Lu Ya-Ke, Dong Jing, Sun Yue, Hu Li-Kun, Liu Yu-Hong, Chu Xi, Yan Yu-Xiang
Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China.
Physical Examination Center, Xuanwu Hospital, Capital Medical University, Beijing, China.
Int J Obes (Lond). 2022 May;46(5):1036-1043. doi: 10.1038/s41366-022-01081-8. Epub 2022 Feb 3.
Early prevention of hypertension is important for global cardiovascular disease morbidity and mortality. This study aims to explore better predictors for hypertension incidence related to baseline level or trajectories of adiposity indices, as well as the gender-specific effect.
6085 subjects from a functional community cohort in urban Beijing participated in our study. Restricted cubic splines were used to estimate nonlinear associations of body mass index (BMI) and waist-to-height ratio (WHtR) as continuous variable with risk of hypertension. Stepwise logistic regression model was performed to estimate the relative risks (RRs) of adiposity indices and metabolic status, adjusted for covariates. Nomogram models and receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive power of BMI trajectory groups and WHtR trajectory groups on hypertension incidence. Further, all analysis were performed by gender.
The risk of hypertension incidence was related to BMI trajectory groups (persistent overweight: RR = 1.88, 95% CI: 1.48-2.37; persistent obesity: RR = 2.79, 95% CI: 2.18-3.56; persistent the highest: RR = 4.30, 95% CI: 3.20-5.78) and WHtR trajectory groups (persistent medium: RR = 2.69, 95% CI: 2.07-3.50; persistent high: RR = 3.85, 95% CI: 2.92-5.09; increasing to higher: RR = 7.00, 95% CI: 4.96-9.89). In total population, BMI trajectories and WHtR trajectories showed similar ability to predict the risk of hypertension incidence with AUC 0.723 and 0.726, respectively. After stratified by gender, both BMI trajectories and WHtR trajectories showed higher power in female than male (BMI trajectories: 0.762 vs. 0.661; WHtR trajectories: 0.768 vs. 0.661).
BMI and WHtR trajectories have higher predictive power for hypertension incidence compared to baseline data. Females are more vulnerable to obesity than males.
早期预防高血压对于全球心血管疾病的发病率和死亡率至关重要。本研究旨在探索与肥胖指数的基线水平或轨迹相关的高血压发病率的更好预测因素，以及性别特异性效应。
来自北京城市功能社区队列的6085名受试者参与了我们的研究。使用受限立方样条来估计体重指数（BMI）和腰高比（WHtR）作为连续变量与高血压风险的非线性关联。进行逐步逻辑回归模型以估计肥胖指数和代谢状态的相对风险（RRs），并对协变量进行调整。使用列线图模型和受试者工作特征（ROC）曲线分析来评估BMI轨迹组和WHtR轨迹组对高血压发病率的预测能力。此外，所有分析均按性别进行。
高血压发病风险与BMI轨迹组（持续超重：RR = 1.88，95%CI：1.48 - 2.37；持续肥胖：RR = 2.79，95%CI：2.18 - 3.56；持续最高：RR = 4.30，95%CI：3.20 - 5.78）和WHtR轨迹组（持续中等：RR = 2.69，95%CI：2.07 - 3.50；持续高：RR = 3.85，95%CI：2.92 - 5.09；升至更高：RR = 7.00，95%CI：4.96 - 9.89）相关。在总人群中，BMI轨迹和WHtR轨迹显示出相似的预测高血压发病风险的能力，AUC分别为0.723和0.726。按性别分层后，BMI轨迹和WHtR轨迹在女性中的预测能力均高于男性（BMI轨迹：0.762对0.661；WHtR轨迹：0.768对0.661）。
与基线数据相比，BMI和WHtR轨迹对高血压发病率具有更高的预测能力。女性比男性更容易肥胖。
