Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Liaoning Province, Shenyang, 110001, People's Republic of China.
Department of Ophthalmology, The First Hospital of China Medical University, Liaoning Province, Shenyang, 110001, People's Republic of China.
BMC Public Health. 2024 Nov 4;24(1):3045. doi: 10.1186/s12889-024-20505-w.
This study aims to explore the association and determine the distinguished potential of anthropometric adiposity indices in screening for hypertension and hyperlipidaemia in the Chinese population.
A recent nationwide cross-sectional study, called the Thyroid Disorders, Iodine State, and Diabetes Epidemiological Survey (TIDE 2015-2017), provided the newest data on the relationships between anthropometric adiposity indices and hypertension and hyperlipidaemia and included 65,231 subjects. The area under the curve (AUC) was used to assess the feasibility of using these indices to distinguish hypertension and hyperlipidaemia. After age stratification, a restricted cubic spline (RCS) fitted for generalized linear regression was used to visualize the relationships of the body mass index (BMI), waist circumference (WC), the waist-to-height ratio (WHtR), the body roundness index (BRI), and the "a body shape index" (ABSI) with hypertension and hyperlipidaemia.
The results showed that there were significant differences in the BMI, WC, the WHtR, the BRI, and the ABSI among the different age groups (P < 0.0001). After adjusting for sex, age, education, income, smoking status, urban or rural residence, and ethnicity in model, The WHtR and BRI had greater discriminatory power in identifying hypertension (AUC = 0.665, 95% confidence interval (CI) 0.660-0.671 for both), hypercholesterolaemia (AUC = 0.629, 95% CI 0.624-0.634 for both), and high low-density lipoprotein cholesterol (LDL-C; AUC = 0.659, 95% CI 0.653-0.664 for both) status in the overall population. When distinguishing hypertriglyceridaemia among the general population, the BMI (AUC = 0.711, 95% CI 0.706-0.716) and WC (AUC = 0.715, 95% CI 0.710-0.720) had greater discriminatory ability than the other anthropometric indices did. The BMI (AUC = 0.631, 95% CI 0.625-0.637) had the highest power for low high-density lipoprotein cholesterol (HDL-C) status in the general population.
Several anthropometric indices show significant correlation with hypertension and hyperlipidaemia. The WHtR and BRI were better in distinguishing hypertension, hypercholesterolaemia and high LDL-C status, while the BMI was better in hypertriglyceridaemia and low HDL-C status. The use of combined indices, such as the BMI, WC, the WHtR and the BRI, can be included in an individual's medical history and can be used as tools for cardiovascular health screening, which may yield superior results for public health.
本研究旨在探讨中国人群中人体肥胖指数与高血压和高脂血症之间的关联,并确定其潜在的鉴别能力。
最近一项名为甲状腺疾病、碘状态和糖尿病流行病学调查(TIDE 2015-2017)的全国性横断面研究提供了关于人体肥胖指数与高血压和高脂血症之间关系的最新数据,共纳入 65231 名受试者。曲线下面积(AUC)用于评估这些指数区分高血压和高脂血症的可行性。在年龄分层后,使用广义线性回归拟合的限制性立方样条(RCS)来可视化体重指数(BMI)、腰围(WC)、腰高比(WHtR)、体圆度指数(BRI)和“a 体型指数”(ABSI)与高血压和高脂血症之间的关系。
结果显示,不同年龄组之间 BMI、WC、WHtR、BRI 和 ABSI 存在显著差异(P < 0.0001)。在校正性别、年龄、教育程度、收入、吸烟状况、城乡居住和种族后,WHtR 和 BRI 在识别高血压(AUC=0.665,95%CI 0.660-0.671)、高胆固醇血症(AUC=0.629,95%CI 0.624-0.634)和高 LDL-C 血症(AUC=0.659,95%CI 0.653-0.664)方面具有更大的鉴别能力。在一般人群中,区分高甘油三酯血症时,BMI(AUC=0.711,95%CI 0.706-0.716)和 WC(AUC=0.715,95%CI 0.710-0.720)的鉴别能力优于其他人体肥胖指数。BMI(AUC=0.631,95%CI 0.625-0.637)在一般人群中对低高密度脂蛋白胆固醇(HDL-C)血症的鉴别能力最高。
多项人体肥胖指数与高血压和高脂血症有显著相关性。WHtR 和 BRI 更有助于鉴别高血压、高胆固醇血症和高 LDL-C 血症,而 BMI 更有助于鉴别高甘油三酯血症和低 HDL-C 血症。综合使用 BMI、WC、WHtR 和 BRI 等指数可以纳入个体的病史中,并作为心血管健康筛查的工具,这可能会为公共健康带来更好的效果。