非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值与中国中老年人群高血压风险的剂量反应关系

doi:10.12183/j.scjpm.2026.0779

摘要/Abstract

摘要： 目的基于中国健康与养老追踪调查（CHARLS）数据,探讨非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值（NHHR）与中国中老年人群高血压风险的剂量反应关系。方法采用横断面研究设计,筛选2011年CHARLS数据库中符合纳入排除标准的研究对象,分为高血压组和非高血压组。计算NHHR,分析其与高血压风险的关联。结果共纳入9 838例,其中高血压4 350例（44.22%）。两组年龄、吸烟、饮酒、体力活动、BMI、腰围及NHHR差异有统计学意义（P<0.05）。限制性立方样条显示NHHR与高血压风险呈非线性曲线型剂量反应关系。多因素logistic回归显示,年龄≥60岁（OR=1.320）、吸烟（既往OR=1.138,当前OR=1.111）、饮酒>15 g/d（OR=1.162）、体力活动未达标（OR=1.157）、超重（OR=1.169）、肥胖（OR=1.249）、腰围（OR=1.024）及NHHR≥2.64（OR=1.733）均为高血压的独立危险因素（P<0.05）。亚组分析显示,NHHR≥2.64在各亚组中均显著增加高血压风险（P<0.05）;年龄与NHHR、BMI与NHHR存在显著交互作用（P<0.001）,而性别与NHHR交互无统计学意义。敏感性分析结果与主分析一致。结论 NHHR与中国中老年人群高血压风险呈非线性剂量反应关系,该关联在不同年龄、性别及BMI分层中均存在,年龄和BMI可共同影响高血压发病风险。

关键词: 非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值, 中老年人, 高血压, 剂量反应, 中国健康与养老追踪调查

Abstract: Objective To investigate the dose-response relationship between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and the risk of hypertension among middle-aged and older adults in China, utilizing data from the China Health and Retirement Longitudinal Study (CHARLS). Methods A cross-sectional study design was employed. Participants meeting the predetermined inclusion and exclusion criteria were selected from the 2011 CHARLS database and stratified into hypertensive and non-hypertensive cohorts. The NHHR was calculated, and its association with the risk of hypertension was systematically analyzed. Results A total of 9 838 participants were included, of whom 4 350 (44.22%) had hypertension. Significant differences were observed between the two groups in age, smoking, alcohol consumption, physical activity, BMI, waist circumference, and NHHR (all P<0.05). Restricted cubic spline analysis revealed a non-linear curvilinear dose-response relationship between NHHR and hypertension risk. Multivariate logistic regression identified age ≥60 years (OR=1.320), smoking (former OR=1.138, current OR=1.111), alcohol consumption>15 g/day (OR=1.162), insufficient physical activity (OR=1.157), overweight (OR=1.169), obesity (OR=1.249), waist circumference (OR=1.024), and NHHR ≥2.64 (OR=1.733) as independent risk factors for hypertension (all P<0.05).Subgroup analyses showed that NHHR ≥2.64 consistently increased the risk of hypertension across all subgroups (all P<0.05). Significant interactions were found between age and NHHR (P<0.001), as well as between BMI and NHHR (P<0.001), whereas no significant interaction was observed between gender and NHHR. Sensitivity analyses confirmed consistency with the primary findings. Conclusion A non-linear dose-response relationship exists between NHHR and the risk of hypertension among the middle-aged and older Chinese population. This robust association persists across disparate age, sex, and BMI stratifications, indicating that age and BMI may synergistically modulate the pathogenesis and risk profile of hypertension.

Key words: Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio, Middle-aged and elderly, Hypertension, Dose-response, China Health and Retirement Longitudinal Study

中图分类号:

R181.3

林南溪, 赵睿学, 翟真. 非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值与中国中老年人群高血压风险的剂量反应关系[J]. 华南预防医学, 2026, 52(7): 779-784.

Lin Nanxi, Zhao Ruixue, Zhai Zhen. Dose-response relationship between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and hypertension risk in Chinese middle-aged and elderly adults[J]. South China Journal of Preventive Medicine, 2026, 52(7): 779-784.

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