Article(id=1311349920414662730, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349919793905738, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202509281, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1758038400000, receivedDateStr=2025-09-17, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790579784729, onlineDateStr=2026-09-28, pubDate=1782316800000, pubDateStr=2026-06-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790579784729, onlineIssueDateStr=2026-09-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790579784729, creator=13701087609, updateTime=1790579784729, updator=13701087609, issue=Issue{id=1311349919793905738, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='12', pageStart='2113', pageEnd='2304', issueExtLink='null', onlineDate='null', pubDate='1782316800000', pubDateStr='2026-06-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1790579784582, creator='13701087609', updateTime=1790588408144, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1311386089701597565, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349919793905738, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1311386089701597566, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349919793905738, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2133, endPage=2138, ext={EN=ArticleExt(id=1311349920649543755, articleId=1311349920414662730, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association of weight-adjusted waist index and comorbidities of hypertension, diabetes, and dyslipidemia among 35 to 75 years old residents, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the association of the weight-adjusted waist index (WWI) and the comorbidities of hypertension, diabetes, and dyslipidemia, and to provide evidence for prevention and control of comorbidities of hypertension, diabetes, and dyslipidemia.

Methods

Data were obtained through questionnaires, physical examinations, and laboratory tests based on the programme of screening and intervention subjects with high risk cardiovascular diseases in Hai’an, Nantong city from 2015 to 2024. Statistical analysises included F-tests, chi-square tests, and multivariate logistic regression models.

Results

Male, current smoking, drinking, unmarried and individuals with high age, waist circumference, body weight, body mass index, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, and individuals with low high-density lipoprotein cholesterol had a higher incidence of comorbidities of hypertension, diabetes, and dyslipidemia. Multivariate logistic regression analysis showed a positive association between WWI and the comorbidities of hypertension, diabetes, and dyslipidemia (OR=1.31, 95%CI: 1.27-1.36). Compared to individuals aged ≥60 years, the positive association between WWI and the comorbidities of hypertension, diabetes, and dyslipidemia was stronger in individuals aged <60 years (OR=1.26 vs. OR=1.46, interaction test P<0.001).

Conclusion

WWI is positively associated with the comorbidities of hypertension, diabetes, and dyslipidemia, and the positive association is stronger in individuals aged <60 years old.

, authors=Jie HUANG1, Ming-rui CHEN1, Ling LIN1, Guang JI2, Yu-qi WANG1, Chu CHU1, Bo CAI1, Lu-lu CHEN3, authorsList=Jie HUANG, Ming-rui CHEN, Ling LIN, Guang JI, Yu-qi WANG, Chu CHU, Bo CAI, Lu-lu CHEN, authorCompany=null, correspAuthors=Lu-lu CHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1311349921790394452, articleId=1311349920414662730, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=35~75岁常住居民体重调整腰围指数与“三高”共病的相关性研究, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

探究体重调整腰围指数(Weight-adjusted Waist Index,WWI)与“三高”共病之间的关联,为“三高”共病的防治提供科学依据。

方法

基于2015—2024年南通海安市国家心血管病高危人群早期筛查与综合干预项目,通过问卷调查、体格测量、实验室检测等方法收集数据,采用F检验、χ2检验和多因素logistic回归分析模型进行数据分析。

结果

男性、目前吸烟、饮酒、非在婚,以及高年龄、腰围、体重、体质指数、收缩压、舒张压、血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇,和低高密度脂蛋白胆固醇人群的“三高”共病患病率更高。多因素logistic回归分析结果显示,WWI与“三高”共病存在正相关关系(OR=1.31, 95%CI:1.27~1.36)。相比年龄≥60岁人群,在年龄<60岁的人群中WWI与“三高”共病之间的正相关关系更强(OR=1.26比OR=1.46,交互作用检验P<0.001)。

