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基于病例-队列设计的BMI、腰围与高血压、T2DM的关联性分析

A case-cohort study on the association between BMI,waist circumference and hypertension,T2DM
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摘要 目的:基于病例-队列设计分析BMI、腰围与高血压、2型糖尿病(T2DM)的关联。方法:采用中国健康与营养调查2009至2015年数据构建2种疾病的病例-队列,绘制限制性立方样条图评估BMI、腰围与高血压、T2DM患病是否具有线性关系,采用Prentice法加权Cox比例风险回归模型估计BMI、腰围与高血压、T2DM患病风险的关联。结果:病例-队列设计初始共纳入4564人,按19%随机抽取863人为对照组,随访结束,4564人中1167人患高血压(高血压病例组),37人患T2DM(T2DM病例组)。限制性立方样条图显示BMI与高血压患病呈非线性关系,与T2DM患病呈线性关系;腰围与二者均呈线性关系(P<0.05)。Prentice法加权Cox比例风险回归分析结果显示校正混杂因素后,超重和肥胖者患高血压的风险分别是正常人的1.36倍和1.46倍(95%CI分别为1.19~1.54,1.19~1.79),而腰围每增加1 cm,患高血压风险增加1.02倍(95%CI为1.01~1.02)(P<0.05);BMI每增加1 kg/m 2,患T2DM风险增加1.13倍,腰围每增加1 cm,患T2DM风险增加1.06倍(95%CI分别为1.03~1.23,1.03~1.10)(P<0.05)。结论:超重、肥胖者更容易患高血压、T2DM,腰围越大,越容易患高血压、T2DM。 Aim:To study the association of BMI and waist circumference with hypertension and type 2 diabetes mellitus(T2DM)based on a case-cohort design.Methods:Using data from the China Health and Nutrition Survey 2009-2015,case-cohorts of 2 diseases were constructed,and restricted cubic spline and the Prentice method weighted Cox proportional risk regression model were used to estimate the association of BMI,waist circumference and the risk of hypertension and T2DM.Results:In the case-cohort design analysis,4564 people were enrolled.Among them,19%(863 people)were sampled as control,and at the end of follow-up,1167 developed hypertension(hypertension case group),and 37 developed T2DM(T2DM case group).The results of restricted cubic spline showed that there were a non-linear relationship between BMI and the onset of hypertension,a linear relationship between BMI and the onset of T2DM,and between waist circumference and the onset of hypertension or T2DM.Prentice method weighted Cox proportional risk regression analysis showed that after correction for confounders,overweight(OR=1.36,95%CI:1.19~1.54)and obesity(OR=1.46,95%CI:1.19-1.79)were risk factors for hypertension;and each unit increased in waist circumference(cm)increased the risk of hypertension by 1.02 times(95%CI:1.01~1.02)(P<0.05).Each unit increased in BMI(kg/m 2),the risk of T2DM increased by 1.13 times(95%CI:1.03-1.23),and each unit increased in waist circumference(cm)increased the risk of T2DM by 1.06 times(95%CI:1.03-1.10)(P<0.05).Conclusion:Overweight and obese people are more likely to develop hypertension and T2DM,and the larger is the waist circumference,the more likely they are to develop hypertension and T2DM.
作者 库超越 奚丽婧 杨雪珂 吴彬彬 王睿哲 代漫 平智广 KU Chaoyue;XI Lijing;YANG Xueke;WU Binbin;WANG Ruizhe;DAI Man;PING Zhiguang(Department of Computer and Health Statistics,College of Public Health,Zhengzhou University,Zhengzhou 450001)
出处 《郑州大学学报(医学版)》 CAS 北大核心 2024年第4期518-523,共6页 Journal of Zhengzhou University(Medical Sciences)
基金 河南省自然科学基金项目(182300410303) 河南省高等院校重点科研项目(23B330005)。
关键词 高血压 2型糖尿病 BMI 腰围 限制性立方样条图 病例-队列设计 hypertension type 2 diabetes mellitus body mass index waist circumference restricted cubic spline case-cohort design
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