老年人不健康生活方式与高血压、糖尿病和血脂异常的关联研究

叶婷婷; 邵英; 余彬; 蔡长伟; 冯传腾; 贾鹏; 杨淑娟

Abstract

叶婷婷,邵英,余彬,蔡长伟,冯传腾,贾鹏,杨淑娟.老年人不健康生活方式与高血压、糖尿病和血脂异常的关联研究[J].Chinese journal of Epidemiology,2024,45(3):385-392

老年人不健康生活方式与高血压、糖尿病和血脂异常的关联研究

Association between unhealthy lifestyles and hypertension, diabetes and dyslipidemia in old adults in China

Received:July 15, 2023

DOI：10.3760/cma.j.cn112338-20230715-00008

KeyWord: 生活方式高血压糖尿病血脂异常网络分析

English Key Word: Lifestyle Hypertension Diabetes Dyslipidemia Network analysis

FundProject:国家重点研发计划（2023YFC3604701）；国家自然科学基金（42271433）；四川省重点研发项目（2023YFS0251）；四川大学-达州校市战略合作专项（2020CDDZ-26-SCU）；武汉大学人民医院交叉创新人才项目（JCRCYG-2022-003）；武汉大学学院国际化发展重点专项支持计划（WHU-GJZDZX-PT07）

Author Name	Affiliation	E-mail
Ye Tingting	West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
Shao Ying	Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
Yu Bin	West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
Cai Changwei	West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
Feng Chuanteng	West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
Jia Peng	School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China	jiapengff@hotmail.com
Yang Shujuan	West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China Affiliated Hospital of Chengdu University, Chengdu 610081, China	rekiny@126.com

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Abstract:

目的分析老年人不健康生活方式对高血压、糖尿病和血脂异常患病的影响及累积效应，并探索起关键作用的生活方式。方法基于2021年云南省行为与疾病监测队列的基线数据，选取年龄≥60岁的16 763名老年人作为研究对象。不健康生活方式包括吸烟、饮酒、不健康饮食、低体力活动、BMI异常和腰围异常，并使用每个研究对象暴露的累积数量来计算不健康生活方式得分。采用多因素logistic回归模型以及混合图模型，分析不健康生活方式与高血压、糖尿病和血脂异常之间的关系。结果老年人的高血压、糖尿病和血脂异常的患病率分别为57.0%、11.5%和37.0%。研究纳入的6种不健康生活方式大多数表现为高血压、糖尿病和血脂异常的危险因素，患病风险随不健康生活方式数量的累积而上升。与无不健康生活方式者相比，同时具有6种不健康生活方式者，患高血压、糖尿病和血脂异常的OR值分别为3.99（95%CI：1.81~8.80）、4.64（95%CI：1.64~13.15）和4.26（95%CI：2.08~8.73）。混合图模型构建的网络中腰围异常（桥强度=0.81）和高血压（桥强度=0.55）为连接不健康生活方式与高血压、糖尿病和血脂异常的关键“桥接节点”。结论老年人的不健康生活方式得分越高，高血压、糖尿病和血脂异常患病风险越大，腰围异常是不健康生活方式中的关键因素。

English Abstract:

Objective To analyze the individual and cumulative effects of unhealthy lifestyle on the prevalence of hypertension, diabetes and dyslipidemia in old adults in China, and find out the critical lifestyle in the network. Methods Based on the baseline data of Yunnan Behavior and Disease Surveillance Cohort in 2021, a total of 16 763 older adults aged ≥60 years were included in our study. The unhealthy lifestyle factors including smoking, drinking, unhealthy eating habit, lower physical activity level, abnormal BMI and abnormal waist circumference. We calculated the unhealthy lifestyle score by using the cumulative exposures of each participant. Multiple logistic regression and mixed graphical models were used to describe the association between unhealthy lifestyle and the prevalence of hypertension, diabetes and dyslipidemia. Results The prevalence of hypertension, diabetes and dyslipidemia were 57.0%, 11.5% and 37.0%, respectively. Most of the unhealthy lifestyles included in the study were risk factors for hypertension, diabetes and dyslipidemia, and the risks of disease increased with the increase of the unhealthy lifestyle score. The participants with the highest score (score: 6) had significantly higher prevalence of hypertension (OR=3.99, 95%CI: 1.81-8.80), diabetes (OR=4.64, 95%CI: 1.64-13.15) and dyslipidemia (OR=4.26, 95%CI: 2.08-8.73) compared with those with lowest score (score: 0). In the network constructed by mixed graphical model, abnormal waist circumference (bridge strength=0.81) and hypertension (bridge strength=0.55) were vital bridge nodes connecting unhealthy lifestyle and hypertension, diabetes and dyslipidemia. Conclusions The unhealthy lifestyle score was associated with risks for hypertension, diabetes and dyslipidemia. Abnormal waist circumference was the key factor for chronic diseases in old adults.

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