结论

WWI与“三高”共病呈正相关,且在<60岁人群中相关性更强。

, authors=黄捷1, 陈铭睿1, 林玲1, 吉光2, 王宇琦1, 楚楚1, 蔡波1, 陈路路3, authorsList=黄捷, 陈铭睿, 林玲, 吉光, 王宇琦, 楚楚, 蔡波, 陈路路, authorCompany=null, correspAuthors=陈路路, authorNote=

黄捷和陈铭睿为共同第一作者。

黄捷(1996—),女,硕士,主管医师,研究方向:健康教育和慢性非传染性疾病控制;

陈铭睿(1998—),女,本科,医师,研究方向:慢性非传染性疾病控制

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陈路路,E-mail:
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注:a进行Z值函数转换;b剔除对应分层变量后分别调整年龄、性别、目前吸烟、饮酒、体质指数、学历、婚姻状态。

, figureFileSmall=KQIiWTEOldAzTYA6qOva6g==, figureFileBig=/lmw6daTm9tHU+egKd4cdA==, tableContent=null), ArticleFig(id=1311349928539029648, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349920414662730, language=EN, label=Table 1, caption=

Multivariate logistic regression analysis variable assignment

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
性别1=男性,2=女性
目前吸烟0=否,1=是
饮酒0=否,1=是
学历0=初中及以下,1=高中及以上
婚姻状态0=非在婚,1=在婚
“三高”共病0=否,1=是
“两种”共病0=否,1=是
“三种”共病0=否,1=是
体重调整腰围指数连续型变量
年龄(岁)连续型变量
体质指数(kg/m2)连续型变量
), ArticleFig(id=1311349928610332817, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349920414662730, language=CN, label=表1, caption=

多因素logistic回归分析变量赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
性别1=男性,2=女性
目前吸烟0=否,1=是
饮酒0=否,1=是
学历0=初中及以下,1=高中及以上
婚姻状态0=非在婚,1=在婚
“三高”共病0=否,1=是
“两种”共病0=否,1=是
“三种”共病0=否,1=是
体重调整腰围指数连续型变量
年龄(岁)连续型变量
体质指数(kg/m2)连续型变量
), ArticleFig(id=1311349928690024594, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349920414662730, language=EN, label=Table 2, caption=

General feature description[n(%)/()]

, figureFileSmall=null, figureFileBig=null, tableContent=
特征“三高”共病χ2/F值P值
否是
性别37.65<0.001
男性5 371(68.7)2 447(31.3)
女性10 096(72.6)3 805(27.4)
年龄(岁)58.2±10.161.6±8.6527.68<0.001
腰围(cm)82.4±9.488.2±9.31 715.29<0.001
体重(kg)63.4±10.068.1±11.2905.36<0.001
体质指数(kg/m2)25.1±3.326.9±3.31 240.45<0.001
收缩压(mmHg)136.0±18.9150.9±17.22 927.26<0.001
舒张压(mmHg)80.1±10.585.7±10.41 288.97<0.001
血糖(mmol/L)5.7±1.17.5±2.45 610.19<0.001
总胆固醇(mmol/L)4.4±0.94.7±1.2374.03<0.001
甘油三酯(mmol/L)1.2±0.62.0±1.14 212.14<0.001
低密度脂蛋白胆固醇(mmol/L)2.4±0.72.5±0.9161.84<0.001
高密度脂蛋白胆固醇(mmol/L)1.5±0.41.2±0.41 700.91<0.001
目前吸烟10.99<0.001
否13 216(71.6)5 231(28.4)
是2 251(68.8)1 021(31.2)
饮酒30.30<0.001
否13 392(71.9)5 233(28.1)
是2 075(67.1)1 019(32.9)
学历0.110.737
初中及以下13 514(71.2)5 473(28.8)
高中及以上1 953(71.5)779(28.5)
婚姻状态13.24<0.001
非在婚1 460(67.8)692(32.2)
在婚14 007(71.6)5 560(28.4)
), ArticleFig(id=1311349928799076499, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349920414662730, language=CN, label=表2, caption=

