基于农村社区人群的心血管危险因素相对效应和性别差异的分层研究  

Gender-specific differences in relative effects of cardiovascular risk factors among rural population

作　　者：唐迅[1] 何柳[1] 曹洋[1] 王晋伟[1] 李娜[2] 田君[1] 刘建江[2] 于立平[2] 许海涛[2] 刘武军[2] 温苏申 窦会东[3] 胡永华[1] 

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]北京市房山区卫生局,北京102488 [3]北京市房山区第一医院检验科,北京102400

出　　处：《北京大学学报（医学版）》2011年第3期379-385,共7页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(30671807;30872173);国家重点基础研究发展计划(973计划;2006CB503903)资助~~

摘　　要：目的:调查北京市房山区农村人群心血管疾病及其相关危险因素的分布,并探讨该人群中主要危险因素与心血管疾病的关联强度。方法:采用普查的方法,对青龙湖镇32个行政村40岁以上人群进行横断面研究;通过问卷调查、体格检查和生化检测收集心血管疾病患病及其相关危险因素的资料,采用分层分析和多因素logistic回归模型进行统计学分析。结果:共计7 577名研究对象中冠心病、脑卒中、糖尿病、高血压、血脂紊乱、超重和肥胖的患病率分别为6.5%、4.1%、10.7%、39.5%、56.7%、44.0%和13.6%。采用多因素logistic回归模型调整变量后比较危险因素对脑卒中/冠心病的现患比值比(prevalence odds ratio,POR),发现高血压与脑卒中的关联更强(POR=2.780,95%CI:2.146～3.602),而糖尿病与冠心病的关联更强(POR=2.671,95%CI:2.121～3.363);按性别分层后各危险因素及数量性状指标与脑卒中的关联存在明显差异,在女性中主要是超重/肥胖(POR=1.652,95%CI:1.122～2.433)、体重指数(POR=1.048,95%CI:1.002～1.096)、收缩压(POR=1.017,95%CI:1.005～1.030)和血糖水平(POR=1.093,95%CI:1.048～1.140),而在男性中主要是血脂紊乱(POR=1.615,95%CI:1.124～2.319)、总胆固醇(POR=3.932,95%CI:1.533～10.086)和HDL-C水平(POR=0.072,95%CI:0.022～0.236)。结论:本研究人群中心血管危险因素的聚集影响脑卒中和冠心病的高患病率,不同危险因素对脑卒中和冠心病的影响程度以及在不同性别人群中的影响存在差异。Objective：To investigate the prevalence and association of cardiovascular disease and its risk factors in Fangshan District,Beijing.Methods：A total of 7 577 rural residents aged over 40 years were surveyed to estimate the prevalence of cardiovascular disease and its risk factors by questionnaire survey,physical examination and biochemical measures.The prevalence odds ratio（POR） was calculated for the association of stroke / coronary heart disease（CHD） with its risk factors in multiple logistic regression models.Results：Prevalence of CHD,stroke,diabetes,hypertension,dyslipidemia,overweight and obesity was presented as 6.5%,4.1%,10.7%,39.5%,56.7%,44.0% and 13.6%,respectively.In the adjusted multiple logistic regression models,hypertension showed stronger association with stroke（POR=2.780,95%CI：2.146-3.602）,while diabetes had a higher correlation with CHD（POR=2.671,95%CI：2.121-3.363）.After stratification by gender,significant risk factors for stroke were overweight / obesity（POR=1.652,95%CI：1.122-2.433）,body mass index（POR=1.048,95%CI：1.002-1.096）,systolic blood pressure（POR=1.017,95%CI：1.005-1.030） and serum glucose（POR=1.093,95%CI：1.048-1.140） in females,whereas dyslipidemia（POR=1.615,95%CI：1.124-2.319）,total cholesterol（POR=3.932,95%CI：1.533-10.086） and high-density lipoprotein cholesterol（POR=0.072,95%CI：0.022-0.236） were associated with stroke in males.Conclusion：Highly prevalent cardiovascular risk factors aggravated the burden brought by stroke and CHD in the rural population,and the various risk factors for stroke and CHD exhibited heterogeneous contributions among the population with different gender.

关 键 词：脑卒中 冠状动脉疾病 危险因素 农村人口 

分 类 号：R181.3[医药卫生—流行病学]