内科

目的分析体质量指数（BMI）及腰高比（WHtR）异常对糖尿病合并高血压发病风险的影响。方法选取2016年5月至2019年3月我院收治的糖尿病合并高血压患者350例作为观察组，选取同期在我院进行常规体检的健康者350名作为对照组，检测比较两组研究对象的血清脂联素（APN）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、BMI及WHtR水平；应用Logistic回归分析法分析BMI、WHtR异常对糖尿病合并高血压发病风险的影响，定性、定量分析BMI、WHtR异常对糖尿病合并高血压发病的交互作用。结果观察组患者的血清APN、HDL-C水平显著低于对照组，TG、LDL-C、TC、BMI、WHtR水平显著高于对照组，差异有统计学意义（P＜0.05）。Logistic回归分析结果显示，在调整吸烟、饮酒、饮食、TG、LDL-C、TC、HDL-C等因素后，BMI、WHtR异常是糖尿病合并高血压发病的独立危险因素（P＜0.05）。以BMI、WHtR正常者为对照，调整吸烟、饮酒、饮食、TG、LDL-C、TC、HDL-C等因素后，BMI或WHtR异常导致糖尿病合并高血压发病的OR值分别为4.091和3.884；BMI、WHtR异常共存者罹患糖尿病合并高血压的风险是BMI、WHtR均正常者的8.317倍；BMI、WHtR异常共存的效应为两者单独存在时效应之和的1.379倍，由BMI、WHtR异常交互作用所导致的糖尿病合并高血压患病率是由其他未预测因子所导致的患病率的1.598倍，在BMI、WHtR异常共存对糖尿病合并高血压发病危险性中，有28.69%是由两者的交互作用所引起。结论BMI、WHtR异常是糖尿病合并高血压发病的独立危险因素，两者共存具有正向交互作用，会显著提高发病风险。

ObjectiveTo analyze the effects of body mass index (BMI) and waist-to-height ratio (WHtR) on the risk of diabetes complicated with hypertension. MethodsA total of 350 patients with diabetes complicated with hypertension admitted to our hospital from May 2016 to March 2019 were selected as the observation group, and 350 healthy people who underwent routine physical examinations in our hospital during the same period were selected as the control group. The serum adiponectin (APN), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), BMI and WHtR levels of the two groups were tested and compared. The logistic regression analysis method was used to analyze the influences of abnormal BMI and WHtR on the risk of diabetes complicated with hypertension, and the interaction between abnormal BMI and WHtR on the morbidity of diabetes complicated with hypertension was quantitatively and qualitatively analyzed. ResultsCompared with the control group, the observation group yielded lower levels of serum APN and HDL-C, whereas higher levels of TG, LDL-C, TC, BMI, and WHtR, with statistically significant differences (P＜0.05). Logistic regression analysis showed that after adjusting for smoking, drinking, diet, TG, LDL-C, TC, HDL-C and other factors, abnormal BMI and WHtR were independent risk factors for diabetes complicated with hypertension (P＜0.05). When people with normal BMI and WHtR were used as controls, and smoking, drinking, diet, TG, LDL-C, TC, HDL-C and other factors were adjusted, the OR values of diabetes complicated with hypertension caused by abnormal BMI or WHtR were 4.091 and 3.884, respectively. The risk of diabetes complicated with hypertension in patients with abnormal BMI and WHtR was 8.317 times higher than that in patients with normal BMI and WHtR, and the effects of patients with abnormal coexistence of BMI and WHtR was 1.379 times higher than those of the sum of the two alone. The prevalence of diabetes complicated with hypertension caused by the interaction of abnormal BMI and WHtR was 1.598 times higher than that by other unpredictable factors. Among the risk of morbidity of diabetes complicated with hypertension caused by abnormal coexistence of BMI and WHtR, 28.69% was caused by the interaction between the two. ConclusionAbnormal BMI and WHtR are independent risk factors for the morbidity of diabetes complicated with hypertension, and abnormal coexistence of the two has a positive interaction, which can prominently increase the risk of morbidity.