一般特征描述[n(%)/()]

, figureFileSmall=null, figureFileBig=null, tableContent=
特征“三高”共病χ2/F值P值
否是
性别37.65<0.001
男性5 371(68.7)2 447(31.3)
女性10 096(72.6)3 805(27.4)
年龄(岁)58.2±10.161.6±8.6527.68<0.001
腰围(cm)82.4±9.488.2±9.31 715.29<0.001
体重(kg)63.4±10.068.1±11.2905.36<0.001
体质指数(kg/m2)25.1±3.326.9±3.31 240.45<0.001
收缩压(mmHg)136.0±18.9150.9±17.22 927.26<0.001
舒张压(mmHg)80.1±10.585.7±10.41 288.97<0.001
血糖(mmol/L)5.7±1.17.5±2.45 610.19<0.001
总胆固醇(mmol/L)4.4±0.94.7±1.2374.03<0.001
甘油三酯(mmol/L)1.2±0.62.0±1.14 212.14<0.001
低密度脂蛋白胆固醇(mmol/L)2.4±0.72.5±0.9161.84<0.001
高密度脂蛋白胆固醇(mmol/L)1.5±0.41.2±0.41 700.91<0.001
目前吸烟10.99<0.001
否13 216(71.6)5 231(28.4)
是2 251(68.8)1 021(31.2)
饮酒30.30<0.001
否13 392(71.9)5 233(28.1)
是2 075(67.1)1 019(32.9)
学历0.110.737
初中及以下13 514(71.2)5 473(28.8)
高中及以上1 953(71.5)779(28.5)
婚姻状态13.24<0.001
非在婚1 460(67.8)692(32.2)
在婚14 007(71.6)5 560(28.4)
), ArticleFig(id=1311349928870379668, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349920414662730, language=EN, label=Table 3, caption=

Multivariate logistic regression analysis of weight-adjusted waist index and comorbidities of hypertension, diabetes, and dyslipidemia

, figureFileSmall=null, figureFileBig=null, tableContent=
变量患病率(%)“三高”共病
OR值(95%CI)bP值OR值(95%CI)cP值
体重调整腰围指数a6 252(28.8)1.45(1.40, 1.50)<0.0011.31(1.27, 1.36)<0.001
体重调整腰围指数四分组
Q1(<24.79)870(16.0)1.001.00
Q2(24.80~30.69)1 441(26.5)1.77(1.61, 1.95)<0.0011.54(1.40, 1.70)<0.001
Q3(30.70~37.29)1 809(33.3)2.32(2.11, 2.55)<0.0011.85(1.68, 2.04)<0.001
Q4(≥37.30)2 132(39.2)2.89(2.63, 3.18)<0.0012.15(1.95, 2.37)<0.001
趋势线检验P值<0.001<0.001
), ArticleFig(id=1311349928937488533, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349920414662730, language=CN, label=表3, caption=

体重调整腰围指数与“三高”共病的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量患病率(%)“三高”共病
OR值(95%CI)bP值OR值(95%CI)cP值
体重调整腰围指数a6 252(28.8)1.45(1.40, 1.50)<0.0011.31(1.27, 1.36)<0.001
体重调整腰围指数四分组
Q1(<24.79)870(16.0)1.001.00
Q2(24.80~30.69)1 441(26.5)1.77(1.61, 1.95)<0.0011.54(1.40, 1.70)<0.001
Q3(30.70~37.29)1 809(33.3)2.32(2.11, 2.55)<0.0011.85(1.68, 2.04)<0.001
Q4(≥37.30)2 132(39.2)2.89(2.63, 3.18)<0.0012.15(1.95, 2.37)<0.001
趋势线检验P值<0.001<0.001
), ArticleFig(id=1311349929008791702, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349920414662730, language=EN, label=Table 4, caption=

Multivariate logistic regression analysis of weight-adjusted waist index and “two” and “three” comorbidities

