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[天津市35-75岁居民高血压、糖尿病和血脂异常合并症患者的患病率及影响因素]

[Prevalence and influencing factors of patients with comorbidity of hypertension, diabetes and dyslipidemia in residents aged 35-75 years in Tianjin].

作者信息

Wang F H, Wei M T, Yang N, Sun J H, Zhang Y L

机构信息

Department of Clinical Epidemiology, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300457, China.

Department of Hypertension, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300457, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Sep 10;45(9):1224-1232. doi: 10.3760/cma.j.cn112338-20240422-00208.

Abstract

To investigate the current comorbidity status among hypertension, diabetes, and dyslipidemia in residents aged 35-75 years in Tianjin and to explore the main influencing factors to provide a scientific basis for the prevention and treatment of chronic disease comorbidity. From June 2019 to November 2023, 10 districts (Hedong, Hexi, Dongli, Beichen, Nankai, Xiqing, Wuqing, Baodi, Jizhou, and Binhai New District) in Tianjin were selected as the project sites. The community and natural village was used as the primary sampling unit, and each project site selected the screening sites by cluster random sampling method. Residents aged 35-75 who lived in the screening sites for 6 months and above were surveyed by questionnaire, physical examination, and biochemical tests. The chi-square test, analysis of variance, and multivariate unconditional logistic regression analysis were used for statistical analysis. Age-standardized prevalence was based on the data of the sixth national census. A total of 146 832 participants were included in this study, including 61 994 males (42.22%) and 84 838 females (57.78%), with an age of (56.83±8.84) years. The number of people with only one disease was 55 485 (37.79%), the number of people with two diseases was 36 942 (25.16%), and the number of people with three diseases was 9 683 (6.59%). The prevalence of hypertension combined with dyslipidemia was the highest (17.23%), and the standardized prevalence were 14.44%. The prevalence rates of three diseases and hypertension combined with diabetes was 6.59% and 4.98%, respectively, and the standardized prevalence was 5.42% and 4.11%, respectively. The prevalence of diabetes combined with dyslipidemia was 2.95%, and the standardized prevalence was 2.45%. Multivariate unconditional logistic regression analysis showed that advanced age (65- 75 years old: =2.69, 95%: 2.28-3.18), overweight/obesity (overweight: =2.21, 95%: 2.02-2.41; obesity: =4.50, 95%: 4.03-5.02), daily smoking (=1.96, 95%: 1.72-2.24), regular and heavy drinking (=1.63, 95%: 1.18-2.27), family history of hypertension/diabetes/hyperlipidemia (family history of hypertension: =81.17, 95%: 74.68-88.22; family history of diabetes: =15.26, 95%: 13.71-16.99; family history of hyperlipidemia: =7.13, 95%: 5.92-8.59), tea drinking (occasional tea drinking group: =1.74, 95%: 1.52-2.00; frequent tea drinking group: =2.23, 95%: 1.92-2.59) were risk factors for the comorbidity of hypertension, diabetes and dyslipidemia (all <0.05), while higher education level was a protective factor (senior high school/technical secondary school: =0.79, 95%: 0.72-0.86; college/bachelor's degree and above: =0.60, 95%: 0.53-0.68, all <0.001). The comorbidity rate of hypertension, diabetes, and dyslipidemia is high in residents aged 35-75 years in Tianjin. It is necessary to strengthen the co-management of blood pressure, blood glucose, and blood lipid in key populations with old age, overweight/obesity, junior high school education or below, daily smoking, daily drinking, occasional or frequent tea drinking, and family history of hypertension/diabetes/dyslipidemia, and promote a healthy lifestyle.

摘要

为调查天津市35 - 75岁居民中高血压、糖尿病和血脂异常的共病现状,并探究主要影响因素,为慢性病共病的防治提供科学依据。2019年6月至2023年11月,选取天津市10个区(河东、河西、东丽、北辰、南开、西青、武清、宝坻、蓟州和滨海新区)作为项目点。以社区和自然村为初级抽样单位,各项目点采用整群随机抽样方法选取筛查点。对居住在筛查点6个月及以上的35 - 75岁居民进行问卷调查、体格检查和生化检测。采用卡方检验、方差分析和多因素非条件logistic回归分析进行统计分析。年龄标准化患病率基于第六次全国人口普查数据。本研究共纳入146832名参与者,其中男性61994名(42.22%),女性84838名(57.78%),年龄为(56.83±8.84)岁。患单一疾病的人数为55485名(37.79%),患两种疾病的人数为36942名(25.16%),患三种疾病的人数为9683名(6.59%)。高血压合并血脂异常的患病率最高(17.23%),标准化患病率为14.44%。三种疾病及高血压合并糖尿病的患病率分别为6.59%和4.98%,标准化患病率分别为5.42%和4.11%。糖尿病合并血脂异常的患病率为2.95%,标准化患病率为2.45%。多因素非条件logistic回归分析显示,高龄(65 - 75岁:=2.69,95%:2.28 - 3.18)、超重/肥胖(超重:=2.21,95%:2.02 - 2.41;肥胖:=4.50,95%:4.03 - 5.02)、每日吸烟(=1.96,95%:1.72 - 2.24)、经常大量饮酒(=1.63,95%:1.18 - 2.27)、高血压/糖尿病/血脂异常家族史(高血压家族史:=81.17,95%:74.68 - 88.22;糖尿病家族史:=15.26,95%:13.71 - 16.99;血脂异常家族史:=7.13,95%:5.92 - 8.59)、饮茶(偶尔饮茶组:=1.74,95%:1.52 - 2.00;经常饮茶组:=2.23,95%:1.92 - 2.59)是高血压、糖尿病和血脂异常共病的危险因素(均<0.05),而较高教育水平是保护因素(高中/中专:=0.79,95%:0.72 - 0.86;大专及以上学历:=0.60,95%:0.53 - 0.68,均<0.001)。天津市35 - 75岁居民中高血压、糖尿病和血脂异常的共病率较高。有必要加强对老年、超重/肥胖、初中及以下学历、每日吸烟、每日饮酒、偶尔或经常饮茶以及有高血压/糖尿病/血脂异常家族史的重点人群的血压、血糖和血脂的共同管理,并倡导健康的生活方式。

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