打鼾与BMI对高血压患病的交互作用

丁帅; 缪伟刚; 覃玉; 苏健; 崔岚; 杜文聪; 周金意; 武鸣

doi:10.16462/j.cnki.zhjbkz.2021.05.017

打鼾与BMI对高血压患病的交互作用

doi: 10.16462/j.cnki.zhjbkz.2021.05.017

丁帅¹,
缪伟刚²,
覃玉²,
苏健²,
崔岚²,
杜文聪²,
周金意²,
武鸣^1, ,

1.
210000 南京，东南大学公共卫生学院流行病与卫生统计学系
2.
210000 南京，江苏省疾病预防控制中心慢性非传染病防制所

基金项目:

国家重大公共卫生项目 Cai She﹝2014﹞No.37

详细信息

通讯作者:
武鸣，E-mail: jswuming@vip.sina.com

中图分类号: R541
计量
- 文章访问数: 340
- HTML全文浏览量: 108
- PDF下载量: 35
- 被引次数: 0
出版历程
- 收稿日期: 2021-02-02
- 修回日期: 2021-03-23
- 网络出版日期: 2021-06-16
- 刊出日期: 2021-05-10

A study on the interaction of snoring and body mass index on hypertension

1.
Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210000, China
2.
Department of Chronic Non-communicable Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210000, China

Funds:

National Major Public Health Service Project Cai She﹝2014﹞No.37

More Information

Corresponding author: WU Ming, E-mail: jswuming@vip.sina.com

摘要

摘要: 目的分析打鼾与BMI对高血压患病的交互作用，以制定合适的预防策略。方法基于2015年9月-2018年6月江苏省心血管病高危人群早期筛查与综合干预项目(China patientcentered evaluative assessment of cardiac events-million persons project, China PEACE-MPP)中82 751名≥35岁居民初筛数据，通过Logistic回归分析模型分析打鼾与BMI对高血压患病的影响，并进一步分析其交互作用。结果 82 751名调查对象中，打鼾者45 013人，占比54.40%，BMI≥24 kg/m²者52 641人，占比63.61%，高血压患者47 295人占比，57.15%。打鼾(OR=1.686, 95% CI: 1.635~1.738)和BMI≥24 kg/m²(OR=2.242, 95% CI: 2.172~2.313)人群罹患高血压的风险较高。打鼾与BMI≥24 kg/m²对高血压患病存在相加交互作用(RERI=1.160, AP=0.311, S=1.738)，两者同时存在时患高血压风险是两者均不存在时的3.732倍(95% CI：3.582~3.888)。结论打鼾与BMI≥24 kg/m²都增加了高血压的患病风险，且存在相加交互作用。应针对打鼾与BMI≥24 kg/m²的人群进行健康教育和血压监测，预防高血压等心脑血管疾病的发生。
- 高血压 /
- 打鼾 /
- MI /
- 交互作用 /
- 心血管疾病
Abstract: Objective To analyze the interaction between snoring and body mass index (BMI) on hypertension, and to develop appropriate prevention strategies. Methods Based on the preliminary screening data of 82 751 residents aged ≥35 in the China Peace-MPP program for High-risk Cardiovascular Disease population in Jiangsu Province from September 2015 to June 2018, logistic regression analysis was used to evaluate the impact of snoring and body mass index on hypertension, and the interaction between snoring and BMI was further analyzed. Results Among the subjects, the prevalence of snorers was 45 013 (54.40%), hypertension was 47 295 (57.15%), people with BMI≥24 kg/m² was 52 641 (63.61%). People who snored and high BMI were at higher risk for hypertension, the odds ratio (OR) was 1.686(95% CI: 1.635-1.738)and 2.242 (95% CI: 2.172-2.313), respectively. Snoring and BMI were found to have synergistic effects on hypertension (RERI=1.160, AP=0.311, S=1.738). The risk of hypertension was 3.732 times greater when these factors both were present compared with neither was present (95% CI: 3.582-3.888). Conclusions Both snoring and overweight increased the risk of hypertension, with synergistic effects. Health education and blood pressure monitoring should be carried out for people who snored and overweight to prevent the occurrence of hypertension and cardiovascular diseases.
- Hypertension /
- Snoring /
- Body mass index /
- Interaction /
- Cardiovascular disease

