•临床研究•DOI:10.3760/cma.j.issn.1000-6699.2016.03.007基金项目:国家代谢性疾病临床医学研究中心(2013BAI09B13);科

技部重大新药创制项目(2012ZX09303006-001)

作者单位:330006南昌,江西省人民医院内分泌科Email:139********@http://www.mianfeiwendang.com 社区中老年人颈围与心血管危险因素的

相关性分析

霍亚南㊀徐芳华㊀徐艳㊀章玉玲㊀REACTION 研究组

㊀㊀ʌ摘要ɔ㊀目的㊀了解社区中老年人颈围与心血管危险因素的相关性㊂方法

对社区40岁及以上居民9665名进行问卷调查,检测身高㊁体重㊁颈围㊁腰围㊁血压㊁血脂㊁血糖㊁HbA 1C ㊁空腹胰岛素等㊂采用SPSS 16.0进行统计学分析㊂结果(1)无论男女,颈围与腰围㊁体重指数㊁血压㊁血糖㊁低密度脂蛋白胆固醇㊁三酰甘油和胰岛素抵抗指数均呈正相关㊁与高密度脂蛋白胆固醇呈负相关(均P <0.05);男性颈围与总胆固醇呈正相关(P <0.01),女性颈围与总胆固醇不相关(P >0.05)㊂(2)男性颈围增大会增加糖尿病的发生风险(OR =1.14,95%CI 1.02~1.28);女性颈围增大会增加高血压(OR =1.17,95%CI 1.08~1.27)㊁糖尿病(OR =1.24,

95%CI 1.13~1.37)㊁血脂异常(OR =1.17,95%CI 1.09~1.27)和胰岛素抵抗(OR =1.15,95%CI 1.06~1.26)的发生风险㊂在女性颈围影响较男性更大㊂结论颈围是心血管危险因素独立关联的指标㊂ʌ关键词ɔ㊀颈围;心血管危险因素;中老年人Relationships between the neck circumference and cardiovascular risk factors of middle-aged and elder people in community Huo Yanan ,Xu Fanghua ,Xu Yan ,Zhang Yuling ,the REACTION Study Group.Department of Endocrinology ,Jiangxi Privincial Peopleᶄs Hospital ,Nachang 330006,China Email :139********@http://www.mianfeiwendang.com ʌAbstract ɔ㊀Objective ㊀To investigate the relationships between the neck circumference and cardiovascular risk factors of middle-aged and elder people in a community.Methods Altogether 9665community residents(ageȡ40years)were enrolled in the present study.The height,weight,neck circumference,waist circumference,blood pressure,total cholesterol,triglycerides,low density lipoprotein-cholesterol (LDL-C),high density lipoprotein-cholesterol (HDL-C),blood glucose,glycosylated hemoglobin,and fasting insulin were measured,and documented in the questionnaire along with other basic information.After adjusted for age,Pearson correlation coefficient was used to analyze the relationship between the neck circumference and the binary variables of cardiovascular risk factors.SPSS 16.0software was used for statistical analysis.Results (1)The neck circumferences were(37.11ʃ2.79)cm in male and (32.79ʃ2.31)cm in female;which were higher in males than females.In both males and females,after adjusted for age,the neck circumference was positively correlated to waist circumference,body mass index,blood pressure,plasma glucose,LDL-C,triglycerides,and insulin resistance,the neck circumference was negatively correlated to HDL-C(all P <0.05);The neck circumference of males was positively correlated to total cholesterol(P <0.01);The neck circumference of females was not correlated with total cholesterol(P >0.05).(2)After adjusted for body mass index and the waist circumference,the neck circumference of males increased with the risk of diabetes (OR =1.14,95%CI 1.02-1.28);while the higher neck circumference of females increased the risk of hypertension (OR =1.17,95%CI 1.08-1.27),diabetes(OR =1.24,95%CI 1.13-1.37),dyslipidemia(OR =1.17,95%CI 1.09-1.27),and insulin resistance (OR =1.15,95%CI 1.06-1.26).The neck circumference exerted higher impact on women than it did on men.Conclusion The neck circumference is associated with the cardiovascular risk factors.This association in females is stronger than that in males.The neck circumference seems to be an independent indicator for the cardiovascular risk.ʌKey words ɔ㊀Neck circumference;Cardiovascular risk factors;Middle-aged and elder people (Chin J Endocrinol Metab ,2016,32:213-216)㊀㊀肥胖已明显影响人类健康㊂通常用体重指数㊁腰围㊁计算机断层扫描(CT)或磁共振成像(MRI)评估肥

胖㊁皮下脂肪和内脏脂肪,但研究发现肌肉组织过多

者,体重指数也相应较高[1]㊂腰围也存在地域化㊁个体化差异,且易受到饮食㊁运动等因素的影响㊂以往认为内脏脂肪的增加将导致胰岛素抵抗㊁2型糖尿病和动脉粥样硬化的增加㊂但Onat 等[2]研究发现内脏脂肪与心血管疾病风险因素的相关性并不大,提示可能存在其他机制或其他脂肪沉积,同样对心血管疾病危险因素的发生起作用㊂有研究发现以颈围评估的上身㊃312㊃中华内分泌代谢杂志2016年3月第32卷第3期㊀Chin J Endocrinol Metab,March 2016,Vol.32,No.3