Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Clin Hypertens (Greenwich). 2021 Jun;23(6):1212-1220. doi: 10.1111/jch.14241. Epub 2021 Mar 20.
It is unclear whether there are different body mass index (BMI) trajectories among a population with normal BMI levels, and the association between BMI patterns and incident hypertension is not well characterized. This prospective cohort study includes surveys conducted at baseline and three follow-ups. 3939 participants who are free of hypertension at baseline or first two follow-ups were enrolled. At baseline, the age of participants ranged from 35 to 82 years and the mean age was 45.9 years. The BMI trajectories were identified using latent mixture modeling with data from the baseline and first two follow-ups. The effects of different BMI trajectories on the development of hypertension were analyzed using a Cox proportional hazard model. Four distinct BMI trajectories were identified over the study period (2004-2010): normal-stable (n = 1456), normal-increasing (n = 2159), normal-fluctuated (n = 166), and normal-sharp-increasing (n = 158). Relative to the normal-stable BMI group, the hazard ratios (HRs) and 95% confidence intervals (CIs) after adjustment for confounding factors of the normal-increasing, normal-fluctuated, and normal-sharp-increasing groups were 1.244 (1.103-1.402), 1.331 (1.008-1.756), and 1.641 (1.257-2.142), respectively. Additionally, subgroup analysis showed that the normal-fluctuated BMI trajectory was associated with a significantly higher risk of hypertension only in women (HR = 1.362; 95% CI = 1.151-1.611). The BMI trajectories were significant predictors of hypertension incidence, and increasing BMI trajectories within the currently designated normal range were associated with an increased hypertension risk, especially in women.
目前尚不清楚正常体重指数 (BMI) 人群中是否存在不同的 BMI 轨迹，BMI 模式与高血压发病之间的关系也尚未明确。本前瞻性队列研究包括基线和三次随访时进行的调查。共纳入了 3939 名在基线或前两次随访时无高血压的参与者。基线时，参与者年龄在 35 至 82 岁之间，平均年龄为 45.9 岁。使用基于基线和前两次随访数据的潜在混合模型确定 BMI 轨迹。使用 Cox 比例风险模型分析不同 BMI 轨迹对高血压发病的影响。在研究期间（2004-2010 年）确定了四种不同的 BMI 轨迹：正常稳定型（n=1456）、正常增长型（n=2159）、正常波动型（n=166）和正常急剧增长型（n=158）。与正常稳定型 BMI 组相比，在校正混杂因素后，正常增长型、正常波动型和正常急剧增长型组的危险比（HR）和 95%置信区间（CI）分别为 1.244（1.103-1.402）、1.331（1.008-1.756）和 1.641（1.257-2.142）。此外，亚组分析显示，正常波动型 BMI 轨迹仅与女性高血压发病风险显著升高相关（HR=1.362；95%CI=1.151-1.611）。BMI 轨迹是高血压发病的显著预测因子，在当前正常范围内，BMI 呈增长趋势与高血压风险增加相关，尤其是在女性中。
