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目的评价《国民体质测定标准》中肥胖指标与正常偏高血压及高血压风险关系,并确定判定切点,为高血压的预防控制提供参考依据。方法采用分层整群抽样方法对在辽宁省沈阳、丹东、朝阳市3个国民体质监测点抽取的5 809名20～69岁未接受高血压药物治疗的居民进行体格检查。结果 5 809名居民的正常偏高血压率和高血压率分别为16.92%和24.89%,其中男性居民正常偏高血压率和高血压率分别为20.98%和31.57%,均高于女性居民的12.94%和18.33%,差异均有统计学意义(P<0.01);多因素logistic回归分析结果表明,年龄≥40岁和体质指数(BMI)是正常偏高血压的危险因素,女性是正常偏高血压的保护因素;年龄≥30岁、BMI和腰围是高血压的危险因素,女性是高血压的保护因素;控制年龄、性别的影响后,BMI每升高1个标准差,正常偏高血压和高血压的风险分别增大1.38倍(95%CI=1.28～1.50)和1.57倍(95%CI=1.39～1.78);腰围每升高1个标准差,高血压的风险增大1.37倍(95%CI=1.20～1.56);以约登指数最大确定切点,BMI判定正常偏高血压的切点为男性24.0 kg/m2、女性24.3 kg/m2,BMI判定高血压的切点为男性25.1 kg/m2、女性24.3 kg/m2,腰围判定高血压的切点为男性87.0 cm,女性80.6 cm;以灵敏度≥80%确定切点,BMI判定正常偏高血压的切点为男性23.0 kg/m2、女性22.3 kg/m2,BMI判定高血压的切点为男性23.4 kg/m2、女性22.8 kg/m2,腰围判定高血压的切点为男性82.0 cm、女性76.9 cm。结论高血压的风险随BMI及腰围的增加而增大,BMI与高血压的关联强度大于腰围。
Objective To evaluate the relationship between obesity index and the risk of hypertension and hypertension in National Physical Fitness Test, and determine the cut-off points for decision-making, which can provide reference for the prevention and control of hypertension. Methods Stratified cluster sampling was used to examine the physical examination of 5 809 inhabitants aged from 20 to 69 who were not treated with hypertension in three national health monitoring sites in Shenyang, Dandong and Chaoyang, Liaoning Province. Results The normal hypertension rate and hypertension rate of 5 809 residents were 16.92% and 24.89%, respectively. Among them, the normal hypertension rate and the hypertension rate of male residents were 20.98% and 31.57%, respectively, which were higher than that of female residents % And 18.33%, respectively (P <0.01). Multivariate logistic regression analysis showed that age≥40 years and body mass index (BMI) were risk factors of normal hypertension, and women were normal hypertension BMI and waist circumference are risk factors for hypertension, and women are the protective factors of hypertension. After controlling for age and sex, BMI increases by 1 standard deviation, normal hypertension and high The risk of blood pressure increased by 1.38 times (95% CI = 1.28-1.50) and 1.57 times (95% CI = 1.39-1.78) respectively. The risk of hypertension increased by 1.37 times (95% CI = 1.20-1.56). The cut-off point was determined according to the Youden index. The cut-point of BMI was 24.0 kg / m2 for male and 24.3 kg / m2 for women. The cut-off point of BMI was 25.1 kg / m2, and 24.3 kg / m2 for women. The cut-off point for determination of high blood pressure in the waist circumference was 87.0 cm for males and 80.6 cm for females; the cut point was determined by the sensitivity of 80% The cut-off point of BMI was 23.0 kg / m2 for male and 22.3 kg / m2 for female. The cut-off point for determining hypertension in BMI was 23.4 kg / m2 for men and 22.8 kg / m2 for women. For men 82.0 cm, women 76.9 cm. Conclusion The risk of hypertension increases with the increase of BMI and waist circumference. The correlation between BMI and hypertension is greater than the waist circumference.