HTML全文

表 1 不同高血压状况研究对象的人口学特征[n(%)]

Table 1. Demographic characteristics of the study population with different hypertension status [n(%)]

项目	高血压		χ²值	P值
项目	是(n=47 295)	否(n=35 456)	χ²值	P值
性别			519.367	＜0.001
男性	19 808(62.10)	12 087(37.90)
女性	27 487(54.05)	23 369(45.95)
年龄(岁)			6749.159	＜0.001
＜45	2 358(25.97)	6 721(74.03)
45~＜60	19 229(51.63)	18 017(48.37)
≥60	25 708(70.58)	10 718(29.42)
年收入(万元)			483.661	＜0.001
＜1	8 383(65.94)	4 331(34.06)
1~≤5	21 187(55.52)	16 973(44.48)
＞5	13 578(55.12)	11 057(44.88)
不清楚	4 147(57.26)	3 095(42.74)
城乡			806.827	＜0.001
城市	21 817(52.31)	19 893(47.69)
农村	25 478(62.08)	15 563(37.92)
文化程度			2 214.995	＜0.001
小学及以下	26 596(64.90)	14 385(35.10)
初中	13 867(51.01)	13 320(48.99)
高中	4 862(50.20)	4 823(49.80)
大学及以上	1 692(38.91)	2 656(61.09)
不清楚	278(50.55)	272(49.45)
婚姻状况			102.307	＜0.001
在婚	43 463(56.66)	33 239(43.34)
其他	3 832(63.35)	2 217(36.65)
BMI(kg/m²)			3 616.923	＜0.001
＜24	13 090(43.47)	17 020(56.53)
≥24	34 205(64.98)	18 436(35.02)
吸烟			100.723	＜0.001
是	9 869(60.64)	6 405(39.36)
否	37 426(56.30)	29 051(43.70)
饮酒			821.484	＜0.001
是	8 825(68.65)	4 030(31.35)
否	38 470(55.04)	31 426(45.96)
打鼾			2 567.453	＜0.001
是	29 319(65.13)	15 694(34.87)
否	17 976 (47.63)	19 762(52.37)
打鼾频率			3 025.225	＜0.001
不打鼾	17 976(47.63)	19 762(52.37)
有时打鼾	6 847(58.06)	4 945(41.94)
经常打鼾	4 720(61.93)	2 901(38.07)
总是打鼾	17 752(69.34)	7 848(30.66)

下载: 导出CSV

表 2 打鼾与BMI与高血压患病的Logistic回归分析

Table 2. Logistic regression analysis for the presence of hypertension according to snoring status and body mass index

变量	高血压/非高血压	模型1^a：OR(95% CI)值	模型2^b：OR(95% CI)值	模型3^c：OR(95% CI)值	P值^d
BMI(kg/m²)					< 0.001
＜24	17 976/19 762	1.000	1.000	1.000
≥24	29 319/15 694	2.412(2.343~2.483)	2.460(2.386~2.537)	2.242(2.172~2.313)
P值		< 0.001	< 0.001	< 0.001
打鼾					< 0.001
否	13 090/17 020	1.000	1.000	1.000
是	34 205/18 436	2.054(1.997~2.112)	1.945(1.888~2.004))	1.686(1.635~1.738)
P值		< 0.001	< 0.001	< 0.001
注：^a模型1：未调整；^b模型2：调整性别、年龄、年收入、文化程度、城乡、婚姻情况；^c模型3：在模型2基础上调整吸烟、饮酒、BMI、打鼾(作为分析因素时除外); ^dP值对于三个模型均有P < 0.001。

