Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam.
High Blood Press Cardiovasc Prev. 2021 Mar;28(2):141-150. doi: 10.1007/s40292-020-00431-9. Epub 2021 Jan 16.
Modelling of associations of systolic blood pressure (BP) and blood glucose (BG) with their explanatory factors in separate regressions treats them as having independent biological mechanisms. This can lead to statistical inferences that are unreliable because the substantial overlap in their etiologic and disease mechanisms is ignored.
This study aimed to examine the relationship of systolic blood pressure (BP) and blood glucose (BG) with measures of obesity and central fat distribution and other factors whilst taking account of the inter-dependence between them.
Participants (n = 14706, 53.5 % females) aged 25-64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols.
Structural modelling identified direct effects for BG (men P = 0.000, women P = 0.029), age (men P = 0.000, women P = 0.000) and body mass index (BMI) (men P = 0.000, women P = 0.000) in the estimation of systolic BP, and for systolic BP (men P = 0.036, women P = 0.000) and waist circumference (WC) (men P = 0.032, women P = 0.009) in the estimation of BG. There were indirect effects of age, cholesterol, physical activity and tobacco smoking via their influence on WC and BMI. The errors in estimation of systolic BP and BG were correlated (men P = 0.000, women P = 0.004), the stability indices (men 0.466, women 0.495) showed the non-recursive models were stable, and the proportion of variance explained was mid-range (men 0.553, women 0.579).
This study provided statistical evidence of a feedback loop between systolic BP and BG. BMI and WC were confirmed to be their primary explanatory factors. Saturated fat intake and physical activity were identified as possible targets of intervention for overweight and obesity, and indirectly for reducing systolic BP and BG. Harmful/hazardous alcohol intake was identified as a target of intervention for systolic BP.
在单独的回归中，对收缩压 (BP) 和血糖 (BG) 与其解释因素的关联进行建模，将它们视为具有独立的生物学机制。这可能导致不可靠的统计推断，因为它们在发病机制和疾病机制方面的大量重叠被忽略了。
本研究旨在检查收缩压 (BP) 和血糖 (BG) 与肥胖和中心脂肪分布以及其他因素的关系，同时考虑到它们之间的相互依赖性。
参与者（n = 14706，53.5%为女性）年龄在 25-64 岁之间，通过多阶段分层聚类抽样从越南八个省中各选择一个代表越南八个地理区域的样本。使用世界卫生组织 STEPS 方案进行测量。
结构建模确定了血糖 (男性 P = 0.000，女性 P = 0.029)、年龄 (男性 P = 0.000，女性 P = 0.000) 和体重指数 (BMI) (男性 P = 0.000，女性 P = 0.000) 在收缩压估计中的直接作用，以及收缩压 (男性 P = 0.036，女性 P = 0.000) 和腰围 (WC) (男性 P = 0.032，女性 P = 0.009) 在血糖估计中的间接作用。年龄、胆固醇、体力活动和吸烟通过对 WC 和 BMI 的影响有间接影响。收缩压和血糖估计中的误差相互关联（男性 P = 0.000，女性 P = 0.004），稳定性指数（男性 0.466，女性 0.495）表明非递归模型稳定，解释方差的比例处于中等范围（男性 0.553，女性 0.579）。
本研究提供了收缩压和血糖之间存在反馈循环的统计证据。BMI 和 WC 被确认为它们的主要解释因素。饱和脂肪摄入和体力活动被确定为超重和肥胖的干预目标，间接地降低收缩压和血糖。有害/危险的酒精摄入被确定为收缩压的干预目标。
