西双版纳3个族群成人不同肥胖指标与血压的关系
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摘要
为了探究不同肥胖判定指标与血压的关系,对云南省西双版纳傣族自治州布朗族、八甲人和基诺族的1 311例(男性为543例,女性为768例)成人进行腰围、腰臀比、内脏脂肪等级、体脂率、BMI等肥胖指标的测量,对各项指标与血压的关系进行相关性分析、logistic回归分析和ROC曲线分析.结果表明:(1)3个族群中,5项肥胖指标与血压均高度相关(P<0.01),其中,内脏脂肪等级、腰臀比、腰围与血压相关性较高,体脂率居中,BMI的相关性最低;(2)几种肥胖判定指标都是高血压患病的危险因素,内脏脂肪等级、腰臀比、腰围增加,危险性更高;(3)各项肥胖指标对高血压的ROC曲线面积均在0.5～0.7之间,内脏脂肪等级、腰臀比、腰围预测高血压的效果最好,其次是体脂率,BMI的效果最差.总的来看,西双版纳3个族群的中心型肥胖(内脏脂肪等级、腰臀比、腰围)与血压的相关性更高,男性腰围、腰臀比超标和女性内脏脂肪等级超标者患高血压的风险最高.
In order to investigate the relationship between obesity index and blood pressure,1 311 adults(543 male and768 female)of Blang,Bajia and Keno in Xishuangbanna Dai Autonomous Prefecture of Yunnan Province were randomly sampled. Five obesity indicators,including waist circumference(WC),waist-to-hip ratio(WHR),visceral fat level(VFL),percent body fat(PBF)and BMI were measured,and the relationships between indicators and blood pressure were analyzed,including correlation analysis,logistic regression analysis and ROC curve analysis. The results showed that:(1)Five obesity indexes have highly statistical correlations with blood pressure(P<0.01),among which the correlations of VFL,WHR and WC with blood pressure are higher,and PBF and BMI have moderate and the lowest correlations with blood pressure respectively;(2) The five obesity indexes are the risk factors of hypertension,and with the increase of VFL,WHR,and WC,hypertension risk is more severe;(3) The ROC curve areas of five obesity indexes with hypertension are ranged from0.5 to 0.7,among which VFL,WHR and WC have the best prediction of hypertension,the predication effect of PBF is moderate,and BMI has the smallest prediction effect. Overall,as for the three ethnic groups in Xishuangbanna,the central type obesity(VFL,WHR and WC)is closely associated with blood pressure and is at greater risk of hypertension. The males with overdue WC and WHR and the females with overdue VFL have the highest hypertension risk.
In order to investigate the relationship between obesity index and blood pressure,1 311 adults(543 male and768 female)of Blang,Bajia and Keno in Xishuangbanna Dai Autonomous Prefecture of Yunnan Province were randomly sampled. Five obesity indicators,including waist circumference(WC),waist-to-hip ratio(WHR),visceral fat level(VFL),percent body fat(PBF)and BMI were measured,and the relationships between indicators and blood pressure were analyzed,including correlation analysis,logistic regression analysis and ROC curve analysis. The results showed that:(1)Five obesity indexes have highly statistical correlations with blood pressure(P<0.01),among which the correlations of VFL,WHR and WC with blood pressure are higher,and PBF and BMI have moderate and the lowest correlations with blood pressure respectively;(2) The five obesity indexes are the risk factors of hypertension,and with the increase of VFL,WHR,and WC,hypertension risk is more severe;(3) The ROC curve areas of five obesity indexes with hypertension are ranged from0.5 to 0.7,among which VFL,WHR and WC have the best prediction of hypertension,the predication effect of PBF is moderate,and BMI has the smallest prediction effect. Overall,as for the three ethnic groups in Xishuangbanna,the central type obesity(VFL,WHR and WC)is closely associated with blood pressure and is at greater risk of hypertension. The males with overdue WC and WHR and the females with overdue VFL have the highest hypertension risk.
引文
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[9]李森,汤强,盛蕾,等.江苏省成年人肥胖与高血压的分布变化趋势[J].中国体育科技,2012,48(5):127-132.LI S,TANG Q,SHENG L,et al. Distribution tendency study of adult obesity and hypertension in Jiangsu Province[J]. China Sport Science and Technology,2012,48(5):127-132(in Chinese).
[10]席焕久,陈昭.人体测量方法[M]. 2版.北京:科学出版社,2010.XI H J,CHEN Z. Anthropometric Methods[M]. 2nd edition. Beijing:Science Press,2010(in Chinese).