下载: 导出CSV

表 3 打鼾和BMI的交互作用分析

Table 3. Interactions between snoring and body mass index

打鼾	BMI	高血压/非高血压	OR^a(95% CI)值	P值
否	＜24 kg/m²	6 636/10 894	1.000	-
是	＜24 kg/m²	6 454/6 454	1.516(1.443~1.592)	< 0.001
否	≥24 kg/m²	11 340/8 868	2.056(1.969~2.148)	< 0.001
是	≥24 kg/m²	22 865/9 568	3.732(3.582~3.888)	< 0.001
交互作用	相加	RERI^a=1.160(1.036~1.284)
		AP^a=0.311(0.282~0.340)
		S^a=1.738(1.622~1.861)
	相乘	OR^a=1.201(1.128~1.278)
注：^a模型1：调整性别、年龄、年收入、文化程度、吸烟、饮酒、城乡、婚姻状况。

下载: 导出CSV

参考文献(30)

[1]	Wang Z, Chen Z, Zhang L, et al. Status of hypertension in China: results from the China hypertension survey, 2012-2015[J]. Circulation, 2018, 137(22): 2344-2356. DOI: 10.1161/CIRCULATIONAHA.117.032380
[2]	Joint Committee for Guideline Revision. 2018 Chinese guidelines for prevention and treatment of hypertension—a report of the Revision Committee of Chinese guidelines for prevention and treatment of hypertension[J]. J Geriatr Cardiol, 2019, 16(3): 182-241. DOI: 10.11909/j.issn.1671-5411.2019.03.014.
[3]	胡盛寿, 高润霖, 刘力生, 等. 《中国心血管病报告2018》概要[J]. 中国循环杂志, 2019, 34(3): 209-220. DOI: 10.3969/j.issn.1000-3614.2019.03.001. Hu SS, Gao RL, Liu LS, et al. Summary of the 2018 report on cardiovascular diseases in China[J]. Chin Circul J, 2019, 34(3): 209-220. DOI: 10.3969/j.issn.1000-3614.2019.03.001.
[4]	Hu FB, Willett WC, Colditz GA, et al. Prospective study of snoring and risk of hypertension in women[J]. Am J Epidemiol, 1999, 150(8): 806-816. DOI: 10.1093/oxfordjournals.aje.a010085.
[5]	Lindberg E, Berne C, Franklin KA, et al. Snoring and daytime sleepiness as risk factors for hypertension and diabetes in women--a population-based study. [J]. Respir Med, 2007, 101(6): 1283-1290. DOI: 10.1016/j.rmed.2006.10.015.
[6]	冯宝玉, 陈纪春, 李莹, 等. 中国成年人超重和肥胖与高血压发病关系的随访研究[J]. 中华流行病学杂志, 2016, 37(5): 606-611. DOI: 10.3760/cma.j.issn.0254-6450.2016.05.004. Feng BY, Chen JC, Li Y, et al. Relationship between overweight/obesity and hypertension among adults in China: a prospective study[J]. Chin J Epidemiol, 2016, 37(5): 606-611. DOI: 10.3760/cma.j.issn.0254-6450.2016.05.004.
[7]	何忠明, 韩芳, 李鸿霞, 等. 打鼾与高血压的关系研究[C] //中国睡眠研究会. 中国睡眠研究会第六届学术年会论文集. 2010: 215-218. He ZM, Han F, Li HX, et al. Investigation on the relationship between snoring and hypertension[C]// Chinese Sleep Research Society. Proceedings of the 6th annual meeting of the Chinese Sleep Research Society. 2010: 215-218.
[8]	马金香, 孙业桓, 曹多志, 等. 男性打鼾与高血压的关系[J]. 中国慢性病预防与控制, 2005, 13(2): 60-62, 72. DOI: 10.3969/j.issn.1004-6194.2005.02.005. Ma JX, Sun YH, Cao DZ, et al. Association between Snoring and Hypertension in Male Workers in Ma'anshan Iron and Steel Enterprise[J]. Chin J Prev Contr Chro Dis, 2005, 13(2): 60-62, 72. DOI: 10.3969/j.issn.1004-6194.2005.02.005.
