BMI、腰围与睡眠质量对成年人高血压患病风险的联合作用

王思佳; 李莉; 孙东晗; 邬闻文

doi:10.16462/j.cnki.zhjbkz.2022.03.003

BMI、腰围与睡眠质量对成年人高血压患病风险的联合作用

doi: 10.16462/j.cnki.zhjbkz.2022.03.003

王思佳¹,
李莉²,
孙东晗²,
邬闻文^{2, 3, ,}

1.
442000 十堰，湖北医药学院第一临床学院麻醉学系
2.
442000 十堰，湖北医药学院附属人民医院循证护理研究所
3.
442000 十堰，湖北医药学院公共卫生与健康学院预防医学教研室

基金项目:

湖北省教育厅中青年人才项目 Q20202104

详细信息

通讯作者:
邬闻文，E-mail: 335631216@qq.com

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2021-06-06
- 修回日期: 2021-08-27
- 网络出版日期: 2022-03-17
- 刊出日期: 2022-03-10

The combined effects of BMI, waist circumference, and sleep quality on the prevalence of hypertension in adults

WANG Si-jia¹,
LI Li²,
SUN Dong-han²,
WU Wen-wen^{2, 3
, ,}

1.
Department of Anesthesia, First Clinical Medicine School, Hubei University of Medicine, Shiyan 442000, China
2.
Institute of Medicine and Nursing, Hubei University of Medicine, Shiyan 442000, China
3.
Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan 442000, China

Funds:

Natural Science Foundation of Hubei Provincial Department of Education Q20202104

More Information

Corresponding author: WU Wen-wen, E-mail: 335631216@qq.com

摘要

摘要: 目的探讨成年人BMI、腰围与睡眠质量的联合作用对高血压患病风险的影响。方法采用便利抽样法，于2020年10月12日―2020年12月18日对十堰市3 195名成年居民进行问卷调查。采用Logistic回归分析模型分析BMI、腰围与睡眠质量对高血压患病的联合作用。结果高血压患病率为18.22%。多因素Logistic回归分析模型分析显示，以BMI正常且睡眠质量好的组为对照组，体重过轻且睡眠质量好的组、超重且睡眠质量好的组、全身型肥胖且睡眠质量好的组、体重过轻且睡眠质量差的组、BMI正常且睡眠质量差的组、超重且睡眠质量差的组、全身型肥胖且睡眠质量差的组高血压患病风险分别是对照组的4.049倍、1.172倍、4.625倍、4.581倍、1.166倍、5.476倍和8.230倍。以腰围正常且睡眠质量好的组为对照组，腹型肥胖且睡眠质量好的组、腰围正常且睡眠质量差的组、腹型肥胖且睡眠质量差的组高血压患病风险分别是对照组的4.017倍、3.074倍和7.495倍。结论睡眠质量差和全身型肥胖或腹型肥胖共存会增加高血压的患病风险，提示睡眠质量差的人群控制BMI和腰围有利于高血压的预防。
- BMI /
- 腰围 /
- 睡眠 /
- 高血压
Abstract: Objective To evaluate the combined effects of BMI, waist circumference (WC) and sleep quality on the prevalence of hypertension in adults. Methods A questionnaire survey was conducted among 3 195 adult residents in Shiyan City from October to December, 2020 by convenience sampling method. The Logistic regression model was used to estimate the combined effects of BMI, WC and sleep quality on hypertension prevalence. Results The prevalence of hypertension was 18.22%. Multivariate Logistic regression analysis showed that compared to those with normal BMI/good sleep quality, the subgroup with BMI < 18.5kg/m²/good sleep quality (OR=4.049), with overweight/good sleep quality (OR=1.172), with general obesity/good sleep quality (OR=4.625), with BMI < 18.5kg/m²/poor sleep quality (OR=4.581), with normal BMI/poor sleep quality (OR=1.166), with overweight/poor sleep quality (OR=5.476), and with general obesity/poor sleep quality (OR=8.230) had increased the risk of hypertension. In addition, compared to those with normal WC/good sleep quality, the subgroup with abdominal obesity/good sleep quality (OR=4.017), with normal WC/poor sleep quality (OR=3.074), and with abdominal obesity/poor sleep quality (OR=7.495) also had increased the risk of hypertension. Conclusion The co-existence of poor sleep quality and general or abdominal obesity increase the risk of hypertension, suggesting that the control of BMI and WC in people with poor sleep quality is beneficial to the prevention of hypertension.
- BMI /
- Waist circumference /
- Sleep /
- Hypertension

