Abstract: Background Petroleum workers，due to prolonged exposure to special environments such as high temperatures，noise，and chemical substances，face an elevated risk of obesity and cardiovascular diseases，necessitating targeted research. However，studies on the relationship between the relative fat mass（RFM）index and hypertension risk in this population remain insufficient. This study investigated the relationship between long-term trends in the RFM index and hypertension risk among petroleum workers in the China Xinjiang Uygur Autonomous Region，employing the Group Trajectory Model（GBTM）to provide scientific support for health management in this population. Methods A total of 1 560 petroleum workers who underwent consecutive health examinations at a central hospital in Karamay，Xinjiang from January 2020 to December 2023 were enrolled. Baseline data were collected through the health examination system，and the top eight covariates were selected using a random forest algorithm. Binary logistic regression analysis was conducted based on the petroleum workers' RFM index and its quartile grouping to calculate the odds ratio（OR）and 95% confidence interval（CI）for hypertension risk，while examining the mediating effects of physical activity and shift work on the relationship between RFM index and hypertension risk. The GBTM was used to identify longitudinal trajectory groups of the RFM index from 2020 to 2023，and multivariate logistic regression analysis was performed to assess hypertension risk across different trajectory groups. Results The study included 1 560 petroleum workers，comprising 543 females and 1 017 males. A binary logistic regression model was conducted using the petroleum workers' RFM index and its quartile grouping as independent variables. The results demonstrated that the RFM index was positively correlated with hypertension risk regardless of gender（P<0.05）. In the mediating analysis，physical activity mediated 30.9% and 9.08% of the association between RFM index and hypertension in females and males，respectively. Additionally，shift work mediated 20.4% and 18.45% of this association in females and males，respectively. GBTM analysis identified the following longitudinal RFM index trajectory groups：low-stability group（n=194，35.73%），moderate-stability group（n=250，46.04%），and high-stability group（n=99，18.23%）for females；and low-stability group（n=337，33.13%），moderate-stability group（n=427，41.99%），and high-stability group（n=253，24.88%）for males. Multivariate logistic regression analysis revealed that compared to the low-stability RFM trajectory group，the OR for hypertension risk was 13.39（95% CI：4.38-40.94）in the high-stability female group and 2.40（95% CI：1.65-3.49）in the high-stability male group. Conclusion Long-term elevated RFM values in petroleum workers are significantly associated with hypertension risk，with this association being more pronounced in females. This suggests the need to promote body fat management among high-risk occupational populations such as petroleum workers to reduce hypertension incidence.

Key words: Hypertension, Petroleum workers, Relative fat mass index, Group trajectory model, Longitudinal study

摘要： 背景 石油工人因长期暴露于高温、噪声和化学物质等特殊环境，面临更高的肥胖和心血管疾病风险，亟需针对性研究。然而，针对该人群相对脂肪量（RFM）指数与高血压风险的研究尚不充分。本研究以中国新疆维吾尔自治区石油工业工人为对象，探讨RFM指数长期变化趋势与高血压风险的关系，采用组轨迹模型（GBTM）方法，以期为该群体健康管理提供科学支持。方法 选取2020年1月—2023年12月于新疆克拉玛依某中心医院连续体检的1 560名石油工人。通过体检系统收集基线数据，采用随机森林筛选前8位协变量，基于石油工人RFM指数及其四分位数分组行二元Logistic回归分析计算高血压风险的OR及95%CI，并分析体力活动与倒班的在RFM指数于高血压风险的中介效应。运用GBTM识别2020—2023年RFM指数纵向轨迹分组，并采用多因素Logistic回归分析评估不同轨迹组的高血压风险。结果 本研究共纳入1 560名石油工人，其中女543名，男1 017名。以石油工人RFM指数及其四分位数分组为自变量，进行二元Logistics回归分析，结果显示显示无论性别，石油工人RFM指数均与高血压风险呈正相关（P<0.05）；石油工人中介分析中，体力活动在女性与男性之间分别介导了30.9%、9.08%的和RFM指数与高血压之间的关联；此外，轮班工作在女性与男性中分别介导了20.4%和18.45%的RFM指数与高血压之间的关联。GBTM分析识别如下RFM指数纵向轨迹分组：女性低稳定组（n=194，35.73%）、中稳定组（n=250，46.04%）和高稳定组（n=99，18.23%）；男性低稳定组（n=337，33.13%）、中稳定组（n=427，41.99%）和高稳定组（n=253，24.88%）。多因素Logistic回归分析结果显示，与RFM指数轨迹低稳定组相比，在女性的高稳定组高血压风险的OR为13.39（4.38~40.94）；男性高稳定组高血压风险的OR为2.40（1.65~3.49）。结论 石油工人长期过高的RFM值与高血压风险显著相关，且该关联在女性中更为明显，提示可应推动对石油工人这类高风险职业人群的体脂管理，以降低高血压发生的风险。

关键词: 高血压, 石油工人, 相对脂肪量指数, 组轨迹模型, 纵向研究