[9]	佟明坤, 满塞丽麦, 金成, 等. 千万例体检人群高血压患病率、知晓率、治疗率和控制率的调查[J]. 中国循环杂志, 2020, 35(9): 866-872. DOI: 10.3969/j.issn.1000-3614.2020.09.004 Tong MK, Man SLM, Jin C, et al. Prevalence, awareness, treatment and control of hypertension in China: survey on a 10 million health check-up population[J]. Chin Circul J, 2020, 35(9): 866-872. DOI: 10.3969/j.issn.1000-3614.2020.09.004
[10]	Lu J, Xuan S, Downing NS, et al. Protocol for the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) Million Persons Project pilot[J]. BMJ Open, 2016, 6(1): e010200. DOI: 10.1136/bmjopen-2015-010200.
[11]	中国肥胖问题工作组. 中国成人超重与肥胖症预防与控制指南(节录)[J]. 营养学报, 2004, 26(1): 1-4. DOI: 10.3321/j.issn:0512-7955.2004.01.001. Group of China Obesity Task Force. Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults[J]. Acta Nutrimenta Sinica, 2004, 26(1): 1-4. DOI: 10.3321/j.issn:0512-7955.2004.01.001.
[12]	人类年龄段划分新标准[J]. 现代养生, 2005, (9): 16. DOI: CNKI:SUN:YSXD.0.2005-09-013. New standards for human age[J]. Xiandaiyangsheng, 2005, (9): 16. DOI: CNKI:SUN:YSXD.0.2005-09-013.
[13]	刘晨越, 吴爽, 邱琳, 等. 陕西省不同年龄段人群吸烟状况研究[J]. 中国慢性病预防与控制, 2020, 28(6): 439-443. DOI: 10.16386/j.cjpccd.issn.1004-6194.2020.06.009. Liu CY, Wu S, Qiu L, et al. Investigation on smoking status of different age groups in shaanxi province[J]. Chin J Prev Contr Chron Dis, 2020, 28(6): 439-443. DOI: 10.16386/j.cjpccd.issn.1004-6194.2020.06.009.
[14]	覃世龙, 徐静东, 罗西. 武汉市20~34岁青年饮酒状况及影响因素研究[J]. 中国慢性病预防与控制, 2019, 27(3): 185-188. DOI: 10.16386/j.cjpccd.issn.1004-6194.2019.03.006. Qin SL, Xu JD, Luo X. Investigation on drinking behavior and its influencing factors among youth aged 20-34 in Wuhan city[J]. Chin J Prev Contr Chron Dis, 2019, 27(3): 185-188. DOI: 10.16386/j.cjpccd.issn.1004-6194.2019.03.006.
[15]	夏艳杰, 周龙, 李莹. 打鼾与高甘油三酯血症关系的横断面研究[J]. 中国循环杂志, 2019, 34(1): 85-89. DOI: 10.3969/j.issn.1000-3614.2019.01.014. Xia YJ, Zhou L, Li Y. Relationship between snoring and hypertriglyceridemia in middle-aged Chinese population : a cross-sectional study[J]. Chinese Circulation Journal, 2019, 34(1): 85-89. DOI: 10.3969/j.issn.1000-3614.2019.01.014.
[16]	Andersson T, Alfredsson L, Kallberg H, et al. Calculating measures of biological interaction[J]. Eur J Epidemiol, 2005, 20(7): 575-579. DOI: 10.1007/s10654-005-7835-x.
[17]	Wenning F, Shiyi C, Bing L, et al. Association of general and central adiposity with blood pressure among Chinese adults: results from the China National Stroke Prevention Project[J]. J Hypertens, 2018. DOI: 10.1097/HJH.0000000000001852.
[18]	Knol MJ, Vanderweele TJ. Recommendations for presenting analyses of effect modification and interaction[J]. Int J Epidemiol, 2012, 41(2): 514-520. DOI: 10.1093/ije/dyr218.
