Cho In Young, Park Hwa Yeon, Lee Kiheon, Bae Woo Kyung, Jung Se Young, Ju Hye Jin, Song Jae Kyeong, Han Jong Soo
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Korean J Fam Med. 2017 Mar;38(2):64-74. doi: 10.4082/kjfm.2017.38.2.64. Epub 2017 Mar 22.
Dyslipidemia is a major risk factor contributing to cardiovascular disease and its prevalence is steadily rising. Although screening tests are readily accessible, dyslipidemia remains undertreated. Evaluating health behavior patterns after diagnosis may help improve lifestyle interventions for the management of dyslipidemia.
Data from the fifth Korean National Health and Nutrition Examination Survey 2010-2012 were used. A total of 6,624 dyslipidemia patients over 20 years old were included according to National Cholesterol Education Program-Adult Treatment Panel III guidelines. Logistic regression analysis was completed using a weighted method to determine whether awareness of dyslipidemia was associated with health behavior. Health behavior was divided into two categories: behavioral factors (smoking, alcohol consumption, exercise) and nutritional factors (adequate intake of fiber, carbohydrate, fat, protein).
There were no significant differences in health behavior among dyslipidemia patients according to awareness after adjustment for covariates, diabetes and hypertension. Awareness in women was associated with decreased smoking (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.32 to 0.94), but when adjusted for diabetes and hypertension the result was not significant (OR, 0.61; 95% CI, 0.35 to 1.06). The same pattern applied to intake of carbohydrate in men (OR, 1.28; 95% CI, 0.99 to 1.67) and protein in women (OR, 1.22; 95% CI, 0.98 to 1.50). In subgroup analysis, awareness of dyslipidemia in men without hypertension or diabetes was associated with adequate intake of carbohydrate (OR, 1.70; 95% CI, 1.06 to 2.72).
Increasing awareness alone may not be enough to improve healthy behavior in patients with dyslipidemia. Efforts including patient education and counseling through a multi-team approach may be required.
血脂异常是导致心血管疾病的主要危险因素,其患病率正在稳步上升。尽管筛查测试很容易获得,但血脂异常的治疗仍不充分。评估诊断后的健康行为模式可能有助于改善血脂异常管理的生活方式干预措施。
使用了2010 - 2012年第五次韩国国民健康与营养检查调查的数据。根据美国国家胆固醇教育计划成人治疗小组III指南,纳入了6624名20岁以上的血脂异常患者。采用加权法进行逻辑回归分析,以确定血脂异常知晓情况是否与健康行为相关。健康行为分为两类:行为因素(吸烟、饮酒、运动)和营养因素(纤维、碳水化合物、脂肪、蛋白质的充足摄入)。
在对协变量、糖尿病和高血压进行调整后,血脂异常患者中根据知晓情况划分的健康行为没有显著差异。女性的知晓情况与吸烟减少相关(比值比[OR],0.55;95%置信区间[CI],0.32至0.94),但在对糖尿病和高血压进行调整后,结果不显著(OR,0.61;95% CI,0.35至1.06)。男性碳水化合物摄入(OR,1.28;95% CI,0.99至1.67)和女性蛋白质摄入(OR,1.22;95% CI,0.98至1.50)也呈现相同模式。在亚组分析中,无高血压或糖尿病的男性对血脂异常的知晓情况与碳水化合物的充足摄入相关(OR,1.70;95% CI,1.06至2.72)。
仅提高知晓率可能不足以改善血脂异常患者的健康行为。可能需要通过多团队方法进行患者教育和咨询等努力。