2010-2012年广西5市县≥18岁城乡居民心血管疾病危险因素及聚集状况分析
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摘要
目的分析广西城乡≥18岁居民心血管疾病的危险因素及聚集性情况。方法利用2010-2012年中国居民营养与健康状况监测项目广西调查点资料,选取广西5市、县≥18岁城乡居民作为调查对象,运用多分类Logistic回归模型分析风险比值。结果被调查者超重肥胖率、高血压患病率、糖尿病患病率、血脂异常率(标化率)分别为23.5%、23.7%、8.0%、40.1%。63.4%的人群至少有1种及以上心血管危险因素,1种、2种、≥3种心血管危险因素聚集比例分别为34.2%、19.7%、9.5%;男性1种、2种、≥3种心血管危险因素聚集风险分别是女性的1.281倍、1.536倍和1.600倍;>65岁人群1种、2种、≥3种心血管危险因素聚集风险分别是18~34岁年龄组的3.714倍、10.366倍和26.662倍;汉族人群2种、≥3种心血管危险因素聚集风险分别是壮族及其他少数民族1.267倍和1.620倍;城镇居民2种、≥3种聚集风险是农村居民的1.366倍和2.587倍。结论广西城乡居民心血管危险因素聚集性较高,特别是血脂异常率对心血管危险因素聚集性的贡献率较大,应加强血脂异常率高危人群管理和防治,减少心血管疾病的发生和发展。
Objective To analyse the clustering status and risk factors of cardiovascular disease among residents aged 18 and above from five cities and counties in Guangxi Province. Methods Data were collected from Chinese residents' nutrition and health monitoring( 2010- 2012). Odds ratio was assessed by multinomial logistic regression. Results The overweight and obesity rate was 23. 5%,the prevalence of hypertension and diabetes was 23. 7% and 8. 0% respectively,also the abnormal rate of dyslipidemia was 40. 1%. 63. 4% had at least one cardiovascular risk factor,34. 2%,19. 7% and 9. 5% of participants had 1,2,and ≥3 major cardiovascular risk factors. The odds ratios of 1,2 and ≥3cardiovascular risk factors in men were 1. 281,1. 536,and 1. 600 times than women. The odds ratio in older age group( > 65) were 3. 714,10. 366 and 26. 662 times than those in younger age group( 18-34). The odds ratio of 2 and ≥3 cardiovascular risk factors in the Hans were 1. 267 and 1. 620 times than those in the Zhuang and other minorities,and 1. 366 and 2. 587 times than those in rural area. Conclusions The cardiovascular risk factors of adult residents in Guangxi Province showed high clustering,especially the dyslipidemia. It is necessary to strength the management on high risk population of dyslipidemia so as to reduce the incidence and improve the progress of cardiovascular disease.
Objective To analyse the clustering status and risk factors of cardiovascular disease among residents aged 18 and above from five cities and counties in Guangxi Province. Methods Data were collected from Chinese residents' nutrition and health monitoring( 2010- 2012). Odds ratio was assessed by multinomial logistic regression. Results The overweight and obesity rate was 23. 5%,the prevalence of hypertension and diabetes was 23. 7% and 8. 0% respectively,also the abnormal rate of dyslipidemia was 40. 1%. 63. 4% had at least one cardiovascular risk factor,34. 2%,19. 7% and 9. 5% of participants had 1,2,and ≥3 major cardiovascular risk factors. The odds ratios of 1,2 and ≥3cardiovascular risk factors in men were 1. 281,1. 536,and 1. 600 times than women. The odds ratio in older age group( > 65) were 3. 714,10. 366 and 26. 662 times than those in younger age group( 18-34). The odds ratio of 2 and ≥3 cardiovascular risk factors in the Hans were 1. 267 and 1. 620 times than those in the Zhuang and other minorities,and 1. 366 and 2. 587 times than those in rural area. Conclusions The cardiovascular risk factors of adult residents in Guangxi Province showed high clustering,especially the dyslipidemia. It is necessary to strength the management on high risk population of dyslipidemia so as to reduce the incidence and improve the progress of cardiovascular disease.
