城市环境暴露状态与心血管疾病危险因素水平及聚集的关系  

Association of urban environmental exposure with level and clustering of cardiovascular risk factors

作　　者：李哲 赵伟[2] 于石成[1] 韩晓燕[2] 刘剑君[1] 许志远[1,2] 么鸿雁 LI Zhe;ZHAO Wei;YU Shi-cheng;HAN Xiao-yan;LIU Jian-jun;XU Zhi-yuan;YAO Hong-yan(Chinese Center for Disease Control and Prevention,Beijing 102206,China;不详)

机构地区：[1]中国疾病预防控制中心,北京102206 [2]北京市朝阳区疾病预防控制中心

出　　处：《中国慢性病预防与控制》2020年第6期406-412,共7页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：“十三五”国家重点研发计划“精准医学研究”重点专项京津冀区域自然人群队列研究(2016YFC0900600)。

摘　　要：目的研究北京地区不同城市环境暴露状态下人群心血管疾病危险因素水平及其聚集性分布特点,探索城市化对人群心血管健康的影响,为卫生行政部门完善相关疾病防控策略,优化资源的分配提供科学依据。方法研究对象来自京津冀地区生活社区自然人群慢性病队列研究中北京地区的基线调查人群。于2017年8月至2018年2月用典型抽样的方法从北京市朝阳区5个街乡共抽取10000名20~86岁居民,收集其人口学、迁移史、慢性病和行为危险因素及体格检查信息,并采集清晨空腹血进行血脂、血糖检测,最终有效样本9325人。依据城市环境暴露状态分为始终居住在农村,由农村迁移至城市<10年,由农村迁移至城市≥10年及始终居住在城市4类人群。用SAS 9.3进行统计分析,参照全国第6次人口普查数据进行率的标化并进行χ2检验,采用log-binomial模型计算各人群与对照人群的患病率比(PR),采用Poisson回归模型分析调整混杂因素后不同城市环境暴露状态与心血管疾病危险因素数量的关系。结果依据城市环境暴露状态分为农村(2084人),由农村迁移至城市<10年(2501人),由农村迁移至城市≥10年(2348人),城市(2392人)4类人群。调整混杂因素后,log-binomial模型分析结果显示,从农村迁移至城市<10年者肥胖率(PR=0.797,95%CI:0.675~0.942)低于农村人群,饮酒率(PR=1.403,95%CI:1.175~1.676)、缺乏身体活动率(PR=1.905,95%CI:1.621~2.238)高于农村人群。从农村迁移至城市≥10年的人群及城市人群的肥胖率(PR=0.796,95%CI:0.683~0.928;PR=0.824,95%CI:0.708~0.960),吸烟率(PR=0.727,95%CI:0.594~0.890;PR=0.737,95%CI:0.607~0.894)均显著低于农村人群,而饮酒率(PR=1.188,95%CI:1.002~1.407;PR=1.193,95%CI:1.010~1.410)和缺乏身体活动率(PR=1.569,95%CI:1.349~1.826;PR=1.384,95%CI:1.189~1.611)显著高于农村人群。Poisson回归结果显示,与农村人群相比,从农村迁移至城市<10年者(RR=0.934,95%CI:0Objective To study the distribution characteristics of level and clustering of cardiovascular risk factors among different population exposed to different urban environmental exposure conditions in Beijing,to explore the impact of urbanization on cardiovascular health of residents,and to provide the scientific basis for prevention and control of diseases and resource distribution.Methods The subjects were from the chronic disease cohort of natural population in Beijing-Tianjin-Hebei region(Beijing area).From August 2017 to February 2018,a representative sampling method was used to select 10000 residents(20-86 years old)from five sub-districts and townships in Chaoyang District of Beijing.Demographic,migration history,chronic disease,behavioral risk factors and physical examination information were collected.Fasting blood was collected for blood lipid and glucose testing,and the final effective sample size was 9325 subjects.According to the exposure status of urban environment,the subjects were divided into four groups:the group 1 lived always in rural areas,the group 2 migrated from rural areas to cities for<10 years,the group 3 migrated from rural areas to cities for≥10 years,and the group 4 always lived in cities.According to the China Population Census(2010),the standardization rate of each cardiovascular risk factor was calculated and theχ2 test was used to analyze the data.The log-binomial model was used to calculate the prevalence rate(PR)between different groups and controls,the Poisson regression model was used to analyze the association of different urban environmental exposure conditions with number of cardiovascular risk factors after adjusting the confounding factors.The used software was SAS 9.3.Results According to urban environmental exposure conditions,the 9325 subjects were divided into the rural residents(2084 cases),residents who migrated from rural areas to cities for<10 years(2501 cases),residents who migrated from rural areas to cities for≥10 years(2348 cases),urban residents(2392 cases

关 键 词：城市环境暴露 心血管危险因素 聚集性 

分 类 号：R54[医药卫生—心血管疾病]