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相对脂肪质量算法预测高血压发生的价值:一项中国人群的 6 年前瞻性研究。

Predictive value of relative fat mass algorithm for incident hypertension: a 6-year prospective study in Chinese population.

机构信息

Department of Internal Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.

Department of Internal Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China

出版信息

BMJ Open. 2020 Oct 16;10(10):e038420. doi: 10.1136/bmjopen-2020-038420.

Abstract

OBJECTIVES

Individuals with obesity especially excessive visceral adiposity have high risk for incident hypertension. Recently, a new algorithm named relative fat mass (RFM) was introduced to define obesity. Our aim was to investigate whether it can predict hypertension in Chinese population and to compare its predictive power with traditional indices including body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR).

DESIGN

A 6-year prospective study.

SETTING

Nine provinces (Hei Long Jiang, Liao Ning, Jiang Su, Shan Dong, He Nan, Hu Bei, Hu Nan, Guang Xi and Gui Zhou) in China.

PARTICIPANTS

Those without hypertension in 2009 survey and respond in 2015 survey.

INTERVENTION

Logistic regression were performed to investigate the association between RFM and incident hypertension. Receiver operating characteristic (ROC) analysis was performed to compare the predictive ability of these indices and define their optimal cut-off values.

MAIN OUTCOME MEASURES

Incident hypertension in 2015.

RESULTS

The prevalence of incident hypertension in 2015 based on RFM quartiles were 14.8%, 21.2%, 26.8% and 35.2%, respectively (p for trend <0.001). In overall population, the OR for the highest quartile compared with the lowest quartile for RFM was 2.032 (1.567-2.634) in the fully adjusted model. In ROC analysis, RFM and WHtR had the highest area under the curve (AUC) value in both sexes but did not show statistical significance when compared with AUC value of BMI and WC in men and AUC value of WC in women. The performance of the prediction model based on RFM was comparable to that of BMI, WC or WHtR.

CONCLUSIONS

RFM can be a powerful indictor for predicting incident hypertension in Chinese population, but it does not show superiority over BMI, WC and WHtR in predictive power.

摘要

目的

肥胖个体,尤其是内脏脂肪过多的个体,发生高血压的风险较高。最近,一种新的算法,即相对脂肪量(RFM),被引入来定义肥胖。我们的目的是探讨它是否可以预测中国人群的高血压,并比较其与传统指标(包括体重指数[BMI]、腰围[WC]和腰高比[WHtR])的预测能力。

设计

一项 6 年的前瞻性研究。

地点

中国 9 个省份(黑龙江、辽宁、江苏、山东、河南、湖北、湖南、广西和贵州)。

参与者

2009 年调查时无高血压且 2015 年调查时应答的人群。

干预

采用 logistic 回归分析 RFM 与新发高血压的关系。进行受试者工作特征(ROC)分析比较这些指标的预测能力,并确定其最佳截断值。

主要观察指标

2015 年新发高血压。

结果

根据 RFM 四分位数,2015 年新发高血压的患病率分别为 14.8%、21.2%、26.8%和 35.2%(趋势 P<0.001)。在总人群中,与 RFM 最低四分位数相比,最高四分位数的 OR 为 2.032(1.567-2.634),在完全调整模型中。ROC 分析显示,RFM 和 WHtR 在男女两性中的 AUC 值最高,但与男性的 BMI 和 WC 的 AUC 值以及女性的 WC 的 AUC 值相比,差异无统计学意义。基于 RFM 的预测模型的性能与 BMI、WC 或 WHtR 相当。

结论

RFM 可作为中国人群预测新发高血压的有力指标,但在预测能力方面并不优于 BMI、WC 和 WHtR。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d8/7569915/0f1c632f2c24/bmjopen-2020-038420f01.jpg

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