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按社会经济地位划分的泰国劳动力人群中的动脉粥样硬化危险因素。

Atheromatous risk factors among Thai labor forces by socioeconomic status.

作者信息

Narksawat K, Podhipak A, Punyaratabundhu P, Podang J

机构信息

Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2003 Jul;86(7):655-65.

Abstract

The purpose of this study was to describe atheromatous risk factors among Thai labor forces by socioeconomic status (SES) such as income, education and occupation. Undesirable levels of artheromatous risk factors were specified as: total serum cholesterol (TC) > 200 mg per cent, body mass index (BMI) > 25 kg/m2, fasting blood sugar (FBS) > 126 mg/dL, systolic blood pressure (SBP) > 140 mmHg and diastolic blood pressure (DBP) > 90 mmHg. Data from the Second National Health Examination survey in Thailand from 1996 to 1997 was used, with a total number of 4,198 participants (1,634 males, 2,561 females) aged 13-60 years old. Results from multivariate analysis demonstrated differences in means TC, BMI, SBP and DBP among different age-groups, both in males and females (p < 0.001). TC, BMI, and SBP increased with age in both sexes, but DBP increased with age in females only. Males who lived in a municipality had a higher risk of having undesirable TC and DBP than those who did not. Risk of undesirable BMI varied according to levels of income in males. Males with an income of 5,001-10,000 and > 25,000 baht/month had OR = 1.57 (95% CI = 1.04-2.39) and OR = 2.59 (95% CI = 1.18-5.66) compared to males with an income of < 5,000 baht/month. TC and DBP varied with levels of income in females. For undesirable TC, females with an income of 5,001-10,000 and > 25,000 baht/month had OR = 1.48 (95% CI = 1.01-2.18) and OR = 2.17 (95% CI = 1.03-4.88) compared to females with an income of < 5,000 baht/month. For undesirable DBP, females with an income > 25,000 baht/month had OR = 3.39 (95% CI = 1.31-8.78) compared to females with income an < 5,000 baht/month. Among different levels of education in males, different risks of undesirable TC, BMI, SBP and DBP were not significant, except a borderline significance in TC among vocational graduates. The same phenomenon was observed among females, except that females only a primary education tended to have a higher risk of undesirable BMI (OR = 2.64, 95% CI = 1.39-5.02) compared to females with graduate studies. The level of occupation seemed not to affect the risk of unfavorable atheromatous risk factors among males. Nonetheless, females in the agricultural section seemed to have a lower risk of undesirable TC (OR = 0.38, 95% CI = 0.18-0.78) compared to the professional group. The results suggested the consideration of critical guidance of epidemiological studies in using SES as the control variable, or for selection of subjects or matching criteria. Specific preventive programs on atheromatous risk factors should be launched for some specific socio-demographic groups in order to prevent coronary heart diseases (CHD) in the future.

摘要

本研究旨在按收入、教育程度和职业等社会经济地位(SES)描述泰国劳动力中的动脉粥样硬化风险因素。动脉粥样硬化风险因素的不良水平定义为:血清总胆固醇(TC)>200毫克/百分比,体重指数(BMI)>25千克/平方米,空腹血糖(FBS)>126毫克/分升,收缩压(SBP)>140毫米汞柱,舒张压(DBP)>90毫米汞柱。使用了1996年至1997年泰国第二次全国健康检查调查的数据,共有4198名年龄在13 - 60岁的参与者(1634名男性,2561名女性)。多变量分析结果显示,不同年龄组的男性和女性在平均TC、BMI、SBP和DBP方面存在差异(p<0.001)。男女的TC、BMI和SBP均随年龄增长而升高,但DBP仅在女性中随年龄增长。居住在直辖市的男性患不良TC和DBP的风险高于未居住在直辖市的男性。男性中不良BMI的风险因收入水平而异。月收入为5001 - 10000泰铢和>25000泰铢的男性与月收入<5000泰铢的男性相比,OR分别为1.57(95%CI = 1.04 - 2.39)和2.59(95%CI = 1.18 - 5.66)。女性的TC和DBP随收入水平而变化。对于不良TC,月收入为5001 - 10000泰铢和>25000泰铢的女性与月收入<5000泰铢的女性相比,OR分别为1.48(95%CI = 1.01 - 2.18)和2.17(95%CI = 1.03 - 4.88)。对于不良DBP,月收入>25000泰铢的女性与月收入<5000泰铢的女性相比,OR为3.39(95%CI = 1.31 - 8.78)。在男性的不同教育水平中,除职业毕业生的TC存在临界显著性外,不良TC、BMI、SBP和DBP的不同风险不显著。女性中也观察到同样的现象,只是与研究生学历的女性相比,仅接受小学教育的女性患不良BMI的风险更高(OR = 2.64,95%CI = 1.39 - 5.02)。职业水平似乎不影响男性中不良动脉粥样硬化风险因素的风险。尽管如此,与专业组相比,从事农业的女性患不良TC的风险似乎较低(OR = 0.38,95%CI = 0.18 - 0.78)。结果表明,在将SES用作控制变量、选择受试者或匹配标准时,应考虑流行病学研究的关键指导。应为某些特定的社会人口群体启动针对动脉粥样硬化风险因素的具体预防计划,以便未来预防冠心病(CHD)。

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