中老年人群中心性肥胖与多种慢性病的关联分析
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摘要
目的探究中老年人群中心性肥胖与高血压、糖尿病、高血脂、心脏病和脑卒中的风险关联及其性别差异,为慢性病高危人群筛查提供科学依据。方法本研究数据来源于2015年中国健康与养老追踪调查数据,采用多阶段分层概率抽样方法抽取全国28个省(直辖市)150个县(区)450个村(社区)中45岁及以上的居民。收集社会人口学特征、体格检查、健康状况、生活方式和健康行为等相关数据,最终纳入有效样本14 361名。采用SPSS 17.0统计软件进行χ~2检验和多因素非条件logistic回归分析。结果在14 361名研究对象中,中心性肥胖患者6 933例,患病率为48.3%,女性中心性肥胖患病率(57.6%)高于男性(38.1%),差异有统计学意义(P<0.01)。调整所有混杂因素后,中心性肥胖与高血压、糖尿病和高血脂的关联均有统计学意义[OR值分别为1.35(95%CI:1.21~1.51)、1.47(95%CI:1.24~1.75)和1.39(95%CI:1.20~1.60),P<0.01],而中心性肥胖与心脏病、脑卒中的关联均无统计学意义(P>0.05)。男性和女性中心性肥胖与高血压、高血脂和糖尿病的关联也均有统计学意义[男性OR值分别为1.37(95%CI:1.15~1.62)、1.38(95%CI:1.11~1.72)和1.82(95%CI:1.38~2.40);女性OR值分别为1.33(95%CI:1.14~1.54)、1.34(95%CI:1.11~1.62)和1.26(95%CI:1.01~1.58),P<0.05,P<0.01],而与心脏病和脑卒中的关联均无统计学意义(P>0.05)。结论中心性肥胖与高血压、糖尿病和高血脂具有关联性,女性中心性肥胖患病率明显高于男性。需针对高危人群采取有效干预措施,降低心脑血管和代谢性疾病的患病率,实现慢性病精准预防。
Objective To explore the risk association and gender differences between central obesity with hypertension,diabetes,hyperlipidemia,heart disease and stroke among middle-aged and elderly population,and to provide the basis for screening the residents with high risk of chronic disease.Methods The China Health and Retirement Longitudinal Survey in 2015(CHARLS)data were used to select residents(≥45 years old) as the subjects by multi-stage stratified probability sampling method.The subjects were from 450 communities(or villages) of 150 counties in 28 provinces.The data of social demography,physical examination,health condition,lifestyle and health behaviors were collected.The last effective samples were 14 361 subjects.Theχ~2 test and multivariate unconditional logistic regression analysis were analyzed,the used software was SPSS 17.0.Results Among the 14 361 subjects,there were 6 933 cases of central obesity(morbidity was 48.3%),female morbidity(57.6%) was significantly higher than male morbidity(38.1%),P<0.01.After adjusting for all confounding factors,the central obesity correlated positively to hypertension,diabetes and hyperlipidemia(OR=1.35,95%CI:1.21-1.51;OR=1.47,95%CI:1.24-1.75;OR=1.39,95%CI:1.20-1.60),P<0.01,but the central obesity did not correlate to heart disease and stroke(P>0.05).The male or female central obesity correlated positively to hypertension,hyperlipidemia and diabetes(males:OR=1.37,95%CI:1.15-1.62;OR=1.38,95%CI:1.11-1.72;OR=1.82,95%CI:1.38-2.40;females:OR=1.33,95%CI:1.14-1.54;OR=1.34,95%CI:1.11-1.62;OR=1.26,95%CI:1.01-1.58),P<0.05,P<0.01.But the central obesity did not correlate to heart disease and stroke(P>0.05).Conclusion Central obesity correlated positively to hypertension,diabetes and hyperlipidemia.The morbidity of central obesity in females was significantly higher than that in males.The effective measures should be taken for high risk residents to reduce the morbidities of cardiovascular and metabolic diseases,and to prevent the chronic diseases.
Objective To explore the risk association and gender differences between central obesity with hypertension,diabetes,hyperlipidemia,heart disease and stroke among middle-aged and elderly population,and to provide the basis for screening the residents with high risk of chronic disease.Methods The China Health and Retirement Longitudinal Survey in 2015(CHARLS)data were used to select residents(≥45 years old) as the subjects by multi-stage stratified probability sampling method.The subjects were from 450 communities(or villages) of 150 counties in 28 provinces.The data of social demography,physical examination,health condition,lifestyle and health behaviors were collected.The last effective samples were 14 361 subjects.Theχ~2 test and multivariate unconditional logistic regression analysis were analyzed,the used software was SPSS 17.0.Results Among the 14 361 subjects,there were 6 933 cases of central obesity(morbidity was 48.3%),female morbidity(57.6%) was significantly higher than male morbidity(38.1%),P<0.01.After adjusting for all confounding factors,the central obesity correlated positively to hypertension,diabetes and hyperlipidemia(OR=1.35,95%CI:1.21-1.51;OR=1.47,95%CI:1.24-1.75;OR=1.39,95%CI:1.20-1.60),P<0.01,but the central obesity did not correlate to heart disease and stroke(P>0.05).The male or female central obesity correlated positively to hypertension,hyperlipidemia and diabetes(males:OR=1.37,95%CI:1.15-1.62;OR=1.38,95%CI:1.11-1.72;OR=1.82,95%CI:1.38-2.40;females:OR=1.33,95%CI:1.14-1.54;OR=1.34,95%CI:1.11-1.62;OR=1.26,95%CI:1.01-1.58),P<0.05,P<0.01.But the central obesity did not correlate to heart disease and stroke(P>0.05).Conclusion Central obesity correlated positively to hypertension,diabetes and hyperlipidemia.The morbidity of central obesity in females was significantly higher than that in males.The effective measures should be taken for high risk residents to reduce the morbidities of cardiovascular and metabolic diseases,and to prevent the chronic diseases.
