Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.
Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China.
Obes Facts. 2022;15(5):638-647. doi: 10.1159/000524653. Epub 2022 May 18.
Few studies have deciphered whether lean body mass (LBM) or fat mass (FM) is predominantly responsible for the body mass index (BMI)-hypertension association. This study aimed to assess the associations of predicted LBM and FM with hypertension risk among Chinese male adults.
A prospective cohort study was conducted among 2,812 male participants free of hypertension in the Fangchenggang Area Males Health and Examination Survey in 2009. We performed multivariable Cox models and restricted cubic spline to examine the associations of predicted LBM and FM and BMI with hypertension, and to further explore the mediating roles of lipid and glycemic traits in the relationship between predicted FM and blood pressure.
Of 1,238 participants included in the cohort study, 306 (24.8%) hypertension cases were identified during a median follow-up of 3.8 years, with an incidence rate of 7.0 per 100 person-years. A positive linear-shaped association was consistently observed between BMI and hypertension (p for trend <0.001). Multivariable-adjusted Cox models including predicted LBM and FM observed a positive association between predicted FM and hypertension. Compared with those in the lowest quartile of predicted FM, men in the highest quartile had a hazard ratio (HR) of 1.83 (95% confidence interval (CI): 1.13-2.97) for hypertension. The HR per standard deviation increase of BMI and predicted FM was 1.11 (95% CI: 1.04-1.19) above 23.1 kg/m2 and 1.05 (95% CI: 1.02-1.15) above 14.6 kg, respectively. However, predicted LBM was not associated with hypertension. In addition, high-density lipoprotein cholesterol (HDL-c) and fasting blood glucose (FBG) mediated the relationship of predicted FM with systolic blood pressure, with a mediation ratio of 37.1% and 8.2%, respectively. Furthermore, total cholesterol (TC) and triglyceride (TG) positively mediated the association of predicted FM with diastolic blood pressure, with a mediation ratio of 9.5% and 9.9%, respectively.
Higher predicted FM might play a central role in the positive linear relationship of the BMI-hypertension association in Chinese male adults, and the link from predicted FM to blood pressure was partially mediated by TC, TG, HDL-c, and FBG.
很少有研究能够揭示瘦体重（LBM）或脂肪量（FM）在 BMI-高血压关联中哪个是主要原因。本研究旨在评估预测的 LBM 和 FM 与中国成年男性高血压风险之间的关联。
在 2009 年的防城港男性健康与体检调查中，我们对 2812 名无高血压的男性参与者进行了前瞻性队列研究。我们使用多变量 Cox 模型和限制立方样条来检查预测的 LBM 和 FM 以及 BMI 与高血压的关联，并进一步探讨预测 FM 与血压之间关系中的脂质和血糖特征的中介作用。
在队列研究中，1238 名参与者中有 306 名（24.8%）被确诊为高血压，中位随访时间为 3.8 年，发病率为每 100 人年 7.0 例。BMI 与高血压之间存在显著的线性关联（趋势检验 P<0.001）。包括预测 LBM 和 FM 的多变量调整 Cox 模型观察到预测 FM 与高血压之间存在正相关。与预测 FM 最低四分位数的男性相比，预测 FM 最高四分位数的男性患高血压的风险比（HR）为 1.83（95%置信区间（CI）：1.13-2.97）。BMI 和预测 FM 每增加一个标准差，患高血压的 HR 分别为 1.11（95% CI：1.04-1.19）和 1.05（95% CI：1.02-1.15）。然而，预测的 LBM 与高血压无关。此外，高密度脂蛋白胆固醇（HDL-c）和空腹血糖（FBG）介导了预测 FM 与收缩压之间的关系，其介导率分别为 37.1%和 8.2%。此外，总胆固醇（TC）和三酰甘油（TG）正向介导了预测 FM 与舒张压之间的关联，其介导率分别为 9.5%和 9.9%。
较高的预测 FM 可能在中国成年男性 BMI-高血压关联的正线性关系中发挥核心作用，而预测 FM 与血压之间的联系部分由 TC、TG、HDL-c 和 FBG 介导。
