CAJ | 학술논문

目的探讨腰围(WC)在随访过程中的动态变化对队列人群高血压发病率的影响.方法采用前瞻性研究方法,以江苏省多代谢异常和代谢综合征综合防治研究队列满足2次随访的人群为研究对象.第一次随访时WC与基线WC之间的差值来衡量WC的动态变化量,并按照基线和第一次随访是否为腹型肥胖分为控制组和非控制组;以第二次随访是否为高血压作为结局变量(高血压=1,正常血压=0).运用Cox比例风险模型分析WC的变化量以及WC控制与否与随访新发高血压关系.结果 2778名研究对象中,660例为新发高血压患者.不论基线WC正常与否,WC水平在后两组的人群随访中发生高血压的RR值均高于第一组人群.基线WC正常组和腹型肥胖组中,非控制组的高血压累积发病率均高于控制组(基线WC正常组:35.0％vs.18.4％;基线腹型肥胖组:34.7％vs..21.4％).在基线腹型肥胖组中,其随访时仍为腹型肥胖的人群相比WC转为正常的人群发生高血压的RR值(95％CI)为1.95(1.19 ～ 3.19);基线WC正常组中,随访时转为腹型肥胖人群相比WC仍保持正常的人群发生高血压的RR值(95％CI)为2.38(1.89～2.99).调整基线性别、年龄和高血压一般危险因素后,基线腹型肥胖和WC正常组中,非控制组人群相比于控制组人群发生高血压的RR值(95％CI)分别为4.36( 1.69～9.74)和1.44( 1.03～2.35).结论 WC动态变化与高血压发病密切相关,控制WC的增长或降低WC是高血压早期预防的有效措施之一.
목적 탐토요위(WC)재수방과정중적동태변화대대렬인군고혈압발병솔적영향.방법 채용전첨성연구방법,이강소성다대사이상화대사종합정종합방치연구대렬만족2차수방적인군위연구대상.제일차수방시WC여기선WC지간적차치래형량WC적동태변화량,병안조기선화제일차수방시부위복형비반분위공제조화비공제조;이제이차수방시부위고혈압작위결국변량(고혈압=1,정상혈압=0).운용Cox비례풍험모형분석WC적변화량이급WC공제여부여수방신발고혈압관계.결과 2778명연구대상중,660례위신발고혈압환자.불론기선WC정상여부,WC수평재후량조적인군수방중발생고혈압적RR치균고우제일조인군.기선WC정상조화복형비반조중,비공제조적고혈압루적발병솔균고우공제조(기선WC정상조:35.0％vs.18.4％;기선복형비반조:34.7％vs..21.4％).재기선복형비반조중,기수방시잉위복형비반적인군상비WC전위정상적인군발생고혈압적RR치(95％CI)위1.95(1.19 ～ 3.19);기선WC정상조중,수방시전위복형비반인군상비WC잉보지정상적인군발생고혈압적RR치(95％CI)위2.38(1.89～2.99).조정기선성별、년령화고혈압일반위험인소후,기선복형비반화WC정상조중,비공제조인군상비우공제조인군발생고혈압적RR치(95％CI)분별위4.36( 1.69～9.74)화1.44( 1.03～2.35).결론 WC동태변화여고혈압발병밀절상관,공제WC적증장혹강저WC시고혈압조기예방적유효조시지일.
Objective To study the impact on dynamic change of waist circumference(WC) through follow-up data on the incidence of hypertension in several cohort groups.Methods In this prospective study,2778 free-hypertension subjects were recruited from a program “Prevention of Multiple Metabolic disorders and metabolic syndrome (MS) in Jiangsu province” (PMMJS) to evaluate the risk of hypertension in relation to WC dynamic change on normal WC or abnorminal obesity group.Dynamic change of WC was measured by WC D-value,which was expressed by data on the difference of WC between baseline and the first follow up.Study outcome was defined as incident hypertension during the first to the second follow up period in this study.The association between dynamic change of WC and incident hypertension was analyzed by using Cox proportional hazards regression model.Results There were 2778 participants,660 subjects developed hypertension during the follow-up,regardless of the normality of the baseline WC,the risk of hypertension increased across the tertiles of WC,while the incidence of hypertension was higher in non-control group than that in control group.In populations with abdominal obesity and normal WC at baseline,RRs (95％CI) of hypertension were 1.95 (1.19-3.19) and 2.38 (1.89-2.99) in subjects with abdominal obesity seen at the first follow up period,compared to subjects with normal WC in the same period.After adjustment for gender,age and other hypertension related risk factors,in populations with abdominal obesity and normal WC at baseline survey,RRs (95％ CI) of hypertension were 4.36 (1.69-9.74) and 1.44( 1.03-2.35 ) respectively,for the non-control group.Conclusion WC dynamic change was associated with hypertension,WC control while WC reduction was important for early prevention on hypertension.