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图 1 睡眠质量、BMI与高血压患病率的关系

注：BMI，1=BMI值< 18.5 kg/m²，2=BMI值为18.5~ < 24.0 kg/m²，3=BMI值为24.0~ < 28.0 kg/m²，4=BMI值为≥28.0 kg/m²；睡眠质量，1=PSQI < 5分，2=PSQI≥5分。

Figure 1. Relationship between sleep quality, BMI and prevalence of hypertension

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图 2 睡眠质量、WC与高血压患病率的关系

注：腰围: 1=正常，2=腹型肥胖；睡眠质量: 1=PSQI < 5分，2=PSQI≥5分。

Figure 2. Relationship between sleep quality, WC and prevalence of hypertension

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表 1 不同特征居民的高血压患病情况[n(%)]

Table 1. The prevalence of hypertension in residents with different characteristics [n(%)]

变量	调查人数	有高血压	无高血压	χ²值	P值	变量	调查人数	有高血压	无高血压	χ²值	P值
性别				0.736	0.391	饮酒				5.853	0.016
男	1 440(45.07)	253(17.57)	1 187(82.43)			不饮酒	1 087(34.02)	173(15.92)	914(84.08)
女	1 775(54.93)	329(18.75)	1 426(81.25)			饮酒	2 108(65.98)	409(19.40)	1 699(80.60)
年龄(岁)				8.253	0.016	劳动强度				15.698	0.001
18~ < 40	545(17.06)	76(13.94)	469(86.06)			轻度	985(30.83)	153(15.53)	823(84.47)
40~ < 60	1 610(50.39)	303(18.82)	1 307(81.48)			中度	1 130(35.37)	193(17.08)	937(82.92)
≥60	1 040(32.55)	203(19.52)	837(80.48)			重度	720(22.53)	161(22.36)	559(77.64)
居住地				7.853	0.005	极重度	360(11.27)	75(20.83)	285(79.17)
城市	1 710(53.52)	281(16.43)	1 429(83.57)			体育锻炼				8.679	0.003
农村	1 485(46.48)	301(20.27)	1 184(79.73)			有	1 930(60.41)	383(19.84)	1 547(80.16)
文化程度				66.259	< 0.001	没有	1 265(39.59)	199(15.73)	1 066(84.27)
初中及以下	765(23.94)	211(27.58)	554(72.42)			糖尿病				238.462	< 0.001
高中/中专	865(27.08)	154(17.80)	711(82.20)			是	545(17.06)	226(41.47)	319(58.53)
大专	770(24.10)	112(14.55)	658(85.45)			否	2 650(82.94)	356(13.43)	2 294(86.57)
本科	495(15.49)	70(14.14)	425(85.86)			WC				113.24	< 0.001
研究生	300(9.39)	35(11.67)	265(88.33)			正常	2 365(74.02)	329(13.91)	2 036(86.09)
婚姻状况				20.014	< 0.001	腹型肥胖	830(25.98)	253(30.48)	577(69.52)
已婚	2 225(69.64)	389(17.48)	1 836(82.52)			BMI(kg/m²)				258.058	< 0.001
未婚	720(22.54)	133(18.47)	587(81.53)			< 18.5	303(9.48)	62(20.46)	241(79.54)
离异	190(5.94)	36(18.95)	154(81.05)			18.5~ < 24.0	1 605(50.24)	128(7.98)	1 477(92.02)
丧偶	60(1.88)	24(40.00)	36(60.00)			24.0~ < 28.0	842(26.35)	214(25.42)	628(74.58)
家庭人均月收入(元)				28.784	< 0.001	≥28.0	445(13.93)	178(40.00)	267(60.00)
< 500	690(21.60)	173(25.07)	507(74.93)			睡眠质量				69.188	< 0.001
500~ < 1 000	855(26.76)	148(17.31)	707(82.69)			好	885(27.70)	80(9.04)	805(90.96)
1 000~2 000	795(24.88)	129(16.23)	666(83.77)			差	2 310(72.30)	502(21.73)	1 808(78.27)
>2 000	855(26.76)	132(15.44)	723(84.56)
吸烟				13.267	< 0.001
不吸烟	1 188(37.18)	178(14.98)	1 010(85.02)
吸烟	2 007(62.82)	404(20.13)	1 603(79.87)