, figureFileSmall=null, figureFileBig=null, tableContent=
变量“两种”共病“三种”共病
OR值(95%CI)bP值OR值(95%CI)bP值
体重调整腰围指数a1.28(1.23, 1.33)<0.0011.31(1.23, 1.39)<0.001
体重调整腰围指数四分组
Q1(<24.79)1.001.00
Q2(24.80~30.69)1.40(1.26, 1.56)<0.0012.22(1.77, 2.79)<0.001
Q3(30.70~37.29)1.69(1.52, 1.87)<0.0012.63(2.11, 3.29)<0.001
Q4(≥37.30)2.00(1.79, 2.22)<0.0012.74(2.19, 3.43)<0.001
趋势线检验P值<0.001<0.001
), ArticleFig(id=1311349929075900567, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311349920414662730, language=CN, label=表4, caption=

体重调整腰围指数与“两种”和“三种”共病的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量“两种”共病“三种”共病
OR值(95%CI)bP值OR值(95%CI)bP值
体重调整腰围指数a1.28(1.23, 1.33)<0.0011.31(1.23, 1.39)<0.001
体重调整腰围指数四分组
Q1(<24.79)1.001.00
Q2(24.80~30.69)1.40(1.26, 1.56)<0.0012.22(1.77, 2.79)<0.001
Q3(30.70~37.29)1.69(1.52, 1.87)<0.0012.63(2.11, 3.29)<0.001
Q4(≥37.30)2.00(1.79, 2.22)<0.0012.74(2.19, 3.43)<0.001
趋势线检验P值<0.001<0.001
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35~75岁常住居民体重调整腰围指数与“三高”共病的相关性研究
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黄捷 1 , 陈铭睿 1 , 林玲 1 , 吉光 2 , 王宇琦 1 , 楚楚 1 , 蔡波 1 , 陈路路 3
现代预防医学 | 流行病与统计方法 2026,53(12): 2133-2138
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现代预防医学 |流行病与统计方法 2026 , 53 (12) : 2133 -2138
35~75岁常住居民体重调整腰围指数与“三高”共病的相关性研究
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黄捷1, 陈铭睿1, 林玲1, 吉光2, 王宇琦1, 楚楚1, 蔡波1, 陈路路3
作者信息
  • 1.南通市疾病预防控制中心,江苏 南通 226007
  • 2.海安市疾病预防控制中心
  • 3.江苏省疾病预防控制中心慢性非传染病防制所
通讯作者:
陈路路,E-mail:
作者简介:

黄捷和陈铭睿为共同第一作者。

黄捷(1996—),女,硕士,主管医师,研究方向:健康教育和慢性非传染性疾病控制;

陈铭睿(1998—),女,本科,医师,研究方向:慢性非传染性疾病控制

Association of weight-adjusted waist index and comorbidities of hypertension, diabetes, and dyslipidemia among 35 to 75 years old residents
Jie HUANG1, Ming-rui CHEN1, Ling LIN1, Guang JI2, Yu-qi WANG1, Chu CHU1, Bo CAI1, Lu-lu CHEN3
Affiliations
  • Nantong Center for Disease Control and Prevention, Nantong, Jiangsu 226007, China
出版时间: 2026-06-25 doi: 10.20043/j.cnki.MPM.202509281
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目的

探究体重调整腰围指数(Weight-adjusted Waist Index,WWI)与“三高”共病之间的关联,为“三高”共病的防治提供科学依据。

方法

基于2015—2024年南通海安市国家心血管病高危人群早期筛查与综合干预项目,通过问卷调查、体格测量、实验室检测等方法收集数据,采用F检验、χ2检验和多因素logistic回归分析模型进行数据分析。

