Pereira M A, Kriska A M, Collins V R, Dowse G K, Tuomilehto J, Alberti K G, Gareeboo H, Hemraj F, Purran A, Fareed D, Brissonnette G, Zimmet P Z
Division of Epidemiology, University of Minnesota, Minneapolis, USA.
Am J Epidemiol. 1998 Jul 15;148(2):148-59. doi: 10.1093/oxfordjournals.aje.a009618.
This study examined the relation between occupation and cardiovascular disease (CVD) risk factors in 2,795 individuals between ages 35 and 54 years from the rapidly developing island nation of Mauritius. Participants attended a 1992 population-based survey of noncommunicable disease (89.1 % response rate). Occupational status, physical activity in the previous year, cigarette smoking, and alcohol consumption were assessed by questionnaire. Anthropometric and metabolic measures included body mass index (kg/m2),waist-to-hip ratio, fasting serum high density lipoprotein cholesterol and low density lipoprotein cholesterol (LDL cholesterol), triglycerides, 2-hour postload plasma glucose and serum insulin concentrations, and blood pressure. In comparison with professional/skilled workers, age-adjusted means of insulin and glucose, LDL cholesterol, triglycerides, and systolic and diastolic blood pressures were significantly (p < 0.05) lower, and the age-adjusted mean for high density lipoprotein cholesterol was significantly higher for unskilled men. In women, risk factors other than LDL cholesterol varied significantly (p < 0.05) across occupational categories, with homemakers tending to have the least favorable profile. Unskilled workers reported significantly more physical activity (p < 0.01), alcohol consumption, and cigarette smoking (men only) (p < 0.05) than did the other groups. Adjustment for multiple covariates revealed an independent association between occupational status and most CVD risk factors, with physical activity attenuating this association. These results elucidate mediating behaviors of CVD risk across occupational categories that could be applied to intervention strategies in Mauritius.
本研究调查了来自快速发展的岛国毛里求斯的2795名年龄在35至54岁之间的个体的职业与心血管疾病(CVD)危险因素之间的关系。参与者参加了1992年基于人群的非传染性疾病调查(应答率为89.1%)。通过问卷调查评估职业状况、前一年的身体活动、吸烟和饮酒情况。人体测量和代谢指标包括体重指数(kg/m²)、腰臀比、空腹血清高密度脂蛋白胆固醇和低密度脂蛋白胆固醇(LDL胆固醇)、甘油三酯、负荷后2小时血浆葡萄糖和血清胰岛素浓度以及血压。与专业/技术工人相比,非技术男性经年龄调整后的胰岛素、葡萄糖、LDL胆固醇、甘油三酯以及收缩压和舒张压的均值显著更低(p<0.05),而高密度脂蛋白胆固醇的经年龄调整后的均值显著更高。在女性中,除LDL胆固醇外的危险因素在不同职业类别之间存在显著差异(p<0.05),家庭主妇的情况往往最不理想。非技术工人报告的身体活动、饮酒和吸烟(仅男性)显著多于其他组(p<0.01和p<0.05)。对多个协变量进行调整后发现职业状况与大多数CVD危险因素之间存在独立关联,身体活动会减弱这种关联。这些结果阐明了不同职业类别中CVD风险的中介行为,可应用于毛里求斯的干预策略。