论文部分内容阅读
目的:基于定量CT（QCT）探讨上海地区人群体质成分与血压的相关性。方法:回顾性选取上海交通大学医学院附属瑞金医院2018年5至12月行低剂量CT肺癌筛查联合QCT体质成分测定的体检人群共1 307例。QCT测定腰2椎体中心层面体质成分包括腹部软组织面积（ASTA）、腹内脂肪面积（VAA）及皮下脂肪面积（SAA）。分别采用Pearson相关、多因素线性回归及多因素Logistic回归分析体质成分与收缩压、舒张压及高血压的相关性。绘制ROC曲线，确定预测高血压的切点值。结果:Pearson相关分析显示ASTA与收缩压、舒张压均呈负相关（n r=-0.237~-0.102，n P<0.05），VAA、SAA与收缩压、舒张压均呈正相关（VAA：n r=0.359~0.486， SAA： n r=0.088~0.365，n P<0.05）。多因素回归分析显示调整年龄、性别、体质指数、腰围因素后，VAA与收缩压（n β=0.142，n P=0.002）、舒张压（n β=0.245，n P<0.001）及高血压（n OR=1.005，95%n CI：1.001~1.008，n P=0.01）均显著相关，而ASTA、SAA与收缩压、舒张压及高血压均不相关。ROC曲线分析显示男性和女性腰2椎体中心层面VAA预测高血压的切点值分别为201.89cmn 2、136.01cmn 2。n 结论:腹内脂肪与高血压关系密切。在高血压健康管理中，应早期筛查腹内脂肪异常增多的人群并加强预防和管理。“,”Objective:To explore the association between body composition and blood pressure by quantitative CT (QCT) in a Shanghai population.Methods:A total of 1 307 participants undergoing low-dose CT lung cancer screening and body composition measurem ents using QCT in our hospital from May to December 2018 were retrospectively enrolled. Body composition, including the abdominal soft tissue area (ASTA), visceral adipose area (VAA), and subcutaneous adipose area (SAA) at the central slice of L2, was measured using QCT. To explore the correlations among body composition and systolic blood pressure, diastolic blood pressure, and hypertension, Pearson’s correlation, multivariate linear regression, and multivariate logistic regression analysis were used. The cut-off value for predicting hypertension was analyzed using the ROC curve.Results:Pearson’s correlation analysis showed that ASTA was negatively correlated with systolic blood pressure and diastolic blood pressure (n r=-0.237- -0.102, n P<0.05), while VAA and SAA were positively correlated with systolic blood pressure and diastolic blood pressure (VAA: n r=0.359-0.486, SAA: n r= 0.088-0.365, n P<0.05n ). After adjusting for age, sex, body mass index, and waist circumference, multivariate regression analysis showed that VAA was significantly associated with systolic blood pressure (β= 0.142, n P= 0.002), diastolic blood pressure (β= 0.245, n P<0.001), and hypertension (n OR=1.005, 95% n CI:n 1.001-1.008, n P=0.01), while ASTA or SAA was not significantly associated with systolic blood pressure, diastolic blood pressure, and hypertension. ROC curve analysis indicated that the cut-off values of VAA at the central slice of L2 for predicting hypertension in males and females were 201.89 cmn 2 and 136.01 cmn 2, respectively.n Conclusion:Visceral adiposity was found to be closely related to hypertension. For hypertension management, early screening and strengthening of prevention and management methods are needed for people with abnormally increased visceral adiposity.