结果

男性、目前吸烟、饮酒、非在婚,以及高年龄、腰围、体重、体质指数、收缩压、舒张压、血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇,和低高密度脂蛋白胆固醇人群的“三高”共病患病率更高。多因素logistic回归分析结果显示,WWI与“三高”共病存在正相关关系(OR=1.31, 95%CI:1.27~1.36)。相比年龄≥60岁人群,在年龄<60岁的人群中WWI与“三高”共病之间的正相关关系更强(OR=1.26比OR=1.46,交互作用检验P<0.001)。

结论

WWI与“三高”共病呈正相关,且在<60岁人群中相关性更强。

体重调整腰围指数  /  三高  /  共病  /  年龄
Objective

To explore the association of the weight-adjusted waist index (WWI) and the comorbidities of hypertension, diabetes, and dyslipidemia, and to provide evidence for prevention and control of comorbidities of hypertension, diabetes, and dyslipidemia.

Methods

Data were obtained through questionnaires, physical examinations, and laboratory tests based on the programme of screening and intervention subjects with high risk cardiovascular diseases in Hai’an, Nantong city from 2015 to 2024. Statistical analysises included F-tests, chi-square tests, and multivariate logistic regression models.

Results

Male, current smoking, drinking, unmarried and individuals with high age, waist circumference, body weight, body mass index, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, and individuals with low high-density lipoprotein cholesterol had a higher incidence of comorbidities of hypertension, diabetes, and dyslipidemia. Multivariate logistic regression analysis showed a positive association between WWI and the comorbidities of hypertension, diabetes, and dyslipidemia (OR=1.31, 95%CI: 1.27-1.36). Compared to individuals aged ≥60 years, the positive association between WWI and the comorbidities of hypertension, diabetes, and dyslipidemia was stronger in individuals aged <60 years (OR=1.26 vs. OR=1.46, interaction test P<0.001).

Conclusion

WWI is positively associated with the comorbidities of hypertension, diabetes, and dyslipidemia, and the positive association is stronger in individuals aged <60 years old.

