Sun Pei, Gao Jie, Liang Xiao, Zhang Xin, Zhang Xiao, Yan Xiaopeng, Ni Chunping
Department of Basic Nursing, School of Nursing, Air Force Medical University, Xi'an, China.
Tob Induc Dis. 2025 Sep 19;23. doi: 10.18332/tid/208109. eCollection 2025.
Gender-specific variations in hormonal profiles, adipose tissue distribution, and metabolic pathways may differentially modulate the health impacts of smoking and alcohol use. Current population-based studies on the impact of smoking and alcohol consumption on cardiometabolic diseases (CMD) and multimorbidity (CMM) often lack gender-stratified analyses, thereby limiting the evidence base for gender-tailored preventive strategies.
This population-based cross-sectional study used data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), and a total of 11447 participants were included in the analysis. Multinomial logistic regression was conducted to assess behavioral risk factors, with interaction terms evaluating effect modification by gender.
The prevalence was 16.67% for CMD and 5.66% for CMM. Participants who smoked were more likely to report CMM than those who did not smoke (OR=2.70, p<0.05). Smoking was significantly associated with the prevalence of CMD in females (AOR=1.34, p<0.05), but not in males (p=0.556). Moreover, female smokers were more likely to report CMM compared to male smokers (AOR=3.53, AOR=2.02, p<0.05). No significant associations were found between alcohol consumption and the prevalence of CMD or CMM, nor were any gender-specific differences observed.
Smoking may have a potential gender-specific effect on the risk of CMD and CMM, with female smokers exhibiting a higher prevalence of CMM than males. This highlights the need to integrate gender considerations into chronic disease prevention frameworks.
激素水平、脂肪组织分布和代谢途径的性别差异可能会对吸烟和饮酒对健康的影响产生不同的调节作用。目前基于人群的关于吸烟和饮酒对心脏代谢疾病(CMD)和多种疾病(CMM)影响的研究往往缺乏性别分层分析,从而限制了制定针对性别定制预防策略的证据基础。
这项基于人群的横断面研究使用了2020年中国健康与养老追踪调查(CHARLS)的数据,共有11447名参与者纳入分析。进行多项逻辑回归以评估行为危险因素,并通过交互项评估性别对效应的修正作用。
CMD的患病率为16.67%,CMM的患病率为5.66%。吸烟的参与者比不吸烟的参与者更有可能报告患有CMM(比值比=2.70,p<0.05)。吸烟与女性CMD患病率显著相关(调整后的比值比=1.34,p<0.05),但与男性无关(p=0.556)。此外,与男性吸烟者相比,女性吸烟者更有可能报告患有CMM(调整后的比值比=3.53,调整后的比值比=2.02,p<0.05)。未发现饮酒与CMD或CMM患病率之间存在显著关联,也未观察到任何性别差异。
吸烟可能对CMD和CMM的风险产生潜在的性别特异性影响,女性吸烟者的CMM患病率高于男性。这凸显了将性别因素纳入慢性病预防框架的必要性。