[11]董文静,王雅萱,宇克莉.探讨3种肥胖指标对凉山彝族中心性肥胖的预测[J].天津师范大学学报(自然科学版),2017,37(1):76-80.DONG W J,WANG Y X,YU K L. Discussion on three kinds of obesity index evaluation of central obesity of Yi nationality[J]. Journal of Tianjin Normal University(Natural Science Edition),2017,37(1):76-80(in Chinese).
[12]乌云格日勒,陈勇,谭清国,等.根据BMI和体脂百分比标准判别成人肥胖度效力的评估性研究[J].山东体育学院学报,2009,25(1):51-56.WUYUNGERILE,CHEN Y,TAN Q G,et al. Assessment of adult obesity potency based on BMI and body fat percentage standard[J].Journal of Shandong Institute of Physical Education and Sports,2009,25(1):51-56(in Chinese).
[13] WILLIAM J,AUDREY C,CHOH,MIRYOUNG L,et al. Characterization of the infant BMI peak:Sex differences,birth year cohort effects,association with concurrent adiposity,and heritability[J]. American Journal of Human Biology,2013,25(3):378-388.
[14]姜勇,赵文华.成人肥胖的评价方法、指标及标准在公共卫生中应用的研究进展[J].卫生研究,2013,42(4):701-705.JIANG Y,ZHAO W H. Research progress on the methods,indicators and standards of adult obesity in public health[J]. Journal of Hygiene Research,2013,42(4):701-705(in Chinese).
[15]李红娟,杨柳,张楠.身体质量指数作为肥胖筛查标准的判别准确性评价[J].中国预防医学杂志,2014,15(6):571-575.LI H J,YANG L,ZHANG N. Accuracy of body mass index as a screening standard for obesity[J]. Chinese Preventive Medicine,2014,15(6):571-575(in Chinese).
[16]宇克莉,郑连斌,李咏兰,等.海南临高人身体成分分析[J].人类学学报,2017,36(1):101-109.YU K L,ZHENG L B,LI Y L,et al. Body Composition Analysis of the Lingao Ethnic Group in Hainan Province[J]. Acta Anthropologica Sinica,2017,36(1):101-109(in Chinese).
[17]蒋建家,曾又晓,林振忠,等.肥胖者内脏脂肪蓄积与脂代谢的关系[J].心血管康复医学杂志,2012,21(5):489-491.JIANG J J,ZENG Y X,LIN Z Z,et al. Relationship between visceral fat accumulation and lipid metabolism in obese patients[J]. Chinese Journal Cardiovascular Rehabilitation Medicine,2012,21(5):489-491(in Chinese).
[18]罗明.心血管疾病新论[M].上海:同济大学出版社,2006.LUO M. New Discussion on Cardiovascular Diseases[M]. Shang Hai:Tongji University Press,2006(in Chinese).
[19]罗海吉,杨铭,江淑仪,等.中国西部三省1 825名居民体成分测试结果分析//中国西部第六届营养与健康学术会议论文集[C].2011.LUO H J,YANG M,JIANG S Y,et al. An Analysis on Body Composition of 1 825 Residents in Three Provinces of China west side//The Sixth Academic Conference on Nutrition and Health in Western China[C]. 2011(in Chinese).
[20]贾德梅,许传志,张川荛,等.昆明地区汉族成人人体成分与血脂的相关性研究[J].昆明医科大学学报,2015,36(2):29-32.JIA D M,XU C Z,ZHANG C Y,et al. Correlation between body component and blood fat of Han adults in Kunming[J]. Journal of Kunming Medical University,2015,36(2):29-32(in Chinese).
[21]张小飞.云南三个少数民族肥胖流行和影响因素对比及与高血压关系的研究[D].昆明:昆明医科大学,2016.ZHANG X F. Comparing Prevalence and Related Factors of Obesity and Central Obesity Among Three Ethnic Minorities in Yunnan Province and Exploring the Relationship with Hypertension[D]. Kunming:Kunming Medical University,2016(in Chinese).
[22]张梅,姜勇,汪媛,等.中国成人腰围、体质指数与高血压关系[J].中国公共卫生,2009,25(6):693-695.ZHANG M,JIANG Y,WANG Y,et al. Analysis on association of waist circum stance and body mass index with risk of hypertension in Chinese adult[J]. Chinese Journal of Public Health,2009,25(6):693-695(in Chinese).
[23]张伟. 20~59岁城市非体力劳动者身体成分现状研究——以江苏省南京市为例[J].北京体育大学学报,2010,33(7):51-54.ZHANG W. A research on the development tendency of body composition of urban non-manual workers—A case study of Nanjing,Jiangsu Province[J]. Journal of Beijing Sport University,2010,33(7):51-54(in Chinese).
