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
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- 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

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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)

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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。

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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。

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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)

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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