Weight-adjusted waist index  /  Hypertension  /  Diabetes  /  Dyslipidemia  /  Comorbidity  /  Age
黄捷, 陈铭睿, 林玲, 吉光, 王宇琦, 楚楚, 蔡波, 陈路路. 35~75岁常住居民体重调整腰围指数与“三高”共病的相关性研究. 现代预防医学, 2026 , 53 (12) : 2133 -2138 . DOI: 10.20043/j.cnki.MPM.202509281
Jie HUANG, Ming-rui CHEN, Ling LIN, Guang JI, Yu-qi WANG, Chu CHU, Bo CAI, Lu-lu CHEN. Association of weight-adjusted waist index and comorbidities of hypertension, diabetes, and dyslipidemia among 35 to 75 years old residents[J]. Modern Preventive Medicine, 2026 , 53 (12) : 2133 -2138 . DOI: 10.20043/j.cnki.MPM.202509281
共病(multimorbidity)是指同一个体同时存在两种或两种以上的慢性病[1]。共病不仅会增高患者残疾和死亡的风险,而且会增加医疗保健支出[1-2]。目前我国中老年人慢性病共病患病形式严峻,总体呈上升趋势[3-4]。截止到2022年,45岁以上中老年人慢性病共病率达到58.21%[3]。高血压、糖尿病和血脂异常(以下简称为“三高”)是我国中老年人群中常见的慢性病共病,在危险因素和发病机制等多方面存在共同点,并且与其他疾病都存在广泛关联[5-6]。肥胖是“三高”的主要危险因素之一[7]。体重调整腰围指数(Weight-adjusted Waist Index,WWI)结合了腰围和体质量,作为一种新兴的评价复合型肥胖的指标,能较全面地反映个体脂肪分布和体型差异[8-9]。本研究旨在讨论WWI与“三高”共病的相关性,为“三高”共病的综合防控提供科学依据。
2015—2024年,在江苏省南通市海安市每年开展心血管病高危人群早期筛查与综合干预项目,共10期。研究对象纳入标准为:年龄35~75岁;过去一年常住6个月以上的居民;自愿签署知情同意书。以区或乡镇为单位,采用方便抽样方法,依据当地地理特点、人口结构及项目承担单位条件等因素,选取5个区或乡镇为整群,后根据纳入标准在每个区或镇招募符合条件的人群进行调查。每年度筛查均在选取的5个区或乡镇按相同的纳入标准重新招募人群,既往年度参加筛查的人群不再参加之后新年度的筛查。共22 873人参加项目调查,排除1 154人(1人未测量腰围、63人未检测总胆固醇、225人未检测高密度脂蛋白胆固醇、210人未检测甘油三酯、655人未检测低密度脂蛋白胆固醇),最终共21 719人纳入分析。本研究通过国家心血管病中心伦理委员会审查(伦理编号:2014-574),所有调查对象均自愿签署了本研究的知情同意书。
(1)问卷调查:调查员均经过统一培训,采用面对面形式进行现场调查。每年调查内容主要包括年龄、婚姻状况、受教育程度、吸烟、饮酒等信息。(2)体格测量:调查员均经过统一培训,身高、体重测量要求脱掉鞋帽,仅穿单薄衣服,身高测量结果精确到0.1 cm,体重测量结果精确到0.1 kg;腰围以肚脐水平线为参照,测量点在肚脐上方1 cm处,测量结果精确到0.1 cm;血压测量前调查对象静坐休息5 min,测量右侧手臂,若前两次测量收缩压差值大于10 mmHg,则需测量第三次,取后两次测量值的均值。高血压定义:平均收缩压大于等于140 mmHg和(或)平均舒张压大于等于90 mmHg者,或自报经临床确诊的高血压病史,或过去两周有服用降压药物史[10] 。(3)实验室检测:使用BeneCheck PD-G001-2快速血糖分析仪测量空腹血糖,糖尿病定义:至少8 h未进食状态下,空腹血糖大于等于7 mmol/L或在进食8 h内随机检测的血糖大于等于11 mmol/L或已被医院诊断糖尿病,或近2周服用降血糖药物者[10];使用Cardiocheck PA型快速血脂检测仪测量空腹总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇。血脂异常定义:总胆固醇大于等于6.2 mmol/L,或甘油三酯大于等于2.3 mmol/L,或高密度脂蛋白小于1.0mmol/L,或低密度脂蛋白大于等于4.1 mmol/L,或自报过去两周内使用降脂药[10]。
WWI=腰围(cm)/体重(kg)1/2[8],WWI四分位数分组:Q1(<24.79),Q2(24.80~30.69),Q3(30.70~37.29),Q4(≥37.30)。“三高”共病是指至少患高血压、糖尿病和血脂异常中的两种及以上疾病[11]。目前吸烟定义为在调查时或近期仍然保持吸烟行为的人[10]。饮酒定义为近12个月内每个月至少有1次的饮酒行为的人[10]。
