江苏省社区居民吸烟与肥胖交互作用对血脂异常的关联分析
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摘要
目的探讨吸烟与肥胖之间交互作用对血脂异常发病的影响。方法在江苏省6个项目实施地区中,共纳入35～75岁居民83 530人,使用国家心血管项目管理办公室统一设计问卷,以面访形式获取调查对象相关信息,并进行血压、身高、体重及腰围测量,采集空腹静脉血检测空腹血糖、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)。运用logistic回归模型分析血脂异常的危险因素,利用加法模型评价吸烟与肥胖的交互作用对血脂异常的影响。结果血脂异常患病率为37.16%,调整年龄、性别、文化程度、家庭收入、农民、婚姻状况等因素后,与对照人群相比,高血压(OR=1.43,95%CI:1.38～1.47)、吸烟(OR=1.06,95%CI:1.02～1.11)、肥胖(OR=1.09,95%CI:1.08～1.09)和糖尿病(OR=1.44,95%CI:1.39～1.49)是罹患血脂异常的危险因素。交互分析中,吸烟与肥胖对血脂异常的加法交互作用有统计学意义,两者同时存在时OR值为2.06(95%CI:1.90～2.24),SI值为2.33(95%CI:1.90～2.86)。结论吸烟与肥胖同时存在会增加血脂异常的患病风险,两者对血脂异常患病存在相加交互作用。
Objective To investigate the effect of interaction between smoking and obesity on the prevalence of dyslipidemia.Methods A total of 83 530 participants aged between 35 to 75 years were recruited under the framework of the China PEACEMPP investigation from 6 project populations of Jiangsu province.Questionnaires designed by the National Office of Cardiovascular Project Management were used to collect relevant information of the participants by interview.Blood pressure,height,weight and waist circumference were measured.Fasting venous blood samples were collected to analyze levels of fasting blood glucose,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C).Logistic regression model was used to analyze the risk factors of dyslipidemia;while additive model was used to evaluate the effect of the interaction between smoking and obesity on dyslipidemia. Results The prevalence of dyslipidemia was 37.16%.After adjusting for age,gender,educational level,family income,farmers,marital status and other factors,compared with the control group,hypertension(OR=1.43,95%CI:1.38-1.47),smoking(OR=1.06,95%CI:1.02-1.11),obesity(OR = 1.09,95%CI:1.08-1.09)and diabetes(OR=1.44,95%CI:1.39-1.49)were risk factors of dyslipidemia.In the interaction analysis,the additive interaction between smoking and obesity on the dyslipidemia was statistically significant;the ORvalue was 2.06(95%CI:1.90-2.24)and SI value was 2.33(95%CI:1.90-2.86)upon co-existence.Conclusion The co-existence of smoking and obesity increases the risk of dyslipidemia.There is an additive interaction between smoking and obesity on dyslipidemia.
Objective To investigate the effect of interaction between smoking and obesity on the prevalence of dyslipidemia.Methods A total of 83 530 participants aged between 35 to 75 years were recruited under the framework of the China PEACEMPP investigation from 6 project populations of Jiangsu province.Questionnaires designed by the National Office of Cardiovascular Project Management were used to collect relevant information of the participants by interview.Blood pressure,height,weight and waist circumference were measured.Fasting venous blood samples were collected to analyze levels of fasting blood glucose,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C).Logistic regression model was used to analyze the risk factors of dyslipidemia;while additive model was used to evaluate the effect of the interaction between smoking and obesity on dyslipidemia. Results The prevalence of dyslipidemia was 37.16%.After adjusting for age,gender,educational level,family income,farmers,marital status and other factors,compared with the control group,hypertension(OR=1.43,95%CI:1.38-1.47),smoking(OR=1.06,95%CI:1.02-1.11),obesity(OR = 1.09,95%CI:1.08-1.09)and diabetes(OR=1.44,95%CI:1.39-1.49)were risk factors of dyslipidemia.In the interaction analysis,the additive interaction between smoking and obesity on the dyslipidemia was statistically significant;the ORvalue was 2.06(95%CI:1.90-2.24)and SI value was 2.33(95%CI:1.90-2.86)upon co-existence.Conclusion The co-existence of smoking and obesity increases the risk of dyslipidemia.There is an additive interaction between smoking and obesity on dyslipidemia.