[24]张海龙,席焕久,李文慧,等.利用生物电阻抗法分析辽宁汉族成人脂肪分布特点[J].解剖学报,2012,43(6):850-854.ZHANG H L,XI H J,LI W H,et al. Analysing the fat distribution characteristics of Han adults in Liaoning by bioelectrical impedance method[J]. Acta Anatomica Sinica,2012,43(6):850-854(in Chinese).
[25]杨帆,李康,杨颖,等.生物电阻抗法测量的内脏脂肪面积与性别年龄及代谢性因素的相关性分析[J].中国介入心脏病学杂志,2016,24(3):134-141.YANG F,LI K,YANG Y,et al. Association of visceral fat area measured by bioelectrical impedance analysis with sex,age and metabolic risk factors[J]. Chinese Journal of Interventional Cardiology,2016,24(3):134-141(in Chinese).
[2] COOK N R,GILLMAN M W,ROSNER B A,et al. Prediction of young adult blood pressure from childhood blood pressure,height,and weight[J]. Journal of Clinical Epidemiology,1997,50(5):571-579.
[3]乐熙文,洪凌燕,周小军,等.南昌市西湖区居民高血压相关因素的非条件logistic回归分析[J].南昌大学学报(医学版),2013,53(6):72-77.LE X W,HONG L Y,ZHOU X J,et al. Non-conditional logistic regression analysis on risk factors for hypertension residents in Xihu District of Nanchang[J]. Journal of Nanchang University(Medical Sciences),2013,53(6):72-77(in Chinese).
[4]芦慧霞. BMI正常腹型肥胖与对照人群饮食及高脂负荷膳餐后糖脂代谢的比较研究[D].南京:东南大学,2011.LU H X. Comparative Studying of Diet and High-Fat Meal on Postprandial Glycemia and Lipid Metabolism Between Abdominal Obesity People with Normal BMI and Control[D]. Nanjing:Southeast University,2011(in Chinese).
[5]刘昭璐.中国成年人群不同肥胖指标的变化趋势及对高血压的影响因素研究[D].济南:山东大学,2016.LIU Z L. The Research of the Trend and the Influence Factors on Hypertension of Different Obesity Indexes of the Adult Population in China[D].Jinan:Shandong University,2016(in Chinese).
[6]雷静.不同肥胖指标与高血压易感性的关联研究及肥胖对高血压靶器官损伤的影响[D].长沙:中南大学,2014.LEI J. The Association Study on Different Obesity Indexes and the Susceptibility Hypertension and the Influence of Obesity on the Target Organ Damage of Hypertension[D]. Changsha:Central South University,2014(in Chinese).
[7]王劲松,余金明,胡大一,等.北京城乡社区20~44岁居民高血压患病率及其危险因素[J].中华高血压杂志,2009,17(9):811-816.WANG J S,YU J M,HU D Y,et al. Prevalence of Hypertension and Risk Factors Among Young Adults Aged 20 to 44 Years in Beijing Community[J]. Chinese Journal of Hypertension,2009,17(9):811-816(in Chinese).
[8]张彦军,朱慧峰,乜金茹.南京某高职院校学生肥胖指标与血压的相关性分析[J].中国学校卫生,2015,36(10):1574-1577.ZHANG Y J,ZHU H F,NIE J R. Analysis of the correlation between obesity and blood pressure in a vocational college in Nanjing[J]. Chinese Journal of School Health,2015,36(10):1574-1577(in Chinese).
[9]李森,汤强,盛蕾,等.江苏省成年人肥胖与高血压的分布变化趋势[J].中国体育科技,2012,48(5):127-132.LI S,TANG Q,SHENG L,et al. Distribution tendency study of adult obesity and hypertension in Jiangsu Province[J]. China Sport Science and Technology,2012,48(5):127-132(in Chinese).
[10]席焕久,陈昭.人体测量方法[M]. 2版.北京:科学出版社,2010.XI H J,CHEN Z. Anthropometric Methods[M]. 2nd edition. Beijing:Science Press,2010(in Chinese).
[11]董文静,王雅萱,宇克莉.探讨3种肥胖指标对凉山彝族中心性肥胖的预测[J].天津师范大学学报(自然科学版),2017,37(1):76-80.DONG W J,WANG Y X,YU K L. Discussion on three kinds of obesity index evaluation of central obesity of Yi nationality[J]. Journal of Tianjin Normal University(Natural Science Edition),2017,37(1):76-80(in Chinese).
[12]乌云格日勒,陈勇,谭清国,等.根据BMI和体脂百分比标准判别成人肥胖度效力的评估性研究[J].山东体育学院学报,2009,25(1):51-56.WUYUNGERILE,CHEN Y,TAN Q G,et al. Assessment of adult obesity potency based on BMI and body fat percentage standard[J].Journal of Shandong Institute of Physical Education and Sports,2009,25(1):51-56(in Chinese).
