【摘要】：目的本研究旨在探討國(guó)人成年早期體重狀態(tài)、成年早期至中年時(shí)期長(zhǎng)期體重變化對(duì)中年時(shí)期高血壓患病風(fēng)險(xiǎn)的影響。方法選取參加1998年中國(guó)心血管病流行病學(xué)多中心協(xié)作研究(ChinaMUCA)的15組人群樣本,每個(gè)人群整群抽樣約1000人,其年齡在35～59歲(定義為中年時(shí)期),男女各半,進(jìn)行心血管病危險(xiǎn)因素調(diào)查,調(diào)查包括詢問研究對(duì)象25歲時(shí)(定義為成年早期)的體重。根據(jù)研究對(duì)象25歲時(shí)的體重和調(diào)查時(shí)的身高,計(jì)算其25歲時(shí)的體重指數(shù)(BMI);研究對(duì)象按成年早期BMI水平分為4組:低體重組(BMI18.5 kg/m2)、正常體重組(BMI:18.5～23.9 kg/m2)、超重組(BMI:24～27.9 kg/m2)、和肥胖組(BMI≥28 kg/m2)。25歲至中年時(shí)期的體重變化為現(xiàn)測(cè)體重與25歲體重差值,根據(jù)體重變化將研究對(duì)象分為-7.5 kg組、-7.5～-2.6 kg組、-2.5～2.5 kg組、2.6～7.5kg組、7.6～12.5kg組和12.5kg組共6組,分別探討25歲時(shí)的體重狀態(tài)和隨后的體重變化與高血壓的關(guān)系。結(jié)果共有14635人納入分析,3525人本次調(diào)查時(shí)被診斷為高血壓,研究對(duì)象25歲時(shí)低體重組、正常體重組、超重組和肥胖組高血壓患病率分別為17.97%(250/1391),23.35%(2558/10953),30.34%(653/2152)和 46.04%(64/139),呈明顯上升趨勢(shì)(趨勢(shì)檢驗(yàn)P0.01)。25歲至中年時(shí)期的體重變化-7.5 kg組、-7.5-2.6kg組、-2.5～2.5 kg組、2.6～7.5 kg組、7.6～12.5 kg組和12.5 kg組高血壓患病率分別為15.99%(154/963),14.96%(303/2025),15.42%(422/2737),20.97%(617/2942),27.13%(756/2787),和40.02%(1273/3181),也呈明顯上升趨勢(shì)(趨勢(shì)檢驗(yàn)P0.01)。多因素Logistic回歸調(diào)整年齡、性別及其他混雜因素后結(jié)果顯示,25歲時(shí)的超重和肥胖以及隨后的體重增加均與中年時(shí)期高血壓患病風(fēng)險(xiǎn)獨(dú)立正相關(guān)(趨勢(shì)檢驗(yàn)P0.01)。體重減輕能顯著降低超重或肥胖者(BMI≥24 kg/m2)中年時(shí)期高血壓患病風(fēng)險(xiǎn),與體重變化-2.5～2.5 kg(穩(wěn)定體重)相比,體重變化-7.5～-2.6 kg組和-7.5 kg組中年時(shí)期高血壓患病風(fēng)險(xiǎn)顯著下降,比值比(OR值)和95%置信區(qū)間(CI)分別為 0.78(0.66-0.92)和 0.59(0.47-0.73),成年早期即處于較低體重者(BMI:18.5-20.9 kg/m2),同樣的體重減輕并不能降低高血壓的患病風(fēng)險(xiǎn),OR(95%CI)分別為0.87(0.59-1.28)和 0.96(0.45-2.06),無統(tǒng)計(jì)學(xué)意義。結(jié)論成年早期的超重和肥胖、成年早期至中年時(shí)期的體重增加均與中年時(shí)期高血壓患病風(fēng)險(xiǎn)獨(dú)立相關(guān),體重減輕能夠顯著降低超重或肥胖者的高血壓患病風(fēng)險(xiǎn),低體重者繼續(xù)減重并無獲益。
[Abstract]:Objective to investigate the effects of early adult weight status and long term weight change from early adulthood to middle age on the risk of hypertension in Chinese adults. Methods Fifteen groups of subjects who participated in the 1998 Chinese multi-center study of cardiovascular epidemiology (ChinaMUCA) were selected. Each group included about 1000 people, whose age was 35 ~ 59 years old (defined as middle age), half male and half male. A cardiovascular risk factor survey was conducted in which subjects were asked about their weight at the age of 25 (defined as early adulthood). According to the weight of the subjects at the age of 25 and their height at the time of the survey, The body mass index (BMI);) at the age of 25 was calculated and divided into four groups according to BMI levels in early adulthood: low weight group (BMI18.5 kg/m2), normal weight group (BMI:18.5~23.9 kg/m2), hyperrecombination (BMI:24~27.9 kg/m2), and obese group (BMI 鈮，

本文編號(hào)：2220457