中国成年人体重指数与心血管危险因素关系的研究

李剑虹; 王丽敏; 黄正京; 张梅; 李镒冲; 王文绢; 陈波; 王临虹

文章摘要

李剑虹,王丽敏,黄正京,张梅,李镒冲,王文绢,陈波,王临虹.中国成年人体重指数与心血管危险因素关系的研究[J].中华流行病学杂志,2014,35(9):977-980

中国成年人体重指数与心血管危险因素关系的研究

Study on the relationship between BMI and the risk of cardiovascular among Chinese adults

收稿日期:2014-03-10 出版日期:2014-09-11

DOI：10.3760/cma.j.issn.0254-6450.2014.09.001

中文关键词: 体重指数超重肥胖心血管危险因素

英文关键词: Body mass index Overweight Obesity Cardiovascular risk factors

基金项目:

作者	单位	E-mail
李剑虹	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心	linhong@chinawch.org.cn
王丽敏	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心
黄正京	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心
张梅	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心
李镒冲	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心
王文绢	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心
陈波	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心
王临虹	100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心

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中文摘要:

目的探讨中国成年人BMI与主要心血管危险因素及其聚集的关系。方法 2010年在全国31个省（区、市）的162个监测点，采用多阶段分层整群随机抽样方法，调查了98 271名>18岁居民。采用面对面询问调查、身体测量和实验室检测方法收集吸烟、饮酒、膳食、身体活动等慢性病主要危险因素及高血压、糖尿病、血脂异常等主要慢性病患病情况。将24 kg/m²≤BMI<28 kg/m²和≥28 kg/m²定义为超重和肥胖，在对样本经过复杂加权后，分析不同BMI组别人群心血管危险因素及其聚集情况。结果我国成年人超重率和肥胖率分别为30.6%（95%CI：29.5%～31.7%）和12.0%（95%CI：11.0%～12.9%），男性超重率高于女性，差异有统计学意义（χ²=16.09，P<0.001），45～65岁组人群超重率和肥胖率最高（χ²值分别为485.17和112.23，P<0.001）。心血管危险因素（SBP、DBP、TG、TC、HDL-C、LDL-C、FPG和空腹胰岛素水平）均随着BMI的增加而增加，超重和肥胖组均高于正常组，差异有统计学意义（超重组：F值分别为4 056.19、6 860.70、3 898.91、1 624.73、2 337.21、2 558.01、1 049.01和1 665.52，P<0.001；肥胖组：F值分别为5 628.68、9 949.81、5 508.77、1 656.34、2 452.05、2 365.92、1 441.72 和6 081.27，P<0.001）。高血压、血脂异常、糖尿病、胰岛素抵抗和心血管危险因素聚集的患病率均随着BMI的增加而增加，超重和肥胖组均高于正常组，差异有统计学意义（超重组：χ²值分别为704.70、521.86、431.35、449.13和686.83，P<0.001；肥胖组：χ²值分别为113.45、645.03、1 063.30、1 547.86和1 909.66，P<0.001）。多因素分析显示，调整年龄和性别后，超重和肥胖组高血压、血脂异常、糖尿病、胰岛素抵抗和心血管危险因素聚集的发病风险分别为正常组的2.5和5.5、2.2和3.4、1.8和2.9、2.9和8.2、3.3和8.9倍。结论我国成年人随着BMI的增加，患心血管疾病的危险增大，应将控制BMI作为慢病防控的优先指标。

英文摘要:

Objective To study the relationship between body mass index (BMI) and cardiovascular risk factors among Chinese adult population. Methods 98 271 subjects aged 18 years or over were recruited from 162 surveillance points around 31 provinces in China's mainland in 2010,under a complex multistage stratified sampling method. The survey included face-to-face interview,physical measurement and laboratory testing,to collect information related to the prevalence of risk factors as smoking,drinking,diet and physical activities as well as the prevalence of main chronic disease as hypertension,diabetes and dyslipidemia. 24 kg/m²≤BMI<28 kg/m² was defined as overweight and BMI≥28 kg/m² was defined as obese. After a complex weighting on the sample,level and proportion of cardiovascular risk factors in groups of different BMI were analyzed. Results The overall prevalence rates of overweight and obesity were 30.6% (95%CI:29.5%-31.7%) and 12.0% (95%CI:11.0%-12.9%) and were significantly higher in men for overweight (χ²=16.09,P<0.001) and those aged 45-65 years old for both overweight and obesity (χ² values were 485.17 and 112.23 both P<0.001), respectively. The levels of systolic blood pressure (SBP), diastolic blood pressure (DBP),triglyceride (TG),total cholesterol(TC),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C),fasting plasma glucose (FPG) and fasting blood insulin (FBI) showed a significantly increase on BMI and were seen higher in overweight (F values were 4 056.19,6 860.70,3 898.91,1 624.73,2 337.21,2 558.01,1 049.01 and 1 665.52,with both Ps<0.001) respectively and obese participants (F values were 5 628.68,9 949.81,5 508.77,1 656.34,2 452.05,2 365.92,1 441.72 and 6 081.27,respectively; all Ps<0.001). The prevalence rates of hypertension,dyslipidemia,diabetes,insulin resistance and clustering of cardiovascular disease showed a significantly increase on BMI and were higher in overweight (χ² values were 704.70,521.86,431.35, 449.13 and 686.83,both Ps<0.001),and obese participants (χ² values were 113.45,645.03,1 063.30,1 547.86 and 1 909.66,both Ps< 0.001),respectively. After adjustment for age and gender,participants with 24 kg/m²≤BMI<28 kg/m² and BMI≥28 kg/m² increased the risks of hypertension, dyslipidemia, diabetes, insulin resistance and clustering of cardiovascular disease by 2.5/5.5,2.2/3.4,1.8/2.9, 2.9/8.2 and 3.3/8.9 times than participants with BMI<28 kg/m²,respectively. Conclusion The risk of cardiovascular disease parallelly increased with BMI among Chinese adults. Rational control on BMI should be viewed as priority on chronic disease prevention and control.

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