Key Laboratory of Public Health Safety & NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China.
Guizhou Center for Disease Control and Prevention, Guiyang 550004, China.
Int J Environ Res Public Health. 2021 Dec 29;19(1):341. doi: 10.3390/ijerph19010341.
This study aimed to assess the effects of different anthropometric indices and their changes on the risk of incident dyslipidemia among the Chinese population. From the Guizhou population health cohort study, 2989 Chinese adults without dyslipidemia at baseline were followed up. Anthropometric parameters including waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), and their changes in the latter two indices, and serum lipids were tested after at least 8 h fasting. Hazard ratio (HR), adjusted hazard ratio (aHR), and 95% confidential interval (CI) were calculated to estimate the association between anthropometric parameters and dyslipidemia risk using multivariate Cox regression. A total of 2089 (69.98%) new dyslipidemia cases were identified over an average follow-up of 7.0 years. Baseline BMI (aHR = 1.12, 95%CI 1.01, 1.23) and WHtR (aHR = 1.06, 95%CI 1.00, 1.13) were positively associated with higher risks of incident dyslipidemia but not WC. Each 5.0 kg/m increment of BMI or 0.05-unit increment of WHtR was significantly associated with 43% or 25% increased risk of incident dyslipidemia, respectively. The aHRs (95%CI) of incident dyslipidemia for subjects maintaining or developing general obesity were 2.19 (1.53, 3.12) or 1.46 (1.22, 1.75), and 1.54 (1.23, 1.82) or 1.30 (1.06, 1.60) for subjects maintaining or developing abdominal obesity, respectively. Linear trends for aHRs of BMI, WHtR change, and BMI change were observed ( for trend: 0.021, <0.001, <0.001, respectively). BMI, WHtR, and their changes were closely associated with the incidence of dyslipidemia for Chinese adults. Loss in BMI and WHtR had protective effects on incident dyslipidemia, whereas gain of BMI or WHtR increased the dyslipidemia risk. Interventions to control or reduce BMI and WHtR to the normal range are important for the early prevention of dyslipidemia, especially for participants aged 40 years or above, male participants, and urban residents with poor control of obesity.
本研究旨在评估不同人体测量学指标及其变化对中国人群血脂异常发病风险的影响。本研究纳入了贵州人群健康队列研究中的 2989 名基线时无血脂异常的中国成年人，至少禁食 8 小时后检测了腰围（WC）、体重指数（BMI）、腰高比（WHtR）及其后两者指标的变化和血清脂质。采用多变量 Cox 回归计算危险比（HR）、调整后的危险比（aHR）和 95%置信区间（CI），以估计人体测量参数与血脂异常风险之间的关联。在平均 7.0 年的随访中，共确定了 2089 例（69.98%）新血脂异常病例。基线 BMI（aHR = 1.12，95%CI 1.01，1.23）和 WHtR（aHR = 1.06，95%CI 1.00，1.13）与血脂异常发病风险的升高呈正相关，但与 WC 无关。BMI 每增加 5.0kg/m 或 WHtR 增加 0.05 单位，与血脂异常发病风险分别增加 43%或 25%显著相关。对于维持或发展为一般肥胖的受试者，血脂异常发病的 aHR（95%CI）分别为 2.19（1.53，3.12）或 1.46（1.22，1.75），对于维持或发展为腹型肥胖的受试者，血脂异常发病的 aHR（95%CI）分别为 1.54（1.23，1.82）或 1.30（1.06，1.60）。BMI、WHtR 变化和 BMI 变化的 aHR 呈线性趋势（趋势检验：0.021、<0.001、<0.001）。中国成年人的 BMI、WHtR 及其变化与血脂异常的发生密切相关。BMI 和 WHtR 的降低对血脂异常的发生有保护作用，而 BMI 或 WHtR 的增加则增加了血脂异常的风险。控制或降低 BMI 和 WHtR 至正常范围的干预措施对血脂异常的早期预防非常重要，尤其是对于 40 岁及以上、男性和肥胖控制不佳的城市居民。