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表 2 高血压患病影响因素的Logistic回归分析模型分析

Table 2. Logistic regression analysis of the possible associated factors for hypertension prevalence

变量	OR(95% CI)值	P值
睡眠质量
好	1.000
差	1.743(1.311~2.317)	< 0.001
BMI(kg/m²)
< 18.5	3.852(2.681~5.533)	< 0.001
18.5~ < 24.0	1.000
24.0~ < 28.0	3.733(2.860~4.874)	< 0.001
≥28.0	5.687(4.231~7.643)	< 0.001
WC
正常	1.000
腹型肥胖	2.457(1.974~3.058)	< 0.001
注：调整的变量有年龄、居住地、文化程度、婚姻状况、家庭人均月收入、吸烟、饮酒、锻炼、劳动强度、糖尿病。

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表 3 睡眠质量与全身型肥胖的联合作用对高血压影响的Logistic回归分析模型分析

Table 3. Logistic regression analysis of the combined effect of sleep quality and systemic obesity on hypertension

BMI(kg/m²)	PSQI < 5分		PSQI≥5分
BMI(kg/m²)	OR(95% CI)值	P值	OR(95% CI)值	P值
模型一
< 18.5	3.592(1.807~7.139)	< 0.001	4.072(2.595~6.391)	< 0.001
18.5~ < 24.0	1.000	―	1.411(0.955~2.083)	0.084
24.0~ < 28.0	1.052(0.479~2.311)	0.899	6.186(4.321~8.856)	< 0.001
≥28.0	6.560(3.499~12.296)	< 0.001	10.314(7.039~15.112)	< 0.001
模型二
< 18.5	4.049(1.968~8.332)	< 0.001	4.581(2.872~7.307)	< 0.001
18.5~ < 24.0	1.000	―	1.166(0.777~1.750)	0.458
24.0~ < 28.0	1.172(0.525~2.617)	0.698	5.476(3.754~7.987)	< 0.001
≥28.0	4.625(2.339~9.146)	< 0.001	8.230(5.492~12.331)	< 0.001
注：模型一校正的变量：年龄；模型二校正的变量：年龄、居住地、文化程度、婚姻状况、家庭人均月收入、吸烟、饮酒、锻炼、劳动强度、糖尿病。

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表 4 睡眠质量与腹型肥胖的联合作用对高血压影响的Logistic回归分析模型分析

Table 4. Logistic regression analysis of the combined effect of sleep quality and central obesity on hypertension

BMI(kg/m²)	PSQI < 5分		PSQI≥5分
BMI(kg/m²)	OR(95% CI)值	P值	OR(95% CI)值	P值
模型一
正常	1.000	-	3.650(2.558~5.208)	< 0.001
腹型肥胖	4.587(2.859~7.358)	< 0.001	8.774(6.042~12.739)	< 0.001
模型二
正常	1.000	-	3.074(2.127~4.442)	< 0.001
腹型肥胖	4.017(2.447~6.594)	< 0.001	7.495(5.071~11.084)	< 0.001
注：模型一校正的变量：年龄；模型二校正的变量：年龄、居住地、文化程度、婚姻状况、家庭人均月收入、吸烟、饮酒、锻炼、劳动强度、糖尿病。

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