling for body weight, height, and age, VAT area and WC were positively associated with SBP (VAT: β = 0.309, p < 0.001; WC: β = 0.148, p = 0.001) and DBP (VAT: β = 0.099, p = 0.034; WC: β = 0.198, p = 0.001) in women. VAT area was positively associated with SBP (β = 0.444, p < 0.001) and DBP (β = 0.146, p = 0.021) in men. WC had a significant correlation with an increased risk of hypertension in women but a borderline association in men (p = 0.059) when adjusted for VAT area and SAT area.
The association of abdominal adiposity with hypertension differs qualitatively by sex. WC may be an important determinant of hypertension and may be used for risk stratification for hypertension among Chinese individuals.
在高血压患者中，体脂、人体测量指数和血压（BP）之间的相互关系存在不一致的解释。此外，这些关系在性别之间是否存在差异尚不清楚。我们旨在阐明使用定量计算机断层扫描（QCT）测量的肥胖指数与 BP 和高血压之间的关系，并确定性别对这些参数相互关系的影响在中国人群中。
1488 名患者（514 名男性，974 名女性）接受 QCT 测量腹部脂肪，包括内脏脂肪组织（VAT）面积和皮下脂肪组织（SAT）面积。测量体重指数（BMI）、腰围（WC）、臀围（HC）、收缩压（SBP）和舒张压（DBP）。使用 Pearson 相关系数、多元分析和接收者操作特征（ROC）曲线来评估性别组内肥胖指数与 BP 和高血压风险的关系和潜力。
高血压组男性的 VAT 面积明显大于女性，但 SAT 面积小于女性。VAT、SAT 和 WC 与男性 SBP 的相关性高于女性。在控制体重、身高和年龄后，VAT 面积和 WC 与 SBP 呈正相关（VAT：β=0.309，p<0.001；WC：β=0.148，p=0.001）和 DBP（VAT：β=0.099，p=0.034；WC：β=0.198，p=0.001）在女性中。VAT 面积与 SBP（β=0.444，p<0.001）和 DBP（β=0.146，p=0.021）呈正相关在男性中。WC 与女性高血压风险增加有显著相关性，但与男性有边缘相关性（p=0.059），当调整 VAT 面积和 SAT 面积时。
腹部肥胖与高血压的相关性因性别而异。WC 可能是高血压的重要决定因素，可用于中国人群高血压的风险分层。
