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[新疆南部居民心脏代谢多重疾病的相关因素及累积效应分析]

[Analysis of the associated factors and cumulative effects of cardiometabolic multimorbidity among residents in southern Xinjiang].

作者信息

Chen S L, Muhetaer Dilimulati, Ma R L, Yang B, Wu X L, Jian L Y, Li J H, Cheng J, Guo S X, Guo H

机构信息

Department of Preventive Medicine,School of Medicine,Shihezi University,Shihezi 832000,China Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps,Shihezi 832000,China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Mar 6;59(3):292-301. doi: 10.3760/cma.j.cn112150-20240613-00465.

Abstract

To analyze the associated factors and cumulative effects of cardiometabolic multimorbidity (CMM) among residents in southern Xinjiang. A stratified random cluster sampling method was used to conduct questionnaire surveys, physical examinations and laboratory tests among the personnel of the 51st Brigade, 3rd Division, Xinjiang, in 2016. The multivariate logistic regression, multivariate linear regression, restricted cubic spline, and network analysis methods were used to study the association of lifestyle (smoking, alcohol consumption and physical activity), socioeconomic (occupation, education and marital status) and clinical factors (waist circumference, body mass index and family history) with CMM. A total of 12 773 study subjects were included. The prevalence of cardiovascular metabolic diseases among residents in southern Xinjiang was 52.49%. Specifically, the prevalence rates of dyslipidemia, hypertension, coronary heart disease, diabetes, and stroke were 31.14%, 29.95%, 6.78%, 6.26%, and 2.47%, respectively, and the prevalence of CMM was 19.06%. Multivariate logistic regression analysis revealed that the associations between clinical and socioeconomic factors and CMM significantly increased with higher scores. Specifically, the rose from 1.75 (clinical factors) and 1.07 (socioeconomic factors) on a score of 1 to 4.41 and 1.93 on a score of 3, respectively. The association between lifestyle factors and CMM was only observed at higher scores (=1.26, 95%:1.07~1.62). The trend test using the scores of each group as continuous variables in the model showed that the risk of disease increased with the accumulation of clinical, socioeconomic and lifestyle factors (all <0.05). Restricted cubic spline analysis demonstrated a non-linear relationship between the total number of associated factors and CMM (<0.05 and <0.05). Network analysis identified hypertension (strength=0.42) as the "core node" among the five diseases. When analyzing the three types of influencing factors, hypertension (strength=0.68), dyslipidemia (strength=0.47), coronary heart disease (strength=0.37), and clinical factors (strength=0.53) emerged as "core nodes". In the network of nine associated factors, abnormal waist circumference and BMI (strength=0.90 and 0.84) were identified as "key factors", while hypertension (strength=0.68) and dyslipidemia (strength=0.52) were identified as "key diseases". The prevalence of CMM among residents in southern Xinjiang is high, and there is a cumulative effect of multiple factors. Hypertension and dyslipidemia are key diseases in the multimorbidity network, while abnormal BMI and waist circumference are key associated factors.

摘要

分析新疆南部居民心血管代谢共病(CMM)的相关因素及累积效应。2016年采用分层随机整群抽样方法,对新疆生产建设兵团第三师五十一团人员进行问卷调查、体格检查和实验室检测。采用多因素logistic回归、多因素线性回归、限制性立方样条和网络分析方法,研究生活方式(吸烟、饮酒和体育活动)、社会经济因素(职业、教育程度和婚姻状况)及临床因素(腰围、体重指数和家族史)与CMM的关联。共纳入12773名研究对象。新疆南部居民心血管代谢疾病患病率为52.49%。具体而言,血脂异常、高血压、冠心病、糖尿病和卒中的患病率分别为31.14%、29.95%、6.78%、6.26%和2.47%,CMM患病率为19.06%。多因素logistic回归分析显示,临床和社会经济因素与CMM的关联随得分升高而显著增加。具体而言,得分从1分的1.75(临床因素)和1.07(社会经济因素)分别升至3分的4.41和1.93。生活方式因素与CMM的关联仅在得分较高时观察到(比值比=1.26,95%可信区间:1.07~1.62)。在模型中以各组得分作为连续变量进行趋势检验,结果显示疾病风险随临床、社会经济和生活方式因素的累积而增加(均P<0.05)。限制性立方样条分析显示相关因素总数与CMM之间存在非线性关系(P<0.05和P<0.05)。网络分析确定高血压(强度=0.42)为五种疾病中的“核心节点”。在分析三类影响因素时,高血压(强度=0.68)、血脂异常(强度=0.47)、冠心病(强度=0.37)和临床因素(强度=0.53)成为“核心节点”。在九个相关因素的网络中,腰围和体重指数异常(强度=0.90和0.84)被确定为“关键因素”,而高血压(强度=0.68)和血脂异常(强度=0.52)被确定为“关键疾病”。新疆南部居民CMM患病率较高,且存在多因素累积效应。高血压和血脂异常是共病网络中的关键疾病,而体重指数和腰围异常是关键相关因素。

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