新疆贫困地区维吾尔族农民肥胖与血脂异常相关性研究

肥胖及血脂异常研究很少涉及低收入地区。本研究分析了新疆低收入地区维吾尔族农民体质指数(BMI)、超重及肥胖与多种血脂分子异常的关系，探讨贫困地区筛查高危人群的适宜策略。在新疆喀什农村对3 286名年龄≥18岁个体(男1 585人，女1 701人) 进行问卷检查、体格检查及多项血脂分子的检测。数据采用Pearson相关性、ROC、Logistic回归等统计学分析。结果显示，在男女性中，随着BMI的增加，甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDLC)的血浓度呈现递增趋势（P<0.01）；男/女性TG、LDLC、TC血浓度均与BMI有显著相关性(P<0.01)。单项或多项血脂异常率均随BMI增加而上升；同一个体2个血脂指标同时异常的高危组合分别是TG+HDLC(高密度脂蛋白胆固醇)和TC+TG。Logistic联合多变量ROC曲线分析表明, 单项指标HDLC(AUC=089)在血脂异常诊断中的权重最高；而组合指标TG+HDLC(AUC=095)的权重高于其它任何组合。单因素Logistic回归分析发现，超重和肥胖是代谢综合征相关血脂指标TG、TC和HDLC异常的危险因素(P<0.05)。上述结果表明，在南疆农村贫困维吾尔族人群中，男女性超重与肥胖者均与血脂指标异常升高相关；HDLC、TG和 TC 任意两个指标同时异常，为血脂异常的高危状态。肥胖伴有“TG+HDLC”异常升高可能是血脂异常相关疾病的“集合危险因素”，在贫困地区具有临床筛查参考价值。

Overweight and Obesity among Low-income Uygur Peasants in China’s Far Western Xinjiang: Correlations Between Body Mass Index and Blood Lipids#br# #br#

Obesity and abnormal blood lipids are rarely studied in low-income communities. This article analyzed the relationships between the body mass index (BMI) and blood lipids in low-income Uyghur peasants in Kashi Prefecture, Xinjiang, China, aiming at developing a suitable screening strategy for such communities. A total of 3 286 Uyghur country residents (1 585 males and 1 701 females, respectively, aged≥18 years) were investigated in a physical examination program. These participants had complete personal information collected and blood lipids tested. Five major findings were observed: (1) In both males and females, increased BMI was correlated with increased mean levels of triglyceride (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDLC). While LDLC showed an uptrend, high density lipoprotein cholesterol (HDLC) showed a downtrend in this population. (2) In both males and females, the levels of TG, TC and LDLC were positively correlated with BMI (P<0.01). (3) In both males and females, increased BMI correlated with an uptrend in rates of dyslipidemia with single or multiple lipids; the high-risk combination of two blood lipid indicators in the same individuals was TG+HDLC or TC+TG. (4) In both males and females, the levels of TC, TG and LDLC were much higher in overweight individuals than those with normal weights and, the levels of TG, TC, and LDLC were significantly higher in obese individuals than normal weight individuals (P<005). (5) Analysis using univariate logistic regression showed that both overweight and obesity were risk factors for metabolic syndrome (MS) related indicators TG, TC and HDLC (P<0.05). In both males and females, overweight and obesity in this low-income Uygur population in Xinjiang’s Kashi Prefecture are correlated with abnormally increased blood lipids. BMI-defined overweight or obesity accompanied by abnormal levels of TG, TC and HDLC may represent “collective risk factors” for MS, implicating a clinical reference value.