肥胖指标对高海拔建筑工人高血压风险的预警价值:剂量-反应关系与性别差异OA

Objective This study aims to investigate the prevalence of hypertension among high-altitude construction workers,compare the predictive performance of traditional and novel anthropometric obesity indicators for hypertension,quantify the dose-response relationship between each obesity indicator and hypertension risk,and ultimately provide an epidemiological basis for developing targeted occupational hypertension screening and weight management strategies for this population.Methods A cross-sectional survey was conducted via conve-nience sampling among 952 workers from three hydropower station and railway construction sites in Xizang Autono-mous Region,in 2020,2022 and 2025.Binary logistic regression models were applied to analyze the association between obesity-related indicators and hypertension,with confounding factors including age,gender and educational level adjusted for.Restricted cubic spline(RCS)was utilized to explore the dose-response relationship between each indicator and hypertension risk.The area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the predictive performance of different obesity indicators for hypertension.The population attributable risk percentage(PAR%)was calculated to quantify the contribution of obesity indicators to hyper-tension,and subgroup analyses were performed to investigate stratified differences in the association between obesity indicators and hypertension.Sensitivity analyses were conducted to confirm the stability of the study findings.Results The prevalence of hypertension in the study population was 37.5%.After adjusting for confounding factors,BMI(OR=2.84,95%CI:1.84-4.37),WC(OR=1.75,95%CI:1.26-2.43),BRI(OR=2.30,95%CI:1.50-3.53),and WHtR(OR=2.53,95%CI:1.51-3.67)were all positively associated with hypertension risk.RCS analysis demonstrated that BMI,WC,BRI,and WHtR all exhibited linear dose-response relationships with hypertension risk(P overall<0.001,P nonlinear>0.05),with no statistically significant non-linear associa-tions detected.ROC curve analysis indicated that the AUC values of BMI,WC,BRI,and WHtR for hypertension risk prediction were 0.629,0.631,0.639,and 0.639,respectively;the PAR%of BMI,WC,and WHtR were 25.99%,11.97%,and 20.68%,respectively.Subgroup analysis revealed that the association between WHtR and hypertension was stronger in the male subgroup(OR=2.03,95%CI:1.51-2.73,P<0.001),and a significant multiplicative interaction between gender and WC was observed in relation to hypertension(P interaction=0.029).Results of sensitivity analysis showed that the positive correlations between hypertension and elevated BMI,abdominal obesity,elevated BRI,and elevated WHtR remained statistically significant across all three sensitivity analyses,confirming the good stability of the study results.Conclusions Workers engaged in high-altitude con-struction suffer from a high hypertension burden.The visceral fat indicators BRI and WHtR demonstrate superior early warning performance for hypertension,and male workers have a higher susceptibility to hypertension induced by abdominal obesity.It is recommended that BRI and WHtR be incorporated into routine occupational physical examinations at plateau construction sites,stratified screening for high-risk populations be conducted based on the localized optimal cut-off values identified in this study,and targeted weight and fat reduction interventions be implemented for male workers to reduce the risk of hypertension prevalence.