引文
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[14]吴波青,高右东,杨汝成,等.2013年德宏州15岁及以上傣族居民血脂异常流行现状及其影响因素分析[J].实用预防医学,2018,25(6):709-713.
[15]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.
[16]王伟伟,徐贵发,张鲁燕,等.中年男性饮酒与血脂异常关系的病例-对照研究[J].卫生研究,2013,42(3):437-441.
[17]王立新,张新卫,何青芳,等.浙江省成年人群生活方式与血脂异常的相关性研究[J].中国预防医学杂志,2015,16(2):86-89.
[18] Andersson T,Alfredsson L,Kallberg H,et al.Calculating measures of biological interaction[J].Eur J Epidemiol,2005,20(7):575-579.
[19]袁悦,李楠,任爱国,等.流行病学研究中相加和相乘尺度交互作用的分析[J].现代预防医学,2015,42(6):961-965,975.
[20]陶然,周金意,苏健,等.成人血脂异常与高血压关系[J].江苏预防医学,2014,25(5):18-21.
[21]陶然,周金意,张永青,等.江苏省老年人体质指数和腰围与主要慢性病的关系[J].江苏预防医学,2015,26(1):1-4.
[2] Yan L,Xu MT,Yuan L,et al.Prevalence of dyslipidemia and its control in type 2diabetes:A multicenter study in endocrinology clinics of China[J].J Clin Lipidol,2016,10(1):150-160.
[3] Parray IA,Parry MA,Latief M.Prevalence of dyslipidemia in school children of Kashmir valley[J].Diabetes Metab Syndr,2016,10(2Suppl 1):47-54.
[4]杨雪莹,王亭,王亚平.天津市成年居民血脂异常流行特征及影响因素分析[J].中国公共卫生,2016,32(3):286-290.
[5]白云,耿坤,徐志鑫.北京市昌平区成人血脂异常流行及相关因素分析[J].中国卫生检验杂志,2018,28(9):1126-1129.
[6]谢梦婷,于健,邹迪莎,等.超重或肥胖及高血糖对血脂异常的交互作用分析[J].山东医药,2016,56(46):39-41.
[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):701-743.
[8]诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953.
[9]王抒,王正,黎健.应用空腹和餐后三酰甘油预测心血管疾病的危险性[J].中国心血管杂志,2011,16(4):255-258.
[10]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.
[11]中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究[J].中华流行病学杂志,2002,23(1):10-15.
[12] Kallberg H,Ahlbom A,Alfredsson L.Calculating measures of biological interaction using R[J].Eur J Epidemiol,2006,21(8):571-573.
[13]陶然,周金意,苏健,等.江苏省成年人血脂异常与糖尿病关系[J].中国公共卫生,2015,31(5):558-562.
[14]吴波青,高右东,杨汝成,等.2013年德宏州15岁及以上傣族居民血脂异常流行现状及其影响因素分析[J].实用预防医学,2018,25(6):709-713.
[15]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.
[16]王伟伟,徐贵发,张鲁燕,等.中年男性饮酒与血脂异常关系的病例-对照研究[J].卫生研究,2013,42(3):437-441.
[17]王立新,张新卫,何青芳,等.浙江省成年人群生活方式与血脂异常的相关性研究[J].中国预防医学杂志,2015,16(2):86-89.
[18] Andersson T,Alfredsson L,Kallberg H,et al.Calculating measures of biological interaction[J].Eur J Epidemiol,2005,20(7):575-579.
[19]袁悦,李楠,任爱国,等.流行病学研究中相加和相乘尺度交互作用的分析[J].现代预防医学,2015,42(6):961-965,975.
[20]陶然,周金意,苏健,等.成人血脂异常与高血压关系[J].江苏预防医学,2014,25(5):18-21.
[21]陶然,周金意,张永青,等.江苏省老年人体质指数和腰围与主要慢性病的关系[J].江苏预防医学,2015,26(1):1-4.