青年职业人群肥胖在血糖与血脂关系中的中介效应研究-现代医学

青年职业人群肥胖在血糖与血脂关系中的中介效应研究

单位：1. 贵州医科大学公共卫生与健康学院环境污染与疾病监控教育部重点实验室, 贵州贵阳 561113;
2. 上海中医药大学护理学院, 上海 201203;
3. 上海中医药大学公共卫生学院, 上海 201203;
4. 上海健康医学院附属周浦医院科研部, 上海 201318;
5. 上海市东方医院

关键词：青年职业人群体重指数腰围血脂异常中介效应

分类号：R195

出版年·卷·期（页码）：2023·51·第十二期（1690-1696）

摘要：

目的：探讨肥胖指标体重指数(BMI)、腰围(WC)在青年职业人群血糖与血脂关系中的中介效应，为预防青年职业人群血脂异常提供新思路。方法：依托上海市某三级医院体检中心，采用便利抽样法抽取2022年7月至12月符合纳入标准的青年职业个体，应用现场问卷调查和体检信息导出的方法进行数据收集。通过收集一般人口学资料、身高、体重、WC、空腹血糖(GLU)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等，分析肥胖在血糖与血脂异常中的中介作用。结果：共纳入研究对象1 068例(年龄18~44岁)，血脂异常检出率为20.60%。BMI、WC分别与GLU、TG、TC、LDL-C均呈正相关(r_BMI-GLU=0.259、r_BMI-TG=0.369、r_BMI-TC=0.160、r_BMI-LDL-C=0.257、r_WC-GLU=0.279、r_WC-TG=0.372、r_WC-TC=0.166、r_WC-LDL-C=0.236，均P<0.05)；与HDL-C呈负相关(r_BMI-HDL-C=-0.467、r_WC-HDL-C=-0.471，均P<0.05)。GLU与TG、TC、LDL-C呈正相关(r_TG-GLU=0.243、r_TC-GLU=0.136、r_LDL-GLU=0.151，均P<0.05)；与HDL-C呈负相关(r_HDL-GLU=-0.245，P<0.05)。在控制年龄、性别、高血压、吸烟及饮酒因素下，血脂水平在GLU、BMI和WC低、中、高3组中的差异具有统计学意义(P<0.001)。中介模型结果显示，在“血糖-血脂”路径中，引入中介(BMI或WC) 时，血脂(TG、TC、HDL-C和LDL-C) 和GLU之间的关联减弱，存在部分中介效应。结论： BMI、WC是青年职业人群血糖与血脂关系的中介变量，改善肥胖是减少青年职业人群预防血脂异常的重要途径。

Objective: To explore the mediating effect of body mass index(BMI), waist circumference(WC) on the relationship between blood glucose and blood lipids in young professionals, and to provide new ideas for preventing dyslipidemia in young professionals populations. Methods: From July 2022 to December 2022, the convenient sampling method was used to select young professional individuals who met the inclusion criteria based on the physical examination center of a tertiary hospital in Shanghai, and the data were collected by on-site questionnaire survey and physical examination information derivation. The mediating role of obesity in glycemia and dyslipidemia was analyzed by collecting general demographic information, height, weight, WC, fasting blood glucose(GLU), triglyceride(TG), total cholesterol(TC), high-density lipoprotein(HDL-C), low-density lipoprotein(LDL-C), etc. Results: A total of 1 068 subjects(age 18-44) were included in the study, and the detection rate of dyslipidemia was 20.60%. BMI and WC were positively correlated with GLU, TG, TC and LDL-C, respectively(r_BMI-GLU=0.259, r_BMI-TG=0.369 r_BMI-TC=0.160, r_BMI-LDL=0.257, r_WC-GLU=0.279, r_WC-TG=0.372, r_WC-TC=0.166, r_WC-LDL=0.236, all P<0.05), and negatively correlated with HDL-C(r_BMI-HDL=-0.467, r_WC-HDL=-0.471, P<0.05). TG, TC and LDL-C were positively correlated with GLU(r_TG-GLU=0.243, r_TC-GLU=0.136, r_LDL-GLU=0.151, all P<0.05), while HDL-C was negatively correlated with GLU(r_HDL-GLU=-0.245, P<0.05). Under the control of age, gender, high blood pressure, smoking and drinking factors, the mean differences of GLU, BMI and WC in different levels of blood lipid levels were significantly different(P<0.001). The mediation model results showed that the association between blood lipids(TG, TC, HDL-C and LDL-C) and GLU was weakened by the introduction of the mediator(BMI or WC), and there was a partial mediation effect in the “glucose-blood lipid” pathway. Conclusion: BMI and WC are intermediary variables for the relationship between blood glucose and blood lipids in young professional population, and improving obesity is an important way to reduce the prevention of dyslipidemia in young professional population.