[19]	Jinyoung K, Hyeryeon Y, Rim SK, et al. Snoring as an Independent Risk Factor for Hypertension in the Nonobese Population: The Korean Health and Genome Study[J]. American Journal of Hypertension, 2007, 20(8). DOI: 10.1016/j.amjhyper.2007.03.007.
[20]	Lindberg E, Janson C, Gislason T, et al. Snoring and hypertension: a 10 year follow-up[J]. Eur Respir J, 1998, 11(4): 884-889. DOI: 10.1183/09031936.98.11040884.
[21]	夏艳杰. 打鼾与心血管病及其代谢性危险因素的关系研究[D]. 中国医学科学院北京协和医学院, 2019. Xia YJ. Relationships of snoring habits with cardiovascular disease and its metabolic risk factors[D]. CAMS and PUMC, 2019.
[22]	Bixler EO, Vgontzas AN, Lin HM, et al. Association of hypertension and sleep-disordered breathing[J]. Arch Intern Med, 2000, 160(15): 2289-2295. DOI: 10.1001/archinte.160.15.2289.
[23]	郭向娇, 李建彬, 武恩平, 等. 郑州市40~79岁居民高血压患病及影响因素分析[J]. 预防医学, 2020, 32(3): 304-306. DOI: 10.19485/j.cnki.issn2096-5087.2020.03.023. Guo XJ, Li JB, Wu EP, et al. Prevalence of hypertension and its influencing factors among residents aged 40 to 79 in Zhengzhou[J]. J Prev Med, 2020, 32(3): 304-306. DOI: 10.19485/j.cnki.issn2096-5087.2020.03.023.
[24]	彭艳. 重庆市高血压患病率及其与超重、肥胖、睡眠时间相关性分析[D]. 重庆: 重庆医科大学, 2018. Peng Y. Prevalence of hypertension and association with overweight, obesity and sleep time in Chongqing.[D]. Chongqing: Chongqing Medical University, 2018.
[25]	Gnatiuc L, Alegre-Diaz J, Halsey J, et al. Adiposity and Blood Pressure in 110 000 Mexican Adults[J]. Hypertension, 2017, 69(4): 608-614. DOI: 10.1161/HYPERTENSIONAHA.116.08791.
[26]	芦波, 桂明泰, 符德玉. 肥胖相关高血压的发病机制[J]. 国际心血管病杂志, 2015, 42(1): 16-18, 25. DOI: 10.3969/j.issn.1673-6583.2015.01.005. Lu B, Gui MT, Fu DY. Pathogenesis of obesity-associated hypertension[J]. Int J Cardiov Dis, 2015, 42(1): 16-18, 25. DOI: 10.3969/j.issn.1673-6583.2015.01.005.
[27]	Kotsis V, Stabouli S, Papakatsika S, et al. Mechanisms of obesity-induced hypertension[J]. Hypertens Res, 2010, 33(5): 386-93. DOI: 10.1038/hr.2010.9.
[28]	Dorresteijn JA, Visseren FL, Spiering W. Mechanisms linking obesity to hypertension[J]. Obes Rev, 2012, 13(1): 17-26. DOI: 10.1111/j.1467-789X.2011.00914.x.
[29]	谢开婿, 王春梅, 陈玲琍. 睡眠打鼾与浙江省成年人高血压患病关联的研究[J]. 中华流行病学杂志, 2020, 41(5): 722-726. DOI: 10.3760/cma.j.cn112338-20190814-00596. Xie KX, Wang CM, Chen LL, et al. Association between snoring and hypertension among Zhejiang adults in a cross sectional study[J]. Chin J Epidemiol, 2020, 41(5): 722-726. DOI: 10.3760/cma.j.cn112338-20190814-00596.
[30]	Li Y, Gao Q, Li L, et al. Additive interaction of snoring and body mass index on the prevalence of metabolic syndrome among Chinese coal mine employees: a cross-sectional study[J], BMC Endocr Disord, 2019, 19(1). DOI: 10.1186/s12902-019-0352-9.

