天津市35~75岁居民高血压、糖尿病和血脂异常共病现况及影响因素分析

王凤华; 魏茂提; 杨宁; 孙佳禾; 张媛荔

Abstract

王凤华,魏茂提,杨宁,孙佳禾,张媛荔.天津市35~75岁居民高血压、糖尿病和血脂异常共病现况及影响因素分析[J].Chinese journal of Epidemiology,2024,45(9):1224-1232

天津市35~75岁居民高血压、糖尿病和血脂异常共病现况及影响因素分析

Prevalence and influencing factors of patients with comorbidity of hypertension, diabetes and dyslipidemia in residents aged 35-75 years in Tianjin

Received:April 22, 2024

DOI：10.3760/cma.j.cn112338-20240422-00208

KeyWord: 高血压糖尿病血脂异常共病

English Key Word: Hypertension Diabetes mellitus Dyslipidemia Comorbidity

FundProject:国家重大公共卫生服务项目；中央财政转移支付地方卫生计生服务项目（Z135080000022）

Author Name	Affiliation	E-mail
Wang Fenghua	Department of Clinical Epidemiology, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300457, China	WFHanzhen@163.com
Wei Maoti	Department of Clinical Epidemiology, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300457, China
Yang Ning	Department of Hypertension, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300457, China
Sun Jiahe	Department of Cardiology, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300457, China
Zhang Yuanli	Department of Medical Education, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300457, China

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Abstract:

目的了解天津市成年人高血压、糖尿病、血脂异常共病现况并探讨其主要影响因素，为慢性病共病的防治提供科学依据。方法 2019年6月至2023年11月在天津市选取10个区（河东、河西、东丽、北辰、南开、西青、武清、宝坻、蓟州、滨海新区）作为项目点，以社区和自然村为基本抽样单位，在每个项目点采用整群随机抽样方法抽取筛查点，对筛查点内居住≥6个月的35~75岁常住居民进行问卷调查、体格检查和生化检测。统计学分析采用χ²检验、方差分析和多因素非条件logistic回归分析，患病率以第六次全国人口普查数据进行年龄标化。结果共纳入146 832例研究对象，其中男性61 994例（42.22%），女性84 838例（57.78%），总人群年龄为（56.83±8.84）岁。55 485例（37.79%）单纯患1种疾病，36 942例（25.16%）共患2种疾病，9 683例（6.59%）共患3种疾病。2种及3种疾病共患模式中，以高血压合并血脂异常患病率最高，为17.23%，标化患病率为14.44%；其次为3种疾病共患、高血压合并糖尿病，患病率分别为6.59%和4.98%，标化后分别为5.42%、4.11%；糖尿病合并血脂异常的患病率最低，为2.95%，标化后为2.45%。多因素非条件logistic回归分析结果显示，高龄（65~75岁：OR=2.69，95%CI：2.28~3.18）、超重/肥胖（超重：OR=2.21，95%CI：2.02~2.41；肥胖：OR=4.50，95%CI：4.03~5.02）、每天吸烟（OR=1.96，95%CI：1.72~2.24）、经常大量饮酒（OR=1.63，95%CI：1.18~2.27）、有高血压/糖尿病/高血脂家族史（高血压家族史：OR=81.17，95%CI：74.68~88.22；糖尿病家族史：OR=15.26，95%CI：13.71~16.99；高血脂家族史：OR=7.13，95%CI：5.92~8.59）、饮茶（偶尔饮茶：OR=1.74，95%CI：1.52~2.00；经常饮茶：OR=2.23，95%CI：1.92~2.59）是高血压、糖尿病及血脂异常共患的重要危险因素（均P<0.05），而高文化程度是其保护因素（高中/中专：OR=0.79，95%CI：0.72~0.86；大专/本科及以上：OR=0.60，95%CI：0.53~0.68，均P<0.001）。结论天津市35~75岁居民高血压、糖尿病和血脂异常3种疾病共患率较高，对高龄、超重/肥胖、初中及以下文化程度、每天吸烟、经常大量饮酒、经常饮茶和有高血压/糖尿病/血脂异常家族史的重点人群需要加强血压、血糖、血脂的共同管理，提倡健康生活方式。

English Abstract:

Objective To investigate the current comorbidity status among hypertension, diabetes, and dyslipidemia in residents aged 35-75 years in Tianjin and to explore the main influencing factors to provide a scientific basis for the prevention and treatment of chronic disease comorbidity. Methods From June 2019 to November 2023, 10 districts (Hedong, Hexi, Dongli, Beichen, Nankai, Xiqing, Wuqing, Baodi, Jizhou, and Binhai New District) in Tianjin were selected as the project sites. The community and natural village was used as the primary sampling unit, and each project site selected the screening sites by cluster random sampling method. Residents aged 35-75 who lived in the screening sites for 6 months and above were surveyed by questionnaire, physical examination, and biochemical tests. The chi-square test, analysis of variance, and multivariate unconditional logistic regression analysis were used for statistical analysis. Age-standardized prevalence was based on the data of the sixth national census. Results A total of 146 832 participants were included in this study, including 61 994 males (42.22%) and 84 838 females (57.78%), with an age of (56.83±8.84) years. The number of people with only one disease was 55 485 (37.79%), the number of people with two diseases was 36 942 (25.16%), and the number of people with three diseases was 9 683 (6.59%). The prevalence of hypertension combined with dyslipidemia was the highest (17.23%), and the standardized prevalence were 14.44%. The prevalence rates of three diseases and hypertension combined with diabetes was 6.59% and 4.98%, respectively, and the standardized prevalence was 5.42% and 4.11%, respectively. The prevalence of diabetes combined with dyslipidemia was 2.95%, and the standardized prevalence was 2.45%. Multivariate unconditional logistic regression analysis showed that advanced age (65- 75 years old: OR=2.69, 95%CI: 2.28-3.18), overweight/obesity (overweight: OR=2.21, 95%CI: 2.02-2.41; obesity: OR=4.50, 95%CI: 4.03-5.02), daily smoking (OR=1.96, 95%CI: 1.72-2.24), regular and heavy drinking (OR=1.63, 95%CI: 1.18-2.27), family history of hypertension/diabetes/hyperlipidemia (family history of hypertension: OR=81.17, 95%CI: 74.68-88.22; family history of diabetes: OR=15.26, 95%CI: 13.71-16.99; family history of hyperlipidemia: OR=7.13, 95%CI: 5.92-8.59), tea drinking (occasional tea drinking group: OR=1.74, 95%CI: 1.52-2.00; frequent tea drinking group: OR=2.23, 95%CI: 1.92-2.59) were risk factors for the comorbidity of hypertension, diabetes and dyslipidemia (all P<0.05), while higher education level was a protective factor (senior high school/technical secondary school: OR=0.79, 95%CI: 0.72-0.86; college/bachelor's degree and above: OR=0.60, 95%CI: 0.53-0.68, all P<0.001). Conclusions The comorbidity rate of hypertension, diabetes, and dyslipidemia is high in residents aged 35-75 years in Tianjin. It is necessary to strengthen the co-management of blood pressure, blood glucose, and blood lipid in key populations with old age, overweight/obesity, junior high school education or below, daily smoking, daily drinking, occasional or frequent tea drinking, and family history of hypertension/diabetes/dyslipidemia, and promote a healthy lifestyle.

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