北京市成年人不同体重异常判断指标与血脂异常的相关性研究

Objective: To analyze the relationship and consistency between indexes of different abnormal weight and dyslipidemia in adults in Beijing City. Methods: From August to December of 2017, 4 975 residents aged 18 to 79 years old in 5 districts of Beijing were randomly selected as subjects by using a multi-stage stratified cluster sampling method. Questionnaire, physical examination and laboratory tests were conducted. The prevalence of overweight/obesity, high body fat rate, central obesity, and high waist-to-height ratio was calculated. Partial correlation was used to analyze the correlation of blood lipid with body mass index (BMI), body fat rate, waist circumference and waist-height ratio. Logistic regression analysis for complex sampling was used to analyze the relationship between indexes of different abnormal weight and dyslipidemia after controlling for relevant risk factors, including age, sex, smoking status, drinking, insufficiency intake of vegetable and fruit, physical inactivity. Kappa value was computed to analyze the consistency between indexes of different abnormal weight. Results: The weighted prevalence of dyslipidemia was 30.48%, and it was higher in men than that in women (40.16% vs. 20.52%, P<0.01). The weighted rate of overweight/obesity, high body fat rate, central obesity, and high waist-to-height ratio was 56.65%, 47.52%, 42.48% and 59.45%, respectively. BMI, body fat rate, waist circumference and waist-to-height ratio were positively correlated with the level of total cholesterol, triglyceride, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol, and negatively correlated with high-density lipoprotein cholesterol. Logistic regression analysis for complex sampling showed that the high body fat rate (OR=1.67, 95%CI: 1.35-2.07), overweight/obesity (OR=1.65, 95%CI: 1.26-2.14) and high waist-to-height ratio (OR=1.46, 95%CI: 1.09-1.96) were associated with dyslipidemias. Kappa values of high body fat rate with overweight/obesity, high waist-to-height ratio and central obesity were 0.65, 0.53 and 0.58, respectively (P<0.05). Conclusion: In 2017, the prevalence of dyslipidemia in adults in Beijing City is high, especially in men. Overweight/obesity, high body fat rate and high waist-to-height ratio are associated with dyslipidemia. The high body fat rate is most associated with dyslipidemia.目的： 探讨北京市成年人不同体重异常判断指标与血脂异常的相关及一致性。 方法： 于2017年8至12月，采用多阶段分层整群随机抽样方法对北京市5个区18~79岁常住居民进行问卷调查、体格测量和实验室检查。分析超重肥胖、身体脂肪率高、中心型肥胖、高腰高比者的血脂异常患病率。通过偏相关分析体重指数（BMI）、身体脂肪率、腰围、腰高比与血脂水平的相关性；采用复杂抽样logistic回归模型分析不同体重异常判断指标与血脂异常之间的关联。计算Kappa值分析不同体重异常判断指标的一致性。 结果： 共纳入研究对象4 975例。血脂异常加权患病率为30.48%，男性（40.16%）高于女性（20.52%），差异有统计学意义（P<0.01）。超重肥胖、身体脂肪率高、中心型肥胖、高腰高比的加权率分别为56.65%、47.52%、42.48%和59.45%。BMI、身体脂肪率、腰围、腰高比与总胆固醇、甘油三酯、低密度脂蛋白胆固醇、非高密度脂蛋白胆固醇呈正相关，与高密度脂蛋白胆固醇呈负相关。复杂抽样logistic回归分析结果显示，身体脂肪率高（OR=1.67，95%CI：1.35~2.07）、超重肥胖（OR=1.65，95%CI：1.26~2.14）、高腰高比（OR=1.46，95%CI：1.09~1.96）与血脂异常有关。身体脂肪率高与超重肥胖、高腰高比、中心型肥胖的一致性检验Kappa值分别为0.65、0.53、0.58。 结论： 2017年北京市成人血脂异常患病率高，尤其是男性。超重肥胖、身体脂肪率高和高腰高比与血脂异常有关，且身体脂肪率高与血脂异常关联性最强。.