引文
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[17]陈秋艳.腹型肥胖、C反应蛋白及其联合作用与脑卒中的关系[D].苏州:苏州大学硕士论文集,2015:1-64
[18]王浩,俞敏,李立明,等.体质指数和腰围对浙江地区成年人糖尿病发生影响的前瞻性研究[J].中华流行病学杂志,2018,39(6):810-815.
[19]Sangros FJ,Torrecilla J,Giraldez-Garcia C,et al.Association of general and abdominal obesity with hypertension,dyslipidemia and prediabetes in the PREDAPS study[J].Rev Esp Cardiol(Engl Ed),2018,71(3):170-177.
[2]翟屹,房红芸,于文涛,等.2010-2012年中国成年人腰围水平与中心型肥胖流行特征[J].中华预防医学杂志,2017,51(6):506-512.
[3]戚圣香,洪祈,王志勇,等.南京市成人中心性肥胖与心血管疾病危险因素聚集及患病的关系[J].中国慢性病预防与控制,2018,26(5):346-350.
[4]Zhao Y,Hu Y,Smith JP,et al.Cohort profile:the China Health and Retirement Longitudinal Study(CHARLS)[J].Int J Epidemiol,2014,43(1):61-68.
[5]中华人民共和国卫生和计划生育委员会.WS/T 428-2013《成人体重判定》[S].2013.
[6]张璐,杨跃进,温瑞,等.超重、肥胖和腹型肥胖与心血管代谢性疾病的关联研究[J].现代预防医学,2016,43(21):3887-3891.
[7]Frank LK,Heraclides A,Danquah I,et al.Measures of general and central obesity and risk of type 2 diabetes in a Ghanaian population[J].Tro Med Int Health,2013,18(2):141-151.
[8]Xue H,Wang C,Li Y,et al.Incidence of type 2 diabetes and number of events attributable to abdominal obesity in China:a cohort study[J].J Diabetes,2016,8(2):190-198.
[9]Salehinia F,Aadi H,Hadaegh F,et al.Abdominal obesity phenotypes and incident diabetes over 12 years of follow-up:The Tehran Lipid and glucose study[J].Diabetes Res Clin Pract,2018,144:17-24.DOI:10.1016/j.diabres.2018.07.021.
[10]Wang T,Zhang R,Ma X,et al.Causal association of overall obesity and abdominal obesity with type 2 diabetes:a mendelian randomization analysis[J].Obesity,2018,26(5):934-942.
[11]Wietlisbach V,Marques-Vidal P,Kuulasmaa K,et al.The relation of body mass index and abdominal adiposity with dyslipidemia in 27general populations of the WHO MONICA Project[J].Nutr Metab Cardiovasc Dis,2013,23(5):432-442.
[12]吴善玉,全贞玉.腹型肥胖与高血压和高血脂及高血糖的相关性[J].中国慢性病预防与控制,2013,21(1):50-52.
[13]Niu J,Seo DC.Central obesity and hypertension in Chinese adults:a12-year longitudinal examination[J].Prev Med,2014,62:113-118.DOI:10.1016/j.ypmed.2014.02.012.
[14]Nurdiantami Y,Watanabe K,Tanaka E,et al.Association of general and central obesity with hypertension[J].Clin Nutr,2018,37(4):1259-1263.
[15]Kim J,Han HR.Physical activity,abdominal obesity and the risk of coronary heart disease:a Korean national sample study[J].Public Health,2012,126(5):410-416.
[16]Towfighi A,Zheng L,Ovbiagele B.Weight of the obesity epidemic:rising stroke rates among middle-aged women in the United States[J].Stroke,2010,41(7):1371-1375.
[17]陈秋艳.腹型肥胖、C反应蛋白及其联合作用与脑卒中的关系[D].苏州:苏州大学硕士论文集,2015:1-64
[18]王浩,俞敏,李立明,等.体质指数和腰围对浙江地区成年人糖尿病发生影响的前瞻性研究[J].中华流行病学杂志,2018,39(6):810-815.
[19]Sangros FJ,Torrecilla J,Giraldez-Garcia C,et al.Association of general and abdominal obesity with hypertension,dyslipidemia and prediabetes in the PREDAPS study[J].Rev Esp Cardiol(Engl Ed),2018,71(3):170-177.