高同型半胱氨酸血症及腹型肥胖对高血压发病的交互作用

摘要

目的：探讨高同型半胱氨酸血症（HHcy）与腹型肥胖对高血压发病的交互作用。方法选择健康体检者3591例，根据是否存在高血压分为非高血压组（对照组）1235例、高血压组2356例。两组均进行问卷调查、体格检查及血同型半胱氨酸（Hcy）检测，观察 HHcy 及腹型肥胖对高血压患病风险的影响。结果在控制混杂因素后，多因素 Logistic 回归分析结果显示，腹型肥胖者患高血压的风险为正常腰围者的1．54倍，HHcy 者患高血压的风险为 Hcy 正常者的2．287倍（OR 分别为2．287、1．54，P 均＜0．05）。交互作用分析显示，有 HHcy 及腹型肥胖者高血压患病风险为无 HHcy 及腹型肥胖者的3．464倍，HHcy 与腹型肥胖同时存在的交互作用指数为1．253，交互作用归因比为14．3％，纯交互作用归因比为20．2％。结论 HHcy、腹型肥胖均为高血压的危险因素，二者对高血压发病具有正交互作用。%Objective To investigate the synergistic effect between hyperhomocystinemia (HHcy)and abdominal obe-sity on the incidence of hypertension.Methods Totally 3 591 subjects were enrolled from health care center.Participants were classified into two groups,namely,non-hypertension group (control group,n =1 235)and hypertension group (n =2 356).A questionnaire survey,physical examination and blood homocysteine (Hcy)test were carried out among the par-ticipants.Results After controlling the age,gender,smoking,alcohol consumption,physical activity and family hyper-tension history,Multiariable Logistic regression analysis showed that the risk of hypertension in patients with abdominal o-besity was 1.54 times higher than that of patients with normal waistline,and the risk of hypertension in patients with HHcy was 2.287 times higher than that of patients with normal Hcy (OR =2.287 and 1.54,all P <0.05).Interaction analysis showed that the risk of patients with HHcy and abdominal obesity was 3.464 times higher than that of patients without HHcy and abdominal obesity.The synergy index between hyperhomocystinemia and abdominal obesity on the incidence of hyper-tension was 1.253,the attributable proportion due to the interaction was 14.3% and the pure attributable proportion due to the interaction was 20.2%.Conclusion HHcy and abdominal obesity are risk factors for hypertension and there is a pos-itive synergistic effect between HHcy and abdominal obesity on the incidence of hypertension.