文章摘要
焦莹莹,王柳森,姜红如,贾小芳,王志宏,王惠君,张兵,丁钢强.中国15省(自治区、直辖市)18~64岁居民心血管代谢性危险因素的流行现况及变化趋势[J].中华流行病学杂志,2022,43(8):1254-1261
中国15省(自治区、直辖市)18~64岁居民心血管代谢性危险因素的流行现况及变化趋势
Epidemiological characteristics and trends of cardiometabolic risk factors in residents aged 18-64 years in 15 provinces of China
收稿日期:2022-02-28  出版日期:2022-08-13
DOI:10.3760/cma.j.cn112338-20220228-00155
中文关键词: 心血管代谢性危险因素  变化趋势  聚集
英文关键词: Cardiometabolic risk factors  Trend  Clustering
基金项目:国家重点研发计划(2020YFC2006300);国家财政项目(131031107000210002)
作者单位E-mail
焦莹莹 中国疾病预防控制中心营养与健康所, 北京 100050  
王柳森 中国疾病预防控制中心营养与健康所, 北京 100050
国家卫健委微量元素与营养重点实验室, 北京 100050 
 
姜红如 中国疾病预防控制中心营养与健康所, 北京 100050
国家卫健委微量元素与营养重点实验室, 北京 100050 
 
贾小芳 中国疾病预防控制中心营养与健康所, 北京 100050
国家卫健委微量元素与营养重点实验室, 北京 100050 
 
王志宏 中国疾病预防控制中心营养与健康所, 北京 100050
国家卫健委微量元素与营养重点实验室, 北京 100050 
 
王惠君 中国疾病预防控制中心营养与健康所, 北京 100050
国家卫健委微量元素与营养重点实验室, 北京 100050 
 
张兵 中国疾病预防控制中心营养与健康所, 北京 100050
国家卫健委微量元素与营养重点实验室, 北京 100050 
 
丁钢强 中国疾病预防控制中心营养与健康所, 北京 100050
国家卫健委微量元素与营养重点实验室, 北京 100050 
dinggq@chinacdc.cn 
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中文摘要:
      目的 探讨中国15个省(自治区、直辖市)18~64岁居民心血管代谢性危险因素的流行特征和变化趋势,并分析人口学特征对其的影响。方法 选取2009、2015和2018年“中国健康与营养调查”中18~64岁19 827名成年居民作为研究对象,利用其人口经济因素、血生化数据和体格测量数据,通过Joinpoint回归模型分析不同年份各代谢性危险因素检出率的变化趋势,并采用多项logit模型分析各危险因素与人口学特征的相关性。结果 在所有危险因素中,超重和中心性肥胖的整体检出率较高,在2018年分别达到36.41%和39.93%,另外,在3个年份中,危险因素聚集率在2015年最高,2018年稍有下降。Joinpoint回归模型分析结果显示,大多数代谢性危险因素的检出率2009-2018年整体呈上升趋势,但年度变化百分比(APC)无统计学意义。在APC>0的危险因素中,肥胖和糖尿病的APC较大(APC=5.37%,t=3.26,P=0.190;APC=5.52%,t=7.70,P=0.082),在APC<0的危险因素中,高敏C反应蛋白(hs-CRP)升高的APC较大(APC=-6.95%,t=-4.17,P=0.150)。多项logit回归模型分析结果显示,除LDL-C、TC和hs-CRP外,男性发生其他各代谢性危险因素的风险均高于女性;45~64岁成年人除HDL-C外发生其他危险因素的风险高于18~44岁低年龄组且在高血压和糖化血红蛋白升高中更为显著,分别为低年龄组的4.67(95%CI:4.07~5.37)倍和3.73(95%CI:2.91~4.77)倍;居住在东部地区的居民发生肥胖、LDL-C边缘升高、高血压、血糖升高和糖尿病的危险性较高,而发生TG升高和hs-CRP升高的危险性较低,西部地区居民发生中心性肥胖、血压升高和高血压的风险较低。结论 在3个年份中,大多数危险因素的检出率及危险因素聚集率在2015年最高,2018年变化不大或稍有下降。性别、年龄和地域分布为心血管代谢性危险因素的主要影响因素,建议采取针对性的预防策略和干预措施,减少心血管代谢性危险因素的发生风险。
英文摘要:
      Objective To investigate the epidemiological characteristics and trends of cardiometabolic risk factors in residents aged 18-64 years in 15 provinces (autonomous regions,municipalities) of China, and to analyze the impact of demographic characteristics on cardiometabolic risk factors. Methods 19 827 adults aged 18-64 from the "China Health and Nutrition Survey" in 2009, 2015 and 2018 were selected as subjects. Using the data of demographic and economic factors, blood biochemical measurements and physical measurements, the trend of detection rates of metabolic risk factors in different years was analyzed by Joinpoint regression model. The association between risk factors and demographic characteristics was analyzed by multinomial logit model. Results Among all the risk factors, overweight and central obesity had the highest detection rates (36.41% and 39.93%, respectively). In addition, among the three years, the clustering of risk factors was highest in 2015 and decreased slightly in 2018. Joinpoint regression model analysis showed that the detection rates of most metabolic risk factors expressing an overall upward trend from 2009 to 2018 but there was no significantly statistical difference in annual percentage change (APC). Among the risk factors under APC>0, the APC of obesity and diabetes was the largest (APC=5.37%, t=3.26, P=0.190; APC=5.52%, t=7.70, P=0.082), while among the risk factors with APC<0, high hs-CRP appeared as the largest (APC=-6.95%, t=-4.17, P=0.150). Multinomial logit model showed that male had higher risk of developing all metabolic risk factors than female except LDL-C, TC and hs-CRP. The risk of other risk factors except HDL-C in adults aged 45-64 years was higher than that in the younger age group aged 18-44 years, and was more significant in hypertension and elevated HbA1c, which were 4.67 (95%CI:4.07-5.37) times and 3.73 (95%CI:2.91-4.77) times of the younger age group, respectively. Residents living in the eastern areas had the highest risk of obesity, borderline high LDL-C, hypertension, elevated blood glucose and diabetes, and the lowest risk of elevated TG and high hs-CRP. People from the western region had the lowest risk of central obesity, elevated blood pressure and hypertension. Conclusions In the three years, the detection rate and clustering of most risk factors were the highest in 2015, and there was little change in 2018. Gender, age and geographical distribution were the main influencing factors of cadiometabolic risk factors. It is suggested to adopt targeted prevention strategies and intervention measures to reduce the risk of cardiovascular disease.
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