施引文献

资源附件(0)

访问统计

点击查看大图

项目	高血压		χ²值	P值
项目	是(n=47 295)	否(n=35 456)	χ²值	P值
性别			519.367	＜0.001
男性	19 808(62.10)	12 087(37.90)
女性	27 487(54.05)	23 369(45.95)
年龄(岁)			6749.159	＜0.001
＜45	2 358(25.97)	6 721(74.03)
45~＜60	19 229(51.63)	18 017(48.37)
≥60	25 708(70.58)	10 718(29.42)
年收入(万元)			483.661	＜0.001
＜1	8 383(65.94)	4 331(34.06)
1~≤5	21 187(55.52)	16 973(44.48)
＞5	13 578(55.12)	11 057(44.88)
不清楚	4 147(57.26)	3 095(42.74)
城乡			806.827	＜0.001
城市	21 817(52.31)	19 893(47.69)
农村	25 478(62.08)	15 563(37.92)
文化程度			2 214.995	＜0.001
小学及以下	26 596(64.90)	14 385(35.10)
初中	13 867(51.01)	13 320(48.99)
高中	4 862(50.20)	4 823(49.80)
大学及以上	1 692(38.91)	2 656(61.09)
不清楚	278(50.55)	272(49.45)
婚姻状况			102.307	＜0.001
在婚	43 463(56.66)	33 239(43.34)
其他	3 832(63.35)	2 217(36.65)
BMI(kg/m²)			3 616.923	＜0.001
＜24	13 090(43.47)	17 020(56.53)
≥24	34 205(64.98)	18 436(35.02)
吸烟			100.723	＜0.001
是	9 869(60.64)	6 405(39.36)
否	37 426(56.30)	29 051(43.70)
饮酒			821.484	＜0.001
是	8 825(68.65)	4 030(31.35)
否	38 470(55.04)	31 426(45.96)
打鼾			2 567.453	＜0.001
是	29 319(65.13)	15 694(34.87)
否	17 976 (47.63)	19 762(52.37)
打鼾频率			3 025.225	＜0.001
不打鼾	17 976(47.63)	19 762(52.37)
有时打鼾	6 847(58.06)	4 945(41.94)
经常打鼾	4 720(61.93)	2 901(38.07)
总是打鼾	17 752(69.34)	7 848(30.66)

表(3)

计量

文章访问数: 340
HTML全文浏览量: 108
PDF下载量: 35
被引次数: 0

姓名
邮箱
手机号码
标题
留言内容
验证码

留言板

打鼾与BMI对高血压患病的交互作用

doi: 10.16462/j.cnki.zhjbkz.2021.05.017

通讯作者:
武鸣，E-mail: jswuming@vip.sina.com

计量

A study on the interaction of snoring and body mass index on hypertension

Corresponding author: WU Ming, E-mail: jswuming@vip.sina.com

计量

目录

留言板

打鼾与BMI对高血压患病的交互作用

doi: 10.16462/j.cnki.zhjbkz.2021.05.017

通讯作者: 武鸣，E-mail: jswuming@vip.sina.com

计量

出版历程

A study on the interaction of snoring and body mass index on hypertension

Corresponding author: WU Ming, E-mail: jswuming@vip.sina.com

计量

出版历程

目录

通讯作者:
武鸣，E-mail: jswuming@vip.sina.com