[13] WILLIAM J,AUDREY C,CHOH,MIRYOUNG L,et al. Characterization of the infant BMI peak:Sex differences,birth year cohort effects,association with concurrent adiposity,and heritability[J]. American Journal of Human Biology,2013,25(3):378-388.
[14]姜勇,赵文华.成人肥胖的评价方法、指标及标准在公共卫生中应用的研究进展[J].卫生研究,2013,42(4):701-705.JIANG Y,ZHAO W H. Research progress on the methods,indicators and standards of adult obesity in public health[J]. Journal of Hygiene Research,2013,42(4):701-705(in Chinese).
[15]李红娟,杨柳,张楠.身体质量指数作为肥胖筛查标准的判别准确性评价[J].中国预防医学杂志,2014,15(6):571-575.LI H J,YANG L,ZHANG N. Accuracy of body mass index as a screening standard for obesity[J]. Chinese Preventive Medicine,2014,15(6):571-575(in Chinese).
[16]宇克莉,郑连斌,李咏兰,等.海南临高人身体成分分析[J].人类学学报,2017,36(1):101-109.YU K L,ZHENG L B,LI Y L,et al. Body Composition Analysis of the Lingao Ethnic Group in Hainan Province[J]. Acta Anthropologica Sinica,2017,36(1):101-109(in Chinese).
[17]蒋建家,曾又晓,林振忠,等.肥胖者内脏脂肪蓄积与脂代谢的关系[J].心血管康复医学杂志,2012,21(5):489-491.JIANG J J,ZENG Y X,LIN Z Z,et al. Relationship between visceral fat accumulation and lipid metabolism in obese patients[J]. Chinese Journal Cardiovascular Rehabilitation Medicine,2012,21(5):489-491(in Chinese).
[18]罗明.心血管疾病新论[M].上海:同济大学出版社,2006.LUO M. New Discussion on Cardiovascular Diseases[M]. Shang Hai:Tongji University Press,2006(in Chinese).
[19]罗海吉,杨铭,江淑仪,等.中国西部三省1 825名居民体成分测试结果分析//中国西部第六届营养与健康学术会议论文集[C].2011.LUO H J,YANG M,JIANG S Y,et al. An Analysis on Body Composition of 1 825 Residents in Three Provinces of China west side//The Sixth Academic Conference on Nutrition and Health in Western China[C]. 2011(in Chinese).
[20]贾德梅,许传志,张川荛,等.昆明地区汉族成人人体成分与血脂的相关性研究[J].昆明医科大学学报,2015,36(2):29-32.JIA D M,XU C Z,ZHANG C Y,et al. Correlation between body component and blood fat of Han adults in Kunming[J]. Journal of Kunming Medical University,2015,36(2):29-32(in Chinese).
[21]张小飞.云南三个少数民族肥胖流行和影响因素对比及与高血压关系的研究[D].昆明:昆明医科大学,2016.ZHANG X F. Comparing Prevalence and Related Factors of Obesity and Central Obesity Among Three Ethnic Minorities in Yunnan Province and Exploring the Relationship with Hypertension[D]. Kunming:Kunming Medical University,2016(in Chinese).
[22]张梅,姜勇,汪媛,等.中国成人腰围、体质指数与高血压关系[J].中国公共卫生,2009,25(6):693-695.ZHANG M,JIANG Y,WANG Y,et al. Analysis on association of waist circum stance and body mass index with risk of hypertension in Chinese adult[J]. Chinese Journal of Public Health,2009,25(6):693-695(in Chinese).
[23]张伟. 20~59岁城市非体力劳动者身体成分现状研究——以江苏省南京市为例[J].北京体育大学学报,2010,33(7):51-54.ZHANG W. A research on the development tendency of body composition of urban non-manual workers—A case study of Nanjing,Jiangsu Province[J]. Journal of Beijing Sport University,2010,33(7):51-54(in Chinese).
[24]张海龙,席焕久,李文慧,等.利用生物电阻抗法分析辽宁汉族成人脂肪分布特点[J].解剖学报,2012,43(6):850-854.ZHANG H L,XI H J,LI W H,et al. Analysing the fat distribution characteristics of Han adults in Liaoning by bioelectrical impedance method[J]. Acta Anatomica Sinica,2012,43(6):850-854(in Chinese).
[25]杨帆,李康,杨颖,等.生物电阻抗法测量的内脏脂肪面积与性别年龄及代谢性因素的相关性分析[J].中国介入心脏病学杂志,2016,24(3):134-141.YANG F,LI K,YANG Y,et al. Association of visceral fat area measured by bioelectrical impedance analysis with sex,age and metabolic risk factors[J]. Chinese Journal of Interventional Cardiology,2016,24(3):134-141(in Chinese).