Wang F H, Yang N, Wang J, Wei M T, Wang X G, Yang C, Zhang Y L
Department of Clinical Epidemiology, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin300457, China.
Department of Hypertension, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin300457, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Dec 10;45(12):1658-1665. doi: 10.3760/cma.j.cn112338-20240513-00267.
To understand the interaction effect of general obesity, central obesity, and dyslipidemia on the risk of hypertension to provide scientific evidence for the early prevention and control of hypertension. From 2019 to 2023, 10 of the 16 districts in Tianjin were selected as project sites. A community and a natural village were selected as monitoring sites in each project site using a multi-stage cluster random sampling method. A questionnaire, physical, and biochemical examination were conducted on permanent residents aged 35-75 who had lived in the surveillance sites for more than half a year. The chi-square test univariate and multivariate logistic regression were used for statistical analysis. The multiplicative and additive models were used to calculate the interaction between general obesity and dyslipidemia, as well as central obesity and dyslipidemia, respectively. A total of 177 160 subjects were included in the study, with an age of (56.44±8.62) years old. There were 29 535 (16.67%) patients with general obesity, 67 338 (38.01%) patients with central obesity, 64 906 (36.64%) patients with dyslipidemia, and 90 266 (50.95%) patients with hypertension. Multiplication interaction analysis results showed that, after adjusting for gender, age, culture level, marriage status, drinking, smoking, and diabetes, the multiplicative interactions between general obesity and dyslipidemia, and central obesity and dyslipidemia on hypertension were statistically significant (all <0.001), and the adjusted and 95% were 2.57 (2.47-2.68) and 2.14 (2.08-2.20), respectively. The results of the additive interaction analysis demonstrated that after adjusting for relevant variables, the relative excess risk of interaction (), the attributable proportion of interaction (), and the synergy index () of the interaction between generalized obesity and dyslipidemia were 0.48 (95%: 0.33-0.63), 0.15 (95%: 0.11-0.19), and 1.27 (95%: 1.18-1.36), respectively; the , , and of the interaction between central obesity and dyslipidemia were 0.37 (95%: 0.28-0.46), 0.13 (95%: 0.10-0.16), and 1.25 (95%: 1.18-1.32), respectively. There might be multiplicative and additive interactions between general obesity, central obesity, and dyslipidemia on the risk of hypertension. Simultaneous control of BMI, waist circumference, and blood lipid levels may effectively reduce the risk of hypertension.
了解一般肥胖、中心性肥胖和血脂异常对高血压风险的交互作用，为高血压的早期预防和控制提供科学依据。2019年至2023年，选取天津市16个区中的10个作为项目点。采用多阶段整群随机抽样方法，在每个项目点选取1个社区和1个自然村作为监测点。对在监测点居住半年以上的35 - 75岁常住人口进行问卷调查、体格检查和生化检查。采用卡方检验单因素和多因素logistic回归进行统计分析。分别采用相乘模型和相加模型计算一般肥胖与血脂异常、中心性肥胖与血脂异常之间的交互作用。本研究共纳入177160名受试者，年龄为（56.44±8.62）岁。一般肥胖患者29535例（16.67%），中心性肥胖患者67338例（38.01%），血脂异常患者64906例（36.64%），高血压患者90266例（50.95%）。相乘交互作用分析结果显示，在调整性别、年龄、文化程度、婚姻状况、饮酒、吸烟和糖尿病因素后，一般肥胖与血脂异常、中心性肥胖与血脂异常对高血压的相乘交互作用具有统计学意义（均<0.001），调整后的RR值及95%CI分别为2.57（2.47 - 2.68）和2.14（2.08 - 2.20）。相加交互作用分析结果显示，在调整相关变量后，一般肥胖与血脂异常交互作用的相对超额危险度（RERI）、交互作用归因比例（AP）和协同指数（SI）分别为0.48（95%CI：0.33 - 0.63）、0.15（95%CI：0.11 - 0.19）和1.27（95%CI：1.18 - 1.36）；中心性肥胖与血脂异常交互作用的RERI、AP和SI分别为0.37（95%CI：0.28 - 0.46）、0.13（95%CI：0.10 - 0.16）和1.25（95%CI：1.18 - 1.32）。一般肥胖、中心性肥胖和血脂异常在高血压风险上可能存在相乘和相加交互作用。同时控制体重指数、腰围和血脂水平可能有效降低高血压风险。
