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2015年中国15个省(自治区、直辖市)60岁以上老年人中心血管代谢危险因素的患病率及人口学作用

[Prevalence of cardiometabolic risk factors and demographic role among Chinese elderly aged over 60 years in fifteen provinces (autonomous regions, municipalities) in 2015].

作者信息

Wang Liusen, Zhang Bing, Wang Huijun, Zhang Jiguo, Du Wenwen, Jiang Hongru, Wang Zhihong

机构信息

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

出版信息

Wei Sheng Yan Jiu. 2019 Mar;48(2):173-178.

Abstract

OBJECTIVE

To analyze the epidemiological characteristics and clustering of cardiometabolic risk factors in people 60 years old and above, and to explore the influence of population economic factors on them.

METHODS

The database of China Health and Nutrition Survey in 2015 was used. Basic information(age, gender), anthropometric data(height, weight and waist size), blood biochemical data and demographic data(occupation, income, education level and geographic location) were included. A multi-stage stratified cluster random sampling was adopted, the county, city, village and suburban village as the basic survey points. Twenty families were randomly selected from each survey site, and all family members were investigated. A total of 3276 people aged 60 years and above were selected as subjects, with the proportion of males was 46. 8%, and the average age was 68 years. According to the definition of the metabolic syndrome released by the International Diabetes Federation(IDF) in 2005, there were five cardiometabolic risk factors, central obesity, raised triglycerides(TG), reduced high density lipoprotein-cholesterol(HDL-C), raised blood pressure and raised plasma glucose. Existing of 2 or more risk factors in a person at the same time was recognized as a risk factor clustering. Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.

RESULTS

In elderly of 15 provinces(regions, municipalities) of China, the prevalence of central obesity, raised blood pressure, raised plasma glucose, raised TG and reduced HDL-C were 57. 8%, 71. 3%, 25. 0%, 27. 6% and 40. 1% respectively. Multivariate Logistic regression analysis showed there were more risk of central obesity(OR=3. 66, 95%CI 3. 16-4. 26), raised TG(OR=1. 60, 95%CI 1. 36-1. 88) and reduced HDL-C(OR=2. 77, 95%CI 2. 38-3. 23)in women than those in men, and less risk of raised blood pressure(OR=0. 84, 95%CI 0. 0. 72-0. 99) in women than those in men. Elderly in the eastern region were significantly more likely to suffer from raised blood pressure(OR=1. 45, 95%CI 1. 20-1. 76) and raised plasma glucose(OR=1. 38, 95%CI 1. 14-1. 67) than those in the mid region. A correlation was found between gender, education level, regions and metabolic risk factors(P<0. 05). Income and metabolic risk factors clustering were positively correlated(P<0. 05).

CONCLUSION

The problem of elevated blood pressure and central obesity in cardiometabolic risk factors were more prominent in the 15 provinces(regions, municipalities) of China. The elderly which was female, in eastern region, had high income or education level relatively had higher risk of risk factors clustering, which should be focused on prevention and control.

摘要

目的

分析60岁及以上人群心血管代谢危险因素的流行病学特征及聚集情况,并探讨人口经济因素对其的影响。

方法

使用2015年中国健康与营养调查数据库。纳入基本信息(年龄、性别)、人体测量数据(身高、体重和腰围)、血液生化数据以及人口统计学数据(职业、收入、教育水平和地理位置)。采用多阶段分层整群随机抽样,以县、市、村和城郊村为基本调查点。从每个调查点随机抽取20个家庭,对所有家庭成员进行调查。共选取3276名60岁及以上人群作为研究对象,男性占46.8%,平均年龄为68岁。根据国际糖尿病联盟(IDF)2005年发布的代谢综合征定义,存在五个心血管代谢危险因素,即中心性肥胖、甘油三酯(TG)升高、高密度脂蛋白胆固醇(HDL-C)降低、血压升高和血糖升高。一个人同时存在2种或更多危险因素被认定为危险因素聚集。采用多变量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。

结果

在中国15个省(自治区、直辖市)的老年人中,中心性肥胖、血压升高、血糖升高、TG升高和HDL-C降低的患病率分别为57.8%、71.3%、25.0%、27.6%和40.1%。多变量logistic回归分析显示,女性发生中心性肥胖(OR=3.66,95%CI 3.16-4.26)、TG升高(OR=1.60,95%CI 1.36-1.88)和HDL-C降低(OR=2.77,95%CI 2.38-3.23)的风险高于男性,而女性血压升高(OR=0.84,95%CI 0.72-0.99)的风险低于男性。东部地区的老年人患血压升高(OR=1.45,95%CI 1.20-1.76)和血糖升高(OR=1.38,95%CI 1.14-1.67)的可能性显著高于中部地区。性别、教育水平、地区与代谢危险因素之间存在相关性(P<0.05)。收入与代谢危险因素聚集呈正相关(P<0.05)。

结论

中国15个省(自治区、直辖市)心血管代谢危险因素中血压升高和中心性肥胖问题较为突出。女性、东部地区、收入或教育水平相对较高的老年人危险因素聚集风险较高,应重点防控。

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