卫生研究

目的探讨中国成年人体质指数(BMI)和腰围(WC)的增加与高血压发病危险的关系。方法利用“中国居民健康与营养调查”资料,以4552例18~60岁参加2000年调查、当时无高血压等慢性病并且2004年调查被随访到者为研究对象,考察基线BMI和WC对高血压的预测作用,以及BMI和WC4年间的变化与高血压发病之间的关系。结果男性和女性随访4年高血压发病率分别为20.01%和13.52%。随着基线肥胖程度的增加,高血压的发病危险增加。与BMI和WC均不肥胖者相比,BMI超重/肥胖并且WC肥胖者发生高血压的危险最高(男性,RR=2.840,95%CI:2.139³.771;女性,RR=2.734,95%CI:2.050³.647)。调整了其它协变量后,4年中BMI每增加一个单位,男性和女性患高血压的危险分别增加0.141和0.109倍;WC每增加1cm,男性和女性患高血压的危险分别增加0.038和0.035倍。结论体质指数和腰围的增加均能增加高血压发病的危险,体质指数和腰围联合使用可增强对高血压发病的预测作用。

Objective To explore whether the increase of body mass index (BMI) and waist circumstances (WC) can predict the higher risk of hypertension in Chinese adults. Methods The data were collected in the China Health and Nutrition Survey (CHNS). A total of 4552 adults aged 18-60 years old were selected as the subjects who were healthy in the baseline survey in 2000 and followed up in 2004. Logistic regression models were used to estimate the relative risk (RR) of developing hypertension associated with the BMI and WC in baseline and the four-year change of BMI and WC. Results The incidence of hypertension of men and women was 20.01% and 13.52% respectively during the four years of follow-up. The risk of developing hypertension rose with the increase of either BMI or WC in baseline. Compared with the group of neither general obesity (defined by BMI) nor abdominal obesity (defined by WC)group with both general obesity and abdominal obesity had the highest risk (men RR=2.840,95%CI:2.139-3.771, women RR=2.734, 95%CI:2.050-3.647) among the different combinations of BMI and WC.Adjusted for other factors the risk of developing hypertension also increased with the four-year augment of either BMI or WC (BMI: men,RR=1.141,95%CI:1.087-1.199,women,RR=1.109,95%CI:1.056-1.164,WC:men,RR=1.038,95%CI:1.022-1.055,women,RR=1.035,95%CI:1.018-1.052). Conclusion The increase of BMI and WC can predict the higher risk of the development of hypertension. The combination of BMI and WC can increase the predictive efficacy of the incidence of hypertension.