摘要
目的 分析40岁及以上高血压前期人群基线BMI及其变化与心血管疾病危险因素的关联.方法 选取2019年塔城地区额敏县体检人群中的40岁及以上高血压前期人群8 150例为研究对象.收集研究对象的基线资料,BMI＜18.5 kg/m2为低体质量,18.5～23.9 kg/m2为正常,24.0～27.9 kg/m2为超重,≥28.0 kg/m2为肥胖.收集研究对象的随访资料,包括心血管疾病危险因素发生情况及随访结束时BMI.根据基线BMI及随访结束时BMI,将BMI变化情况分为4类,分别为持续正常(基线和随访结束时体质量均正常)、持续异常(基线时和随访结束时均超重或肥胖)、逆转正常(基线时超重或肥胖,随访结束时体质量正常)、转归异常(基线时体质量正常,随访结束时超重或肥胖).采用Cox回归分析探讨基线BMI及其变化与心血管疾病危险因素的关联.结果 8 150例受试者的基线BMI情况:正常2 694例(33.1%),超重3 195例(39.2%),肥胖2 261例(27.7%);BMI变化情况:持续正常1 880例(23.1%),持续异常4 201例(51.5%),逆转正常1 255例(15.4%),转归异常814例(10.4%).Cox回归分析结果显示,超重、肥胖是40岁及以上高血压前期人群发生高血压、糖尿病及TC、TG、HDL-C、LDL-C不达标的影响因素(P＜0.05);调整性别、年龄后,超重、肥胖仍是40岁及以上高血压前期人群发生高血压、糖尿病及TC、TG、HDL-C、LDL-C不达标的影响因素(P＜0.05).持续异常是40岁及以上高血压前期人群发生高血压、糖尿病及TC、TG、HDL-C、LDL-C不达标的影响因素,逆转正常是40岁及以上高血压前期人群发生高血压、糖尿病及TG、HDL-C不达标的影响因素,转归异常是40岁及以上高血压前期人群发生TG、HDL-C不达标的影响因素(P＜0.05);调整性别、年龄后,持续异常仍是40岁及以上高血压前期人群发生高血压、糖尿病及TC、TG、HDL-C、LDL-C不达标的影响因素,逆转正常是40岁及以上高血压前期人群发生糖尿病及TG、HDL-C不达标的影响因素,转归异常仍是40岁及以上高血压前期人群发生TG、HDL-C不达标的影响因素(P＜0.05).结论 超重、肥胖是40岁及以上高血压前期人群发生高血压、糖尿病及TC、TG、HDL-C、LDL-C不达标的危险因素;基线时和随访结束时均超重或肥胖是40岁及以上高血压前期人群发生高血压、糖尿病及TC、TG、HDL-C、LDL-C不达标的危险因素;基线时超重或肥胖,随访结束时体质量正常是40岁及以上高血压前期人群发生糖尿病及TG、HDL-C不达标的危险因素;基线时体质量正常,随访结束时超重或肥胖是40岁及以上高血压前期人群发生TG、HDL-C不达标的危险因素.
Abstract
Objective To analyze the association between baseline BMI and its changes and cardiovascular disease risk factors in individuals aged 40 years and above with prehypertension.Methods A total of 8 150 prehypertensive patients aged 40 years and above who underwent physical examination in Emin County,Tacheng area in 2019 were selected as the study objects.Baseline data were collected.BMI<18.5 kg/m2 was considered low body mass,18.5-23.9 kg/m2 was considered normal,24.0-27.9 kg/m2 was considered overweight,and≥28.0 kg/m2 was considered obese.Follow-up data were collected,including cardiovascular disease risk factors and BMI at the end of follow-up.Based on baseline BMI and BMI at the end of follow-up,changes in BMI were divided into four categories:sustained normal(normal body mass at baseline and at the end of follow-up),sustained abnormal(overweight or obese at baseline and at the end of follow-up),reversed normal(overweight or obese at baseline and normal body mass at the end of follow-up),and abnormal outcome(normal body mass at baseline and overweight or obese at the end of follow-up).Cox regression analysis was used to investigate the association of baseline BMI and its changes with cardiovascular disease risk factors.Results Among the 8 150 participants,baseline BMI distribution included:normal in 2 694 cases(33.1%),overweight in 3 195 cases(39.2%),and obese in 2 261 cases(27.7%);BMI change distribution was:sustained normal in 1 880 cases(23.1%),sustained abnormal in 4 201 cases(51.5%),reversed normal in 1 255 cases(15.4%),and abnormal outcome in 814 cases(10.4%).Cox regression analysis showed that overweight and obesity were influencing factors for hypertension,diabetes,and substandard TC,TG,HDL-C,and LDL-C in prehypertensive individuals aged 40 years and above(P<0.05);after adjusting for gender and age,overweight and obesity were still influencing factors for hypertension,diabetes,and substandard TC,TG,HDL-C,and LDL-C in prehypertensive individuals aged 40 years and above(P<0.05).Sustained abnormal was the influencing factor for hypertension,diabetes,and substandard TC,TG,HDL-C,and LDL-C in prehypertensive individuals aged 40 years and above,reversed normal was the influencing factor for hypertension,diabetes,and substandard TG,and HDL-C in prehypertensive individuals aged 40 years and above,abnormal outcome was the influencing factor for substandard TG,and HDL-C in prehypertensive individuals aged 40 years and above(P<0.05);after adjusting for gender and age,sustained abnormal was still the influencing factor for hypertension,diabetes,and substandard TC,TG,HDL-C,and LDL-C in prehypertensive individuals aged 40 years and above,reversed normal was the influencing factor for diabetes,and substandard TG,and HDL-C in prehypertensive individuals aged 40 years and above,abnormal outcome was still the influencing factor for substandard TG,and HDL-C in prehypertensive individuals aged 40 years and above(P<0.05).Conclusion Overweight and obesity are risk factors for hypertension,diabetes,and substandard TC,TG,HDL-C,and LDL-C in prehypertensive individuals aged 40 years and above.Overweight or obesity at baseline and at the end of follow-up are risk factors for hypertension,diabetes,and substandard TC,TG,HDL-C and LDL-C in prehypertensive individuals aged 40 years and above;overweight or obesity at baseline and normal body mass at the end of follow-up are risk factors for diabetes and substandard TG,and HDL-C in prehypertensive individuals aged 40 years and above;normal body mass at baseline and overweight or obesity at the end of follow-up are risk factors for substandard TG,and HDL-C in prehypertensive individuals aged 40 years and above.
维普
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