新疆和西藏地区居民体重指数及腰围与10年冠状动脉粥样硬化性心脏病发病风险的关系

摘要

目的 探讨我国新疆和西藏地区居民体重指数、腰围与10年冠状动脉粥样硬化性心脏病(冠心病)发病风险的关系.方法 采用多阶段分层随机抽样的方法,于2015年6月至2017年3月共抽取新疆和西藏地区≥35岁研究对象7 631例,其中资料完整的5 737例纳入分析.体重指数分为3个等级组:A组＜ 24 kg/m2(2 005例)、B组24 ～＜ 28 kg,/m2(2 178例)、C组≥28 kg/m2(1 554例),按腰围分为3个等级组:Ⅰ组＜ 85(男)/80(女)cm(1 657例)、Ⅱ组85～＜90(男)/80 ～＜ 85(女)cm(973例)、Ⅲ组≥90(男)/85(女)cm(3 107例).应用中国多省队列研究(CMCS) 10年冠心病发病风险预测模型,探究体重指数及腰围与冠心病发病风险的关系.结果 体重指数C组和腰围Ⅲ组高血压、高总胆固醇、低HDL-C和糖尿病比例较大(均P＜0.01).体重指数各等级组的10年冠心病发病风险绝对值随腰围水平的增加而增加(趋势检验P ＜0.000 1);对于腰围水平低的对象,其体重指数水平越高,冠心病发病风险绝对值越高(趋势检验P=0.000 6).多因素Logistic分析显示,对于同一体重指数(或腰围)等级的研究对象,其10年冠心病发病风险随腰围(或体重指数)水平的增加而增加(趋势检验P ＜0.05);体重指数C组且腰围Ⅲ组的冠心病发病风险最大(比值比=4.191,95％置信区间:3.578 ～4.909).结论 新疆和西藏地区居民体重指数和腰围是10年冠心病发病风险的独立影响因素,体重指数和腰围同时处于较高水平者或是10年冠心病发病的高危人群.%Objective To investigate the association among body mass index(BMI),waist circumference (WC) and the 10-year coronary atherosclerotic heart disease (CHD) in Xinjiang and Tibet areas of China.Methods Based on stratified multi-stage random sampling method,7 631 people of 35 years or older were enrolled from Xinjiang and Tibet regions from June 2015 to March 2017;5 737 cases with complete data were analyzed.BMI and WC were measured;the population was allocated into group A BMI ＜ 24 kg/m2 (2 005 cases),group B BMI 24-＜ 28 kg,/m2 (2 178 cases),group C BMI≥28 kg/m2 (1 554 cases);group Ⅰ WC ＜ 85 (male)/80 (female) cm (1 657 cases),group Ⅱ WC 85-＜ 90 (male)/80-＜ 85 (female) cm (973 cases),group Ⅲ WC ≥90(male)/85(female)cm(3 107 cases).The relation among BMI,WC and CHD risk was analyzed based on the Chinese Multi-provincial Cohort Study(CMCS) 10-year CHD risk prediction model.Results Group C and group Ⅲ had higher percentages of hypertension,high total cholesterol,low high density lipoprotein cholesterol and diabetes compared to the groups with lower BMI or WC (P ＜ 0.01).The absolute 10-year CHD risk increased with WC in groups with same BMI (P ＜ 0.000 1);it increased with BMI in population with low WC (P =0.000 6).Multivariate logistic analysis showed that 10-year CHD risk increased with BMI(or WC) in groups with same WC (or B MI) (P ＜ 0.05);group C + group Ⅲ had the highest 10-year C HD risk (odds ratio =4.191,95 ％ confidence interval:3.578-4.909).Conclusion Both BMI and WC are independendy associated with the 10-year CHD risk;the population with higher BMI and WC has a higher 10-year CHD risk in Tibet and Xinjiang areas of China.