CAJ | 학술논문

目的分析超重和肥胖与动脉僵硬度的关系.方法选取2007至2009年江苏省社区自然人群4585名为研究对象进行回顾性研究.以体质指数(BMI)评价超重和肥胖,肱踝脉搏波传导速度(baPWV)评价动脉僵硬度.将BMI分别作为连续变量(以l kg/m2递增)和等级变量(体重正常、体重过轻、超重和肥胖)进行logistic多因素逐步回归分析,评价高动脉僵硬度风险和人群归因危险度百分比,并通过受试者工作(ROC)曲线分析BMI对高动脉僵硬度的预测价值.结果 (1)控制年龄后,男性和女性的BMI与baPWV均呈正相关(r值分别为0.213和0.186,P均＜0.01).超重、肥胖人群baPWV和高动脉僵硬度发生率均高于正常组(P均＜0.01).(2)logistic回归模型校正年龄、性别、高血压因素后,连续变量BMI致高动脉僵硬度的OR值为1.146(95％CI:1.117～1.175,P＜0.01)；当BMI为等级变量时,体重过轻OR值为0.369(95％ CI:0.141～0.962,P＜0.05),超重和肥胖OR值分别为1.576(95％CI:1.333～1.863,P＜0.01)和2.087(95％CI:1.615 ～2.698,P＜0.01).超重和肥胖者高动脉僵硬度的人群归因危险度百分比分别为19.1％和11.6％.(3) BMI评估高动脉僵硬度的ROC曲线下面积为0.661(95％ CI:0.645 ～0.678,P＜0.01),BMI预测高动脉僵硬度的最佳分割值为24.25 kg/m2.结论超重和肥胖人群的动脉僵硬度高于体重正常人群.超重和肥胖是独立于年龄、性别、高血压之外的高动脉僵硬度危险因素.
목적 분석초중화비반여동맥강경도적관계.방법 선취2007지2009년강소성사구자연인군4585명위연구대상진행회고성연구.이체질지수(BMI)평개초중화비반,굉과맥박파전도속도(baPWV)평개동맥강경도.장BMI분별작위련속변량(이l kg/m2체증)화등급변량(체중정상、체중과경、초중화비반)진행logistic다인소축보회귀분석,평개고동맥강경도풍험화인군귀인위험도백분비,병통과수시자공작(ROC)곡선분석BMI대고동맥강경도적예측개치.결과 (1)공제년령후,남성화녀성적BMI여baPWV균정정상관(r치분별위0.213화0.186,P균＜0.01).초중、비반인군baPWV화고동맥강경도발생솔균고우정상조(P균＜0.01).(2)logistic회귀모형교정년령、성별、고혈압인소후,련속변량BMI치고동맥강경도적OR치위1.146(95％CI:1.117～1.175,P＜0.01)；당BMI위등급변량시,체중과경OR치위0.369(95％ CI:0.141～0.962,P＜0.05),초중화비반OR치분별위1.576(95％CI:1.333～1.863,P＜0.01)화2.087(95％CI:1.615 ～2.698,P＜0.01).초중화비반자고동맥강경도적인군귀인위험도백분비분별위19.1％화11.6％.(3) BMI평고고동맥강경도적ROC곡선하면적위0.661(95％ CI:0.645 ～0.678,P＜0.01),BMI예측고동맥강경도적최가분할치위24.25 kg/m2.결론 초중화비반인군적동맥강경도고우체중정상인군.초중화비반시독립우년령、성별、고혈압지외적고동맥강경도위험인소.
Objective To evaluate the relationship between overweight,obesity and arterial stiffness in community residents.Methods A total of 4585 community-dwelling adults in Jiangsu province,China were surveyed with the method of stratified and cluster sampling from 2007 to 2009.Overweight and obesity were defined by body mass index (BMI) and arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV).Statistical analysis of arteriosclerosis included multivariate logistic regression testing among which BMI was viewed as continuous variable( 1 kg/m2 increasing to BMI)and categorical variables (underweight,normal,overweight and obesity) respectively.Odds ratio,population attributable risk percent and the optimal cut-off points for BMI to evaluate arteriosclerosis were analyzed using receiver operator characteristic (ROC) curve.Results ( 1 ) After age control,BMI of male or female were positively correlated with baPWV (r =0.213,P ＜0.01; r =0.186,P ＜0.01).baPWV and prevalence of arteriosclerosis were significantly higher in obese residents compared with normal body weight group ( all P ＜ 0.01 ).(2)As a continuous variable,the odds ratio value of BMI on predicting arteriosclerosis was 1.146 (95％CI:1.117 - 1.175,P ＜ 0.01 ) after adjusting of age,gender and hypertension.As categorical variables,the odds ratio value of BMI was 0.369(95％ CI:0.141 -0.962,P ＜0.05) for underweight group,1.576 (95％ CI:1.333 - 1.863 ) for overweight group and 2.087 ( 95％ CI:1.615 - 2.698 ) for obesity group (all P ＜0.01 ).(3) The population attributable arteriosclerosis risk was 19.1％ and 11.6％in overweight and obesity groups,respectively.The area under the ROC curve was 0.661 (95％ CI:0.645 -0.678,P ＜ 0.01 ) and the optimal cut-off point for BMI to evaluate arteriosclerosis was 24.25 kg/m2.Conclusions Overweight and obese residents faced higher risk for arteriosclerosis than normal population.Overweight and obesity are independent risk factors for arteriosclerosis after adjusting for age,gender and hypertension.