原发性高血压腹型肥胖患者腰身比与心血管危险因素

Relationship Between Waist-to-height Ratio and Cardiovascular Risk Factors in Hypertensive Patients with Central Obesity

    摘要
  • 摘要: 背景腰身比是新近被推荐可替代腰围和腰臀比的腹型肥胖判断指标。目的探讨在原发性高血压人群中,腰身比这一便于测量而又得到推荐的反映腹型肥胖的指标与传统心血管危险因素的关系。方法入选初诊或未经治疗的原发性高血压患者606例,根据国外研究推荐的腰身比切点将所有入选对象分为两组:非腹型肥胖组(腰身比<0.5,n=254)和腹型肥胖组(腰身比≥0.5,n=352)。结果腹型肥胖组患者的高血压病史、腰围、体质量指数(BMI)、臂围、诊室舒张压、平均动脉压、丙氨酸氨基转移酶(ALT)、空腹血糖、血清尿酸、三酰甘油、总胆固醇/高密度脂蛋白胆固醇(HDL-C)和高敏C反应蛋白均高于非腹型肥胖组(P<0.05～0.01),而HDL-C低于非腹型肥胖组(1.1±0.3)比(1.4±0.3)mmol/L,P<0.01。Pearson相关分析显示,腰身比与年龄、高血压病史、高脂血症史、饮酒史、臂围、诊室收缩压、诊室舒张压、平均动脉压、ALT、血清肌酐、空腹血糖、血清尿酸、三酰甘油和总胆固醇/HDL-C呈正相关(r=0.086,0.233,0.160,0.135,0.707,0.098,0.187,0.168,0.320,0.113,0.140,0.115,0.323,0.297,P<0.05～0.01),与HDL-C呈负相关(r=-0.373,P<0.01)。以腰身比为因变量行多元线性回归分析,结果显示,年龄、高血压病史、ALT、HDL-C和臂围是腰身比的独立影响因素。结论高血压患者腰身比与代谢综合征各组分及诊室血压水平显著相关;年龄、高血压病史、ALT、HDL-C和臂围是腰身比的独立影响因素。

     

    Abstract: Background Waist-to-height ratio is a newly recommended alternative for waist circumference （WC） and waist-to-height ratio（WHR） in the assessment of abdominal obesity index. Objective To investigate the relationship between waist-to-height ratio,an indicator that can be measured and has been recommended reflecting abdominal obesity,and the traditional cardiovascular risk factors in patients with essential hypertension. Methods A total of 606 untreated primary hypertensive patients were consecutively recruited. They were divided into group A and group B according to previous study recommended cut points. In group A （WHR＜0.5） had 254 subjects,and in group B （WHR≥0.5） 352 subjects. Results Comparing to group A,the subjects in group B had significantly longer history of hypertension,higher WC,body mass index （BMI）,arm circumference,office diastolic blood pressure,mean arterial pressure （MAP）,serum alanine aminotransferase （ALT）,fasting blood glucose,uric acid （UA）,triglyceride （TG）,total cholesterol/high density lipoprotein cholesterol （TC/HDL-C） and high-sensitivity C reactive protein （hsCRP） （P＜0.05-0.01）; HDL-C was significantly lower in group B than that in group A （1.1±0.3） vs（1.4±0.3）mmol/L,P＜0.01. Pearson correlation analysis showed that WHR was positively and significantly correlated with age,histories of hypertension,hyperlipidemia and drinking,as well as arm circumference,office systolic,diastolic blood pressures,MAP,ALT,serum creatinine,fasting blood glucose,UA,TG,and TC/HDL-C （r=0.086,0.233,0.160,0.135,0.707,0.098,0.187,0.168,0.320,0.113,0.140,0.115,0.323,0.297,P＜0.05-0.01）; whereas negatively correlated with HDL-C（r=-0.373,P＜0.01）. Multiple linear regression analysis showed that age,history of hypertension,ALT,HDL-C and arm circumference were independent factors of WHR. Conclusion WHR is significantly correlated with components of metabolic syndrome and office blood pressure in hypertensive patients. Age,history of hypertension,ALT,HDL-C and arm circumference are independent factors to affect WHR.

     

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