[Relationship between weight change and the changes in blood pressure, blood glucose and blood lipid profiles in middle-aged and elderly Chinese people: a cohort study].

Objective: To explore the relationship between weight change and the changes in blood pressure, blood glucose and blood lipid profiles in middle-aged and elderly Chinese people. Methods: All participants were from the Dongfeng-Tongji cohort study. The study included 16 606 middle-aged and elderly Chinese people with complete information in the baseline survey in 2008 and the first follow-up survey in 2013. We collected the data on demographic characteristics, lifestyle, history of diseases and medication, and the results of medical health examinations, including height, weight, blood pressure, fasting blood glucose and lipid profiles. We divided the weight change into five groups, moderate or above weight loss (<-8.0%), slight weight loss (-8.0%, -3.1%), weight maintenance (-3.0%, 3.0%), slight weight increased (3.1%, 8.0%), and moderate or above weight increased (>8.0%). Generalized linear regression model was used to analyze the relationship between weight change and the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG). Subgroup analyses were used to explore the influences of gender, age and baseline BMI level on the relationship between weight change and the above-mentioned metabolic indicators. Results: The average age of participants in baseline survey was (62.19±7.28) years with a range of 45 to 89 years. During the five-year period, there were 18.86% (2 633), 28.03% (4 655), 35.87% (5 956), 13.96% (2 319), 6.28% (1 043) people with moderate or above weight loss, slight weight loss, weight maintenance, slight weight increased, and moderate or above weight increased, respectively. Regression analyses showed that body weight change were positively correlated with changes in SBP, DBP, FBG, TC, LDL-C and TG, and negatively correlated with change in HDL-C (all linear trend P values were<0.05); As every 10% of weight changed, the β (95%CI) of changes in SBP (mmHg) (1 mmHg=0.133 kPa), DBP (mmHg), FBG (mmol/L), TC (mmol/L), LDL-C (mmol/L), HDL-C (mmol/L) and TG (mmol/L) were 4.94 (4.32, 5.55), 2.50 (2.11, 2.88), 0.05 (0.02, 0.08), 0.13 (0.11, 0.16), 0.14 (0.12, 0.16), -0.05 (-0.07, -0.04) and 0.16 (0.14, 0.18), respectively. Furthermore, subgroup analyses showed that weight change can lead to greater changes in blood pressure in older and overweight or obesity elderly people (all P for interaction<0.05). Conclusion: Weight loss was beneficial for middle-aged and elderly people to improve the blood pressure, blood glucose and blood lipid profiles, regardless of the weight at the baseline, while weight gain was not.目的：探讨中老年人群体重变化对血压、血糖和血脂变化的影响。 方法：研究对象来自东风-同济队列研究。选取在2008年基线调查及2013年第1次随访调查中均有完整资料的16 606名中老年人为研究对象，收集其基本信息、生活方式、患病及服药情况，身高、体重及血压测量结果，以及空腹血糖和血脂的检测结果数据。将体重变化分为5组，分别为体重中度及以上减轻（<-8.0%)、轻度减轻（-8.0%~-3.1%)、维持稳定（-3.0%~3.0%)、轻度增加（3.1%~8.0%）和中度及以上增加（>8.0%）。采用广义线性回归模型分析体重变化与收缩压、舒张压、空腹血糖、总胆固醇、LDL-C、HDL-C和甘油三酯变化的关系。采用分层分析探讨不同性别、年龄和基线BMI水平的人群中体重变化与上述指标变化关系。 结果：研究对象在基线调查时的年龄为（62.19±7.28）岁，范围为45~89岁。5年期间体重中度及以上减轻、轻度减轻、体重维持稳定、轻度增加、体重中度及以上增加的中老年人分别占18.86%（2 633名）、28.03%（4 655名）、35.87%（5 956名）、13.96%（2 319名）、6.28%（1 043名）。体重变化与收缩压、舒张压、空腹血糖、总胆固醇、LDL-C和甘油三酯变化呈正线性相关，与HDL-C变化呈负线性相关（线性趋势性P值均<0.05）；体重每变化10%，收缩压（mmHg）、舒张压（mmHg）、空腹血糖（mmol/L）、总胆固醇（mmol/L）、LDL-C（mmol/L），HDL-C（mmol/L）和甘油三酯（mmol/L）变化的β (95%CI）值分别为4.94(4.32，5.55)、2.50(2.11，2.88)、0.05 (0.02，0.08)、0.13 (0.11，0.16)、0.14 (0.12，0.16)、-0.05 (-0.07，-0.04）和0.16 (0.14，0.18)。分层分析结果显示，年龄大、基线超重或肥胖的中老年人群，体重变化能够导致更大的血压变化（交互作用P值均<0.05）。 结论：在中老年人群中，无论体重正常还是超重肥胖者，体重减轻有利于血压、血糖及血脂水平的改善，体重增加则不利于上述指标的改善。.