腰围动态变化与高血压发病关系的前瞻陛研究

骆文书; 郭志荣; 胡晓抒; 周正元; 武鸣; 张丽君; 刘景超

Abstract

骆文书,郭志荣,胡晓抒,周正元,武鸣,张丽君,刘景超.腰围动态变化与高血压发病关系的前瞻陛研究[J].Chinese journal of Epidemiology,2012,33(1):28-31

腰围动态变化与高血压发病关系的前瞻陛研究

A prospective study on the association between dynamic change of waist circumference and incident hypertension

Received:September 07, 2011

DOI：

KeyWord: 腰围高血压前瞻性研究

English Key Word: Waist ckcumference Hypertension Prospective study

FundProject:卫生部科学研究基金(WKJ2004—2-014)

Author Name	Affiliation	E-mail
LUO Wen-shu	Department of Radiology＆Public Health, Soochow University, Suzhou 215123, China
GUO Zhi-rong	Department of Radiology＆Public Health, Soochow University, Suzhou 215123, China	Email：guozhiron928@163．com
HU Xiao-shu	Health Bureau of Jiangsu Province
ZHOU Zheng-yuan	Changshu City Center for Disease Control and Prevention
WU Ming	Jiangsu Provincial Center for Disease Control and Prevention
ZHANG Li-jun	Department of Radiology＆Public Health, Soochow University, Suzhou 215123, China
LIU Jing-chao	Department of Radiology＆Public Health, Soochow University, Suzhou 215123, China

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Abstract:

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。

English Abstract:

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.

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