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目的探讨腰臀比纵向轨迹与动脉硬化的关联。方法研究队列由开滦卒中队列、老年人群队列、妊娠队列和外周血管疾病筛查队列组成,其中符合入选标准的研究对象共9080名。通过SAS Proc Traj程序确定观察对象2006-2007、2008-2009、2010-2011年健康体检的腰臀比纵向轨迹,生成4组不同的腰臀比轨迹组:低-中轨迹组、中-稳定轨迹组、高-高轨迹组、高-中轨迹组,并于2010-2015年对观察对象进行了肱踝动脉脉搏波传导速度(baPWV)检测。采用协方差分析校正了年龄、性别后不同腰臀比纵向轨迹分组baPWV的差异。采用多因素Logistic回归模型分析腰臀比纵向轨迹与动脉硬化的关联。定义baPWV≥1400cm/s为动脉硬化。结果与其他腰臀比轨迹组相比,高-高轨迹组的baPWV值[(1545.56±4.31)cm/s]、动脉硬化人群比例(67.5%)均最高。低-中轨迹组、中-稳定轨迹组、高-高轨迹组、高-中轨迹组动脉硬化的发生率分别为:28.8%、50.0%、67.5%、55.4%。在多因素Logistic回归分析中,校正了其他混杂因素后,与低-中轨迹组相比,中-稳定轨迹组、高-高轨迹组、高-中轨迹组是动脉硬化发生的危险因素,对应的OR值(95%CI)分别为1.42(1.15~1.76)、1.80(1.42~2.29)、1.63(1.11~2.38),均P<0.05。此外,分别除外服用降压药、降糖药、降脂药人群后进行了敏感性分析,结果与主要研究结果趋势一致。结论腰臀比纵向轨迹水平升高是发生动脉硬化的危险因素。
Objective To investigate the relationship between the longitudinal waistline to hip ratio and atherosclerosis. Methods The study cohort consisted of a Kailuan Stroke Queue, an Elderly Cohort, a Pregnancy Cohort, and a Peripheral Vascular Disease Screening Cohort, in which 9080 subjects met the inclusion criteria. SAS Proc Traj program was used to determine the waist-to-hip ratio longitudinal trajectory of the observed subjects from 2006-2007, 2008-2009, 2010-2011 to generate 4 groups of different waist-hip ratio trajectories: low-medium trajectory group, medium-stable trajectory Group, high-high group and high-medium group. The brachial-ankle pulse wave velocity (baPWV) was detected in the observation subjects from 2010 to 2015. Covariance analysis was used to correct the difference of baPWV between longitudinal and tracheal longitudinal trajectory groups after age and sex. Multivariate Logistic regression model was used to analyze the association of longitudinal and longitudinal hip trajectory with atherosclerosis. Definition baPWV ≥ 1400cm / s for atherosclerosis. Results The baPWV value [(1545.56 ± 4.31) cm / s] and the percentage of atherosclerosis patients (67.5%) were the highest in the high-high trajectory group compared with those in the other groups. The incidence rates of atherosclerosis in the low-medium trajectory group, the medium-stable trajectory group, the high-high trajectory group and the high-medium trajectory group were 28.8%, 50.0%, 67.5% and 55.4%, respectively. In multivariate Logistic regression analysis, after adjusting for other confounding factors, the medium-stable trajectory group, high-high trajectory group and high-medium trajectory group were the risk factors for atherosclerosis compared with the low-medium trajectory group, corresponding to The OR values (95% CI) were 1.42 (1.15-1.76), 1.80 (1.42-2.29) and 1.63 (1.11-2.38) respectively, all P <0.05. In addition, except for taking antihypertensive drugs, hypoglycemic agents, lipid-lowering drugs, respectively, the sensitivity of the population was analyzed. The results are consistent with the results of the main research. Conclusions The level of waist-to-hip ratio is a risk factor for atherosclerosis.