受教育程度与肥胖交互作用对高血压患病的影响

摘要

目的：探究体质指数（BMI）和腰围身高比（WHtR）与受教育程度交互作用对高血压患病的影响。方法采用概率比例抽样（PPS）法，于2012年5—8月对江苏省昆山市≥18周岁户籍居民进行问卷调查、体格检查与血压测量。样本数据通过复杂加权后进行统计分析，使用多因素 Logistic 回归探究高血压与诸因素的关联强度及交互作用。结果通过复杂加权后高血压患病率为17.2％〔95％ CI（16.8％，17.6％）〕，其中男性患病率为17.2％〔95％ CI（16.6％，17.7％）〕，女性患病率为17.3％〔95％ CI（16.7％，17.8％）〕。调整年龄、性别、吸烟与饮酒状态及体力活动情况之后，在不同的受教育程度分层中，随着 BMI 水平的增加其与高血压患病关联强度均呈现上升趋势（趋势检验，P ＜0.001，R2＝0.977）；WHtR ＞0.5与高血压患病关联强度亦有统计学意义（趋势检验，P ＜0.05，R2＝0.966）。受教育程度与 BMI 交互作用（乘积项，β＝0.153，Sβ＝0.015，χ2＝106.70，P ＜0.001）、受教育程度与WHtR 交互作用（乘积项，β＝0.691，Sβ＝0.039，χ2＝310.98，P ＜0.001）与高血压患病之间的关联均有统计学意义。结论 BMI、WHtR 与高血压患病关联，另外，受教育程度较低与肥胖同时存在时与高血压患病呈现相乘交互作用。%Objective To investigate the interaction between BMI,waist to height ratio( WHtR)and educational attainment for the prevalence of hypertension. Methods Using probability proportionate sampling(PPS)method,we conducted questionnaire survey,physical examination and blood pressure measurement on residents aged ≥18 with household registration in Kunshan of Jiangsu Province from May to August in 2012. Statistic analysis was conducted on the collected data after complex weighting. Multivariate Logistic regression analysis was conducted to investigate the strength of correlation between hypertension and each factor and the interaction effect. Results After complex weighting,the prevalence of hypertension was 17. 2%〔95% CI(16. 8% ,17. 6% )〕,with 17. 2% 〔95% CI(16. 6% ,17. 7% )〕for males and 17. 3% 〔95% CI(16. 7% , 17. 8% )〕for females. After the adjustment of age,gender,smoking,alcohol consumption and physical activity,at different education attainment level,the increase of BMI level saw increase in the strength of its correlation with the prevalence of hypertension(trend test,P < 0. 001,R2 = 0. 977);the strength of correlation between WHtR > 0. 5 and the prevalence of hypertension was significant( trend test,P < 0. 05,R2 = 0. 966). The interaction between educational attainment and BMI (product term,β = 0. 153,Sβ = 0. 015,χ2 = 106. 70,P < 0. 001)and the interaction between educational attainment and WHtR(product term,β = 0. 691,Sβ = 0. 039,χ2 = 310. 98,P < 0. 001)for the prevalence of hypertension were statistically significant. Conclusion BMI,WHtR have correlation with the prevalence of hypertension. Besides,multiplicative interaction exists between low educational attainment and obesity for the prevalence of hypertension.