参考文献：

[1] 张俊梅,杨媛媛,陆一鸣,等.甘肃省五类职业人群健康素养水平及影响因素[J].环境与职业医学,2019,36(1):68-72.
[2] HAGBERG M,VIOLANTE F S,BONFIGLIOLI R,et al.Prevention of musculoskeletal disorders in workers:classification and health surveillance-statements of the scientific committee on musculoskeletal disorders of the international commission on occupational health[J].BMC Musculoskelet Disord,2012,13:109.
[3] RUBIO VALVERDE J R,MACKENBACH J P,DE WAEGENAERE A M B,et al.Projecting years in good health between age 50-69 by education in the Netherlands until 2030 using several health indicators-an application in the context of a changing pension age[J].BMC Public Health,2022,22(1):859.
[4] 王丽娜,姬芙蓉,葛君琍.10 476例表观健康人群血糖与血脂相关分析[J].中国现代医学杂志,2015,25(15):84-86.
[5] 王江云,樊嘉祥,杨洁,等.体检人群血糖血脂血压年度变化及相关因素分析[J].农垦医学,2023,45(1):39-44.
[6] 叶映丹,盛红艳,陈俐枫,等.常熟市成人血脂异常与糖尿病关系研究[J].华南预防医学,2021,47(6):722-726.
[7] 龚春梅,孙仕强,周继昌,等.3 235例健康体检者体质指数与血压血脂血糖及血尿酸的相关分析[J].中国慢性病预防与控制,2015,23(11):839-842.
[8] 边保华.某高校职工血脂、血糖、血尿酸水平相关分析[J].现代预防医学,2006(9):1573-1574.
[9] GONCALVES F B,KOEK M,VERHAGEN H J,et al.Body-mass index,abdominal adiposity,and cardiovascular risk[J].Lancet,2011,378(9787):227-228.
[10] World Health Organization.Waist circumference and waist-hip ratio report of a WHO expert consultation[R].Geneva(Switzerland):World Health Organization,2008.
[11] 诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953.
[12] 牛米雪,邢秀雅,付连国,等.安徽省35~75岁居民血脂异常情况及影响因素分析[J].疾病监测,2023,38(6):741-746.
[13] DIEZ-FERNANDEZ A,SANCHEZ-LOPEZ M,MORA-RODRIGUEZ R,et al.Obesity as a mediator of the influence of cardiorespiratory fitness on cardiometabolic risk:a mediation analysis[J].Diabetes Care,2014,37(3):855-862.
[14] CHEN Y L,AN P,WANG A P,et al.Discussion on neck circumference and risk of hyperuricemia[J].Journal of PLA Medical College,2020,41(4):324-328,332.
[15] HAYES A F.Introduction to mediation,moderation,and conditional process analysis:a regression-based approach(methodology in the social sciences)[M].New York:The Guilford Press,2013:7-8.
[16] BARON R M,KENNY D A.The moderator-mediator variable distinction in social psychological research:conceptual,strategic,and statistical considerations[J].J Pers Soc Psychol,1986,51(6):1173-1182.
[17] 王红梅,闫雅更,董凤丽,等.不同绝经状态下血脂异常的可控风险因素分析[J].现代医学,2021,49(9):1048-1057.
[18] 潘长玉.代谢综合征认识和防治的新进展——评《国际糖尿病联盟关于代谢综合征定义的全球共识》[J].中华内分泌代谢杂志,2005(4):298-300.
[19] 刘艳梅,于建成,胥柯,等.空腹血糖水平与血脂相关关系的分析[J].河北医药,2010,32(22):3168-3169.
[20] 柳晓琳,段笑娜,聂丹丹.医学院校教职工体重指数与血压、血糖、血脂及尿酸的相关分析[J].辽宁医学院学报,2011,32(4):347-350.
[21] 钱卫冲,王海燕,杜福昌,等.人体测量指标与血脂、血糖及血压水平的典型相关[J].中国循环杂志,1997(1):41-44.
[22] 程臻,胡瑜,刘雨濛.体检人群中体重指数与血压、血脂、血糖及血尿酸的相关性分析[J].当代医学,2021,27(1):22-25.
[23] SUN H,REN X,CHEN Z,et al.Association between body mass index and mortality in a prospective cohort of Chinese adults[J].Medicine(Baltimore),2016,95(32):e4327.
[24] 王黎,帕热扎提·阿不都热依木,姚华,等.新疆地区体检人群体质指数分布情况及其与血脂、血糖的相关性分析[J].现代医学,2022,50(5):555-561.

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