Objective: To understand the interaction effect of general obesity, central obesity, and dyslipidemia on the risk of hypertension to provide scientific evidence for the early prevention and control of hypertension. Methods: From 2019 to 2023, 10 of the 16 districts in Tianjin were selected as project sites. A community and a natural village were selected as monitoring sites in each project site using a multi-stage cluster random sampling method. A questionnaire, physical, and biochemical examination were conducted on permanent residents aged 35-75 who had lived in the surveillance sites for more than half a year. The chi-square test univariate and multivariate logistic regression were used for statistical analysis. The multiplicative and additive models were used to calculate the interaction between general obesity and dyslipidemia, as well as central obesity and dyslipidemia, respectively. Results: A total of 177 160 subjects were included in the study, with an age of (56.44±8.62) years old. There were 29 535 (16.67%) patients with general obesity, 67 338 (38.01%) patients with central obesity, 64 906 (36.64%) patients with dyslipidemia, and 90 266 (50.95%) patients with hypertension. Multiplication interaction analysis results showed that, after adjusting for gender, age, culture level, marriage status, drinking, smoking, and diabetes, the multiplicative interactions between general obesity and dyslipidemia, and central obesity and dyslipidemia on hypertension were statistically significant (all P<0.001), and the adjusted OR and 95%CI were 2.57 (2.47-2.68) and 2.14 (2.08-2.20), respectively. The results of the additive interaction analysis demonstrated that after adjusting for relevant variables, the relative excess risk of interaction (RERI), the attributable proportion of interaction (API), and the synergy index (SI) of the interaction between generalized obesity and dyslipidemia were 0.48 (95%CI: 0.33-0.63), 0.15 (95%CI: 0.11-0.19), and 1.27 (95%CI: 1.18-1.36), respectively; the RERI, API, and SI of the interaction between central obesity and dyslipidemia were 0.37 (95%CI: 0.28-0.46), 0.13 (95%CI: 0.10-0.16), and 1.25 (95%CI: 1.18-1.32), respectively. Conclusions: There might be multiplicative and additive interactions between general obesity, central obesity, and dyslipidemia on the risk of hypertension. Simultaneous control of BMI, waist circumference, and blood lipid levels may effectively reduce the risk of hypertension.
目的： 了解全身性肥胖及中心性肥胖与血脂异常之间的交互作用对高血压患病的影响，为高血压的早期防控提供科学依据。 方法： 2019-2023年在天津市16个区中选取10个区作为项目点，在每个项目点采用多阶段整群随机抽样方法各抽取1个社区及1个自然村作为监测点，对监测点内居住半年以上的35~75岁常住居民进行问卷调查、体格检查和生化检查。BMI用于衡量全身性肥胖，腰围用于衡量中心性肥胖。统计学分析采用χ2检验、单因素和多因素logistic回归，运用相乘模型和相加模型分别计算全身性肥胖与血脂异常、中心性肥胖与血脂异常的交互作用。 结果： 共纳入177 160名研究对象，年龄为（56.44±8.62）岁，其中，全身性肥胖患者29 535名（16.67%），中心性肥胖患者67 338名（38.01%），血脂异常患者64 906名（36.64%），高血压患者90 266名（50.95%）。相乘交互作用分析结果显示，调整性别、年龄、文化程度、婚姻状况、饮酒状况、吸烟状况、糖尿病患病后，全身性肥胖与血脂异常、中心性肥胖与血脂异常对高血压患病的相乘交互作用有统计学意义（均P<0.001），调整OR值（95%CI）分别为2.57（2.47~2.68）、2.14（2.08~2.20）。相加交互作用分析结果显示，调整相关变量后，全身性肥胖和血脂异常的交互作用相对超额危险度（RERI）、归因百分比（API）、协同指数（SI）分别为0.48（95%CI：0.33~0.63）、0.15（95%CI：0.11~0.19）、1.27（95%CI：1.18~1.36）；中心性肥胖和血脂异常的交互作用RERI、API、SI分别为0.37（95%CI：0.28~0.46）、0.13（95%CI：0.10~0.16）、1.25（95%CI：1.18~1.32）。 结论： 全身性肥胖与血脂异常、中心性肥胖与血脂异常对高血压的患病风险可能均存在正向相乘及相加交互作用。同时控制BMI、腰围和血脂水平可能会有效降低高血压的患病风险。.