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目的探讨山东省济南地区35~75岁人群肥胖类型与血脂促动脉硬化指数的相关性。方法 2011年6月—2013年7月,采用整群随机抽样方法抽取山东省济南地区35~75岁人群10 079人,测量受试者腰围、身高、体重、颈-股动脉的脉搏波速度(cf PWV)及空腹血脂指标,并计算体质指数(BMI)及血脂促动脉硬化指数(PAI)。结果 BMI<28 kg/m~2+非腹型肥胖组cf PWV及PAI分别为(9.15±1.62)m/s和(2.27±0.96),BM I<28 kg/m~2+腹型肥胖组分别为(9.82±1.78)m/s和(2.56±1.18),BM I≥28 kg/m~2+非腹型肥胖组分别为(9.45±1.82)m/s和(2.44±1.19),BM I≥28 kg/m~2+腹型肥胖组分别为(10.99±1.91)m/s和(3.21±1.71)。与BM I<28 kg/m~2+非腹型肥胖组比较,其余各组cf PWV及PAI明显升高(P<0.05)。与BM I<28 kg/m~2+腹型肥胖组比较,BMI≥28 kg/m~2+非腹型肥胖组cf PWV明显升高(P<0.05)。与BM I≥28 kg/m~2+非腹型肥胖组比较,BM I≥28 kg/m~2+腹型肥胖组cf PWV及PAI明显升高(P<0.05)。BM I及腰围对cf PWV及PAI共同效应有统计学意义(F=61.366、42.682,P<0.001)。以BMI<28kg/m~2非腹型肥胖组为参照,在校正年龄、性别、收缩压、舒张压、FPG等因素后,BM I≥28 kg/m~2非腹型肥胖组PAI>4及cf PWV>10m/s的OR值分别为1.649(95%CI=1.154~2.144)和1.551(95%CI=1.117~1.985),P均<0.001;BM I<28kg/m~2腹型肥胖组OR值分别为1.764(95%CI=1.370~2.158)和1.577(95%CI=1.264~1.890),P均<0.001;BM I≥28 kg/m~2腹型肥胖组OR值分别为5.666(95%CI=3.726~7.606)和4.631(95%CI=2.615~6.647),P均<0.001。结论在山东济南地区35~75岁人群中,单纯性肥胖及腹型肥胖均是动脉硬化的独立危险因素,腰围及BMI增加在致动脉硬化中具有协同作用。
Objective To investigate the correlation between obesity type and lipid-induced atherosclerosis index in 35 ~ 75-year-old population in Jinan area of Shandong province. Methods From June 2011 to July 2013, 10 079 people aged 35-75 years in Shandong province were enrolled in this study. The waist circumference, height, weight, pulse wave velocity of neck-femoral artery cf PWV) and fasting blood lipids, and calculate body mass index (BMI) and lipid-induced atherosclerosis index (PAI). Results The PWV PWI and PAI were (9.15 ± 1.62) m / s and (2.27 ± 0.96), BM I <28 kg / m 2 + abdominal obesity group with BMI <28 kg / m ~ (9.82 ± 1.78) m / s and (2.56 ± 1.18), BM I≥28 kg / m ~ (-2) + non-abdominal obesity group were (9.45 ± 1.82) m / s and I≥28 kg / m ~ 2 and abdominal obesity group were (10.99 ± 1.91) m / s and (3.21 ± 1.71) respectively. Compared with BM I <28 kg / m ~ 2 + non-abdominal obesity group, the levels of cf PWV and PAI in the other groups were significantly increased (P <0.05). Compared with BM I <28 kg / m ~ 2 + abdominal obesity group, the PW PWV of BMI ≥28 kg / m ~ 2 + non-abdominal obesity group was significantly higher (P <0.05). Compared with BM I≥28 kg / m ~ 2 + non-abdominal obesity group, the levels of cf PWV and PAI in BM I≥28 kg / m ~ 2 + abdominal obesity group were significantly increased (P <0.05). The co-effects of BM I and waist circumference on cf PWV and PAI were statistically significant (F = 61.366, 42.682, P <0.001). BMI <28kg / m ~ 2 non-abdominal obesity group as a reference, after adjusting for age, gender, systolic blood pressure, diastolic blood pressure, FPG and other factors, BMI≥28kg / And cf PWV> 10m / s were 1.649 (95% CI = 1.154-2.1444) and 1.551 (95% CI = 1.117-1.985) respectively, P <0.001 and BM I <28 kg / The odds ratios (OR) were 1.764 (95% CI = 1.370-2.158) and 1.577 (95% CI = 1.264-1.890), respectively, P <0.001; OR for BM I≥28 kg / m ~ 2 was 5.666 (95% CI = 3.726 ~ 7.606) and 4.631 (95% CI = 2.615 ~ 6.647), P <0.001. Conclusion In 35-75-year-old population in Shandong province, simple obesity and abdominal obesity are both independent risk factors for atherosclerosis. Increased waist circumference and BMI have synergistic effects on atherosclerosis.