数据均采用R 4.2.3软件进行分析。定量资料采用表示,组间比较用F检验。定性资料采用n(%)表示,组间比较用χ2检验。变量赋值见表1。采用多因素logistic回归模型分析WWI与“三高”共病之间的关联,并建立logistic回归模型分析分层变量与WWI的相乘交互作用。检验水准α=0.05。
本研究共21 719人纳入最终分析,“三高”共病6 252人(28.8%),其中同时患两种疾病4 987人(23.0%),患三种疾病1 265人(5.8%)。男性、吸烟、饮酒、非在婚,以及高年龄、腰围、体重、体质指数、收缩压、舒张压、血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇,和低高密度脂蛋白胆固醇人群的“三高”共病患病率更高(P<0.001)。见表2。
在调整年龄、性别、目前吸烟、饮酒、体质指数、学历、婚姻状态等因素后,多因素logistic回归分析结果显示,WWI与“三高”共病存在正相关关系(OR=1.31, 95%CI:1.27~1.36)。相比于Q1组,WWI在Q4组与“三高”共病的正相关性更高(OR=2.15, 95%CI:1.95~2.37),且这种正相关性在WWI四分位数分组中持续升高(趋势性检验P<0.001),见表3。此外,在两种疾病共患和三种疾病共患中也显示出相似的结果,见表4。
每个分层变量模型剔除对应分层变量后分别调整年龄、性别、目前吸烟、饮酒、体质指数、学历、婚姻状态后发现,相比年龄≥60岁人群,在年龄<60岁的人群中WWI与“三高”共病之间的正相关关系更强(OR=1.26比OR=1.46,交互作用检验P<0.001)。见图1。
WWI作为一种新型的人体测量指数,不仅兼顾了腰围的优点,同时还减弱了与体质指数的联系,既可以区分脂肪和肌肉质量,还能反映中心性肥胖问题[12-16]。研究显示,WWI升高与心血管疾病、骨质疏松症、卒中、高血压、糖尿病等[15-20]多种疾病密切相关[9]。
本研究发现,WWI与“三高”共病之间存在正相关关系,WWI在Q4组与“三高”共病的正相关性更高,且这种正相关性在WWI四分位数分组中持续升高。与Chen等和韩梦莹等发现WWI增加与多病发生风险呈正相关的结果相似[20-24]。Lan等[22]也证实了WWI与“三高”共病的相关性,WWI指数会增加“三高”共病的患病风险。可能的机制是:高WWI可能表明脂肪组织功能障碍,尤其是内脏脂肪的增加[23]。脂肪细胞增大是内脏脂肪增加的主要表现,可能会引发脂肪细胞缺氧和脂肪细胞内细胞器受到压力,这些问题最终会导致内分泌、免疫反应、代谢疾病和CVD风险增加[24]。
本研究进一步分析发现,相比年龄≥60岁人群,在<60岁的人群中WWI与“三高”共病之间的正相关关系更强。既往研究亦发现WWI与高血压的关系在<60岁的人群中较强[25],这可能与该年龄人群存在不良生活习惯,例如运动不足、高热量饮食等情况影响WWI指数,因此与年龄的交互作用放大有关。因此,本研究提示“三高”共病的防治工作应重点关注<60岁群体的WWI变化。对于本研究的这个发现还需进一步论证,并进一步探索WWI潜在机制和影响因素。
本研究利用近10年连续收集的数据作为支撑,探索WWI与“三高”共病之间的关系,创新性地发现年龄这一因素对WWI与“三高”共病关系的影响,为未来对这一重要研究领域的进一步研究提供了参考。然而,本研究仍然存在一定的局限性:(1)作为横断面研究,在因果关系推断中存在局限,鼓励未来的研究使用其他方法来验证这些发现。(2)研究人群是通过方便抽样招募的形式,可能会存在选择偏倚。(3)本研究缺少饮食、身体活动、睡眠情况等的数据,不能完全排除相应残余混杂的影响。
综上所述,WWI与“三高”共病呈正相关,且在<60岁人群中相关性更强。提示在今后“三高”共病的防治工作中应重点关注<60岁人群的WWI变化,将WWI控制在较低水平,以延缓“三高”疾病的发生和发展。
  • 江苏省卫生健康委科研课题(Ym2023081)
  • 南通大学临床医学专项科研基金(2025JQ026)
  • 南通市卫生健康委员会科研课题(QN2025058)
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doi: 10.20043/j.cnki.MPM.202509281
  • 接收时间:2025-09-17
  • 首发时间:2026-09-28
  • 出版时间:2026-06-25
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  • 收稿日期:2025-09-17
基金
江苏省卫生健康委科研课题(Ym2023081)
南通大学临床医学专项科研基金(2025JQ026)
南通市卫生健康委员会科研课题(QN2025058)
作者信息
    1.南通市疾病预防控制中心,江苏 南通 226007
    2.海安市疾病预防控制中心
    3.江苏省疾病预防控制中心慢性非传染病防制所

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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