引文
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[2]国家心血管中心.《中国心血管病报告2012》发布每10秒就有1人死于心血管病[J].河北中医,2013,35(8):1129.
[3]Malik S,Wong ND,Franklin SS,et al.Impact of the metabolic syndrome on mortality from coronary heart disease,cardiovascular disease,and all causes in United States adults[J].Circulation,2004,110(10):1245-1250.
[4]MulèG,Cottone S,Mongiovi R,et al.Influence of the metabolic syndrome on aortic stiffness in never treated hypertensive patients[J].Nutr Metab Cardiovasc Dis,2006,16(1):54-59.
[5]李志芳,段培芬,武阳丰,等.山西省东南部地区常见心脑血管病危险因素及诊疗习惯的研究[J].中华疾病控制杂志,2014,18(9):829-832.
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):2-42.
[7]刘力生.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-708.
[8]中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华心血管病杂志,2007,35(5):390-419.
[9]中国肥胖问题工作组.中国成人超重和肥胖症预防与控制指南(节录)[J].营养学报,2004,26(1):1-4.
[10]林晓斐.《中国居民营养与慢性病状况报告(2015年)》发布[J].中医药管理杂志,2015,23(13):89.
[11]马永辉.吉林省成年居民心血管疾病危险因素的人群聚集现状及影响因素分析[D].长春:吉林大学,2015.
[12]庞艳蕾,王增武,王馨,等.北方农村地区心血管病危险因素调查与高血压患病分析[J].中华疾病控制杂志,2015,19(4):327-329.
[13]莫景富,宋秀玲,许燕君,等.广东省成人血脂异常患病率及其危险因素的相关性研究[J].华南预防医学,2013,39(2):11-17.
[14]赖亚新,李晨嫣,滕晓春,等.辽宁省城乡成年居民血脂异常患病率及其危险因素分析[J].中国医科大学学报,2012,41(2):151-154.
[15]唐振柱,陈兴乐,韩彦彬,等.1982-2002年广西城乡居民膳食结构与营养相关慢性病变迁的研究[J].应用预防医学,2011,17(4):196-201.
[16]朱婷,方志峰,杨虹,等.应用因子分析与结构方程模型探索膳食模式与高血压的关系[J].中国卫生统计,2016,33(1):16-19.
[17]NHANES.1999-2000 addendum to the NHANESⅢanalytic guidelines[EB/OL].(2015-11-06)[2016-03-21].http://www.cdc.gov/nchs/data/nhanes/guidelines1.pdf.
[18]张雷,崔红月,刘爱萍,等.北京市城乡结合部中老年人心血管疾病危险因素及聚集情况分析[J].中国慢性病预防与控制,2010,18(3):238-240.
[19]李开春,童贵显,柴静,等.皖西农村地区留守村民心脑血管疾病影响因素探究[J].中华疾病控制杂志,2015,19(1):17-19.
[20]唐振柱,方志峰,李忠友,等.1991-2009年广西6市县≥18岁居民高血压流行趋势分析[J].中华高血压杂志,2015,23(3):262-266.
[21]唐振柱.广西壮族自治区居民营养健康状况调查报告(2010-2012年)[M].南宁:广西科学技术出版社,2015:113-115
[22]殷瑛,任杰,赵兴胜.高血压与血脂异常对亚临床动脉粥样硬化病变影响的研究进展[J].医学综述,2009,15(7):1060-1062.
[23]Henyan NN,Riche DM,East HE,et al.Impact of statins on risk of stroke:a meta-analysis[J].Ann Pharmacother,2007,41(12):1937-1945.
[24]Li N,Wang H,Yan Z.Ethnic disparities in the clustering of risk factors for cardiovascular disease among the Kazakh,Uygur,Mongolian and Han populations of Xinjiang:a cross-sectional study[J].BMC Public Health,2012,12:499.