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[中国15省份农民心血管代谢相关危险因素分析]

[Analysis on cardio-metabolic related risk factors in farmers of 15 provinces in China].

作者信息

Wang L S, Zhang B, Wang H J, Guo C L, Zhang Y P, Zhang J G, Du W W, Wang Z H

机构信息

National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing 100050, China.

Chinese Center for Diseases Control and Prevention, Beijing 102206, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Sep 10;39(9):1239-1243. doi: 10.3760/cma.j.issn.0254-6450.2018.09.018.

Abstract

To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China, to explore the influence of population economic factors on them. A total of 3 367 farmers, including fishermen or hunters, aged ≥18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015. Basic information (age, gender), data on anthropometric (body height, weight and waist size), blood biochemical and socioeconomic (occupation, income, education level and living area) were included. According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005, five cardio-metabolic risk factors appeared as central obesity, increased triglycerides, decreased HDL-C, increased blood pressure and increased plasma glucose. Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time. Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors. In 3 367 framers of 15 provinces (autonomous region and municipality), the prevalence rates of central obesity, increased blood pressure, increased plasma glucose, increased triglycerides and decreased HDL-C were 51.8, 59.0, 17.0, 25.5 and 38.7 respectively. Multivariate logistic regression analysis showed that the risks for central obesity (=3.69, 95: 3.17-4.28) and decreased HDL-C (=3.28, 95: 2.81- 3.82) were higher in women than in men, and the risks for increased blood pressure (=0.73, 95: 0.63-0.84), increased blood glucose (=0.80, 95: 0.67-0.97) were lower in women than in men. Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend <0.05). Framers in western China had obviously lower risk for central obesity compared with farmers in central China. No significant correlation was found between farmers' income level, education level or the prevalence of metabolic risk factors. In 15 provinces of China, the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5 of the farmers, and the co-prevalence of cardio-metabolic risk factor was found in 60 of farmers. The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender. It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.

摘要

分析中国≥18岁农民心血管代谢相关危险因素的患病率及共患病率,探讨人口经济因素对其的影响。从2015年中国居民营养与健康状况变迁项目数据库中选取3367名≥18岁的农民(包括渔民或猎人)作为研究对象。纳入基本信息(年龄、性别)、人体测量数据(身高、体重和腰围)、血液生化指标以及社会经济数据(职业、收入、教育水平和居住地区)。根据国际糖尿病联盟(IDF)2005年发布的代谢综合征定义,心血管代谢危险因素包括中心性肥胖、甘油三酯升高、高密度脂蛋白胆固醇降低、血压升高和血糖升高。危险因素共患病率定义为同一人同时检测出2种或更多危险因素。采用多因素logistic回归模型分析社会经济因素与代谢危险因素之间的关系。在15个省(自治区、直辖市)的3367名农民中,中心性肥胖、血压升高、血糖升高、甘油三酯升高和高密度脂蛋白胆固醇降低的患病率分别为51.8%、59.0%、17.0%、25.5%和38.7%。多因素logistic回归分析显示,女性中心性肥胖(比值比=3.69,95%置信区间:3.17-4.28)和高密度脂蛋白胆固醇降低(比值比=3.28,95%置信区间:2.81-3.82)的风险高于男性,而女性血压升高(比值比=0.73,95%置信区间:0.63-0.84)、血糖升高(比值比=0.80,95%置信区间:0.67-0.97)的风险低于男性。年龄与代谢危险因素的患病率或共患病率呈正相关(趋势P<0.05)。与中部地区农民相比,西部地区农民中心性肥胖风险明显较低。农民的收入水平、教育水平与代谢危险因素的患病率之间未发现显著相关性。在中国15个省,85.5%的农民至少有一种心血管代谢危险因素,60%的农民存在心血管代谢危险因素共患情况。心血管代谢危险因素的患病率和共患病率与年龄和性别显著相关。建议根据心血管代谢因素患病率和共患病率的分布特征进行有针对性的营养干预和健康教育,加强疾病的早期防控工作。

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