CAJ | 학술논문

目的比较不同类型肥胖与心血管疾病(CVD)危险因素的关联,为预防和控制心血管疾病提供科学依据.方法利用"2002年中国居民营养与健康状况调查"资料,按照<中国成人超重和肥胖症预防控制指南>中判定肥胖的界值点[体重指数(BMI):24kg/m2和28 kg/m2;腰围:男性85 cm和95 cm,女性80 cm和90 cm]判定肥胖类型,比较不同类型肥胖人群与罹患CVD危险因素的关联;用logistic回归和多元线性回归分析BMI和腰围与CVD危险因素的关系.结果与体重和腰围均在正常范围的人群(OR=1)相比,正常体重并高腰围Ⅰ(男性85～95 cm,女性80～90 cm)的人群、超重但腰围正常的人群罹患CVD危险因素的风险为1～2倍,超重并高腰围Ⅰ、肥胖但腰围正常的人群为2～3倍,超重并高腰围Ⅱ(男性≥95 cm,女性≥90 cm)、肥胖并高腰围Ⅰ或Ⅱ(男性≥85 cm,女性≥80 cm)的人群为≥3倍;同一腰围组中,随着BMI增加罹患CVD危险因素的风险也呈逐渐增加趋势;BMI和腰围同时解释CVD危险因素变异的1.7%～9.4%,大于BMI或腰围单独解释的比例(1.5%～9.0%);BMI对于收缩压的标化回归系数为0.129,略大于腰围(0.123),腰围对甘油三酯、总胆固醇和高密度脂蛋白胆同醇标化回归系数的绝对值大于BMI.结论 BMI和腰围与CVD危险因素独立相关,建议评估疾病危险时同时使用BMI和腰围两项指标.
목적 비교불동류형비반여심혈관질병(CVD)위험인소적관련,위예방화공제심혈관질병제공과학의거.방법 이용"2002년중국거민영양여건강상황조사"자료,안조<중국성인초중화비반증예방공제지남>중판정비반적계치점[체중지수(BMI):24kg/m2화28 kg/m2;요위:남성85 cm화95 cm,녀성80 cm화90 cm]판정비반류형,비교불동류형비반인군여리환CVD위험인소적관련;용logistic회귀화다원선성회귀분석BMI화요위여CVD위험인소적관계.결과 여체중화요위균재정상범위적인군(OR=1)상비,정상체중병고요위Ⅰ(남성85～95 cm,녀성80～90 cm)적인군、초중단요위정상적인군리환CVD위험인소적풍험위1～2배,초중병고요위Ⅰ、비반단요위정상적인군위2～3배,초중병고요위Ⅱ(남성≥95 cm,녀성≥90 cm)、비반병고요위Ⅰ혹Ⅱ(남성≥85 cm,녀성≥80 cm)적인군위≥3배;동일요위조중,수착BMI증가리환CVD위험인소적풍험야정축점증가추세;BMI화요위동시해석CVD위험인소변이적1.7%～9.4%,대우BMI혹요위단독해석적비례(1.5%～9.0%);BMI대우수축압적표화회귀계수위0.129,략대우요위(0.123),요위대감유삼지、총담고순화고밀도지단백담동순표화회귀계수적절대치대우BMI.결론 BMI화요위여CVD위험인소독립상관,건의평고질병위험시동시사용BMI화요위량항지표.
Objective To compare the odds ratio of waist circumference (WC) and/or body mass index (BMI) on cardiovascular risk factors. Methods Data on a cross-sectional study involving 41 087 adults (19 567 male, 21 520 female) from the 2002 China National Nutrition and Health Survey were examined. According to the obesity definition of the Chinese Working Group on Obesity for Children (WGOC) (BMI, 24 and 28 kg/m2; WC, male 85 cm, female 80 cm), the study population were divided into 9 groups. The prevalence and odds ratio (OR) of cardiovascular disease (CVD) risk factors were compared among these 9 groups. Variation and standard β were indexes being used to compare the likelihood of BMI and/or WC on CVD risk factors. Results Within each of the BMI categories, with few exceptions, indices levels on CVD risk factors were significantly increased (decreased for HDL-C levels) with the increase of WC, and vice versa. After adjusting the effects of age, sex, income, education, sedentary activity and dietary factors, the ORs of hypertension in adults with higher WC within each of the BMI categories were higher than adults with lower WC, and the ORs of hypertension in adults with higher BMI within each of the WC categories were higher than adults with lower BMI. Similar trends were found for high fast plasma glucose (FPG) and dyslipidemia. The variation in CVD risk factors explained only by WC and BMI were quite similar,but slightly larger when combined WC with BMI. Standard β was higher on BMI when predicting systolic BP and was higher on WC when predicting TG, TC and HDL-C. Conclusion BMI and WC were independently associated with the risk factors on CVD.To combine the BMI and WC, the results could accurately evaluate the risk of CVD, thus to provide substantive evidence that the WGOC cutoff points for the WC might help in identifying those population under increased risk.