Sun Jin-Yu, Hua Yang, Zou Hua-Yi-Yang, Qu Qiang, Yuan Yue, Sun Guo-Zhen, Sun Wei, Kong Xiang-Qing
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Front Cardiovasc Med. 2021 Oct 12;8:717257. doi: 10.3389/fcvm.2021.717257. eCollection 2021.
This study aimed to investigate the association between waist circumference and the prevalence of (pre) hypertension. Cross-sectional data from the 2007-2018 National Health and Nutrition Examination Survey were analyzed. The historical trend of abdominal obesity was assessed by the Cochran-Armitage trend test. After preprocessed by the multiple imputation strategy, we used generalized additive models to assess the association of waist circumference with systolic/diastolic blood pressure and performed correlation analysis by the Spearman correlation coefficient. Moreover, we used multivariable logistic regression (non-adjusted, minimally adjusted, and fully adjusted models), restricted cubic spline, and sensitivity analysis to investigate the association between waist circumference and (pre) hypertension. A total of 27,894 participants were included in this study. In the fully adjusted model, waist circumference was positively associated with (pre) hypertension with odds ratios (95% confidence intervals) of 1.28 (1.18-1.40) in the young group and 1.23 (1.15-1.33) in the old group. Restricted cubic spline showed a higher prevalence of (pre) hypertension with the increase of waist circumference. In the subgroup analysis, waist circumference showed a robust trend across all BMI categories with odds ratios (95% confidence intervals) of 3.33 (1.29-8.85), 1.35 (1.17-1.57), 1.27 (1.13-1.41), and 1.09 (1.01-1.17) in underweight, normal weight, overweight, and obese individuals, respectively. This study highlighted waist circumference as a significant biomarker to evaluate the risk of (pre) hypertension. Our results supported the measure of waist circumference regardless of BMI when evaluating the cardiometabolic risk related to fat distribution.
本研究旨在调查腰围与(预)高血压患病率之间的关联。分析了2007 - 2018年国家健康与营养检查调查的横断面数据。通过 Cochr an - Armitage趋势检验评估腹部肥胖的历史趋势。在采用多重填补策略进行预处理后,我们使用广义相加模型评估腰围与收缩压/舒张压的关联,并通过Spearman相关系数进行相关性分析。此外,我们使用多变量逻辑回归(未调整、最小调整和完全调整模型)、受限立方样条和敏感性分析来研究腰围与(预)高血压之间的关联。本研究共纳入27,894名参与者。在完全调整模型中,腰围与(预)高血压呈正相关,年轻组的优势比(95%置信区间)为1.28(1.18 - 1.40),老年组为1.23(1.15 - 1.33)。受限立方样条显示,随着腰围增加,(预)高血压患病率更高。在亚组分析中,腰围在所有BMI类别中均呈现出显著趋势,体重过轻、正常体重、超重和肥胖个体的优势比(95%置信区间)分别为3.33(1.29 - 8.85)、1.35(1.17 - 1.57)、1.27(1.13 - 1.41)和1.09(1.01 - 1.17)。本研究强调腰围是评估(预)高血压风险的重要生物标志物。我们的结果支持在评估与脂肪分布相关的心脏代谢风险时,无论BMI如何,都应测量腰围。