北京市顺义区35~75岁居民心血管病高危人群检出情况及高危预测模型建立  

Detection of individuals at high risk of cardiovascular diseases and construction of a high risk prediction model among 35-75 years old residents in Shunyi district,Beijing

作　　者：贾佳 赵红叶[1] 游凯[1] 李长青[1] JIA Jia;ZHAO Hong-ye;YOU Kai(Department of Chronic Disease Control and Prevention,Shunyi District Center for Disease Control and Prevention,Beijing 101300,China)

机构地区：[1]北京市顺义区疾病预防控制中心慢性病防制科,101300

出　　处：《中国公共卫生》2022年第4期456-460,共5页Chinese Journal of Public Health

基　　金：国家卫生和计划生育委员会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。

摘　　要：目的了解北京市顺义区35~75岁居民心血管病(CVD)高危人群检出情况并建立CVD高危预测模型,为CVD的预防控制提供参考依据。方法于2017年3月—2019年10月采用分层随机抽样方法在北京市顺义区抽取16520名35~75岁居民进行问卷调查和体格检查,分析CVD高危人群检出情况;应用多因素logistic回归分析方法建立CVD高危预测模型,并采用受试者工作特征曲线(ROC)对预测模型进行效果评价。结果北京市顺义区最终纳入分析的16279名35~75岁居民中,检出CVD高危人群3718人,CVD高危人群检出率为22.84%;多因素非条件logistic回归分析结果显示,年龄≥40岁和吸烟是北京市顺义区35~75岁居民CVD高危人群检出的危险因素,女性、文化程度大专及以上、职业为商业/服务业人员和私营业主/其他人员、家庭年均收入>5万元、居住在顺义东部和中部地区是北京市顺义区35~75岁居民CVD高危人群检出的保护因素;CVD高危人群体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)分别为(27.06±3.62)kg/m2、(158.46±19.39)、(90.36±12.38)mm Hg、(6.78±1.96)、(4.92±1.28)、(1.78±1.03)和(2.86±1.15)mmol/L,均高于非高危人群的(26.40±3.60)、(131.70±14.18)、(79.94±9.05)mm Hg、(6.27±1.58)、(4.63±0.91)、(1.59±0.93)和(2.46±0.73)mmol/L,差异均有统计学意义(均P<0.001);纳入年龄、性别、人口学特征(文化程度、职业、家庭年收入、地区)、吸烟和无创伤可自测体格检测指标(SBP、DBP、BMI)建立的CVD高危预测模型为:Y=-19.315+0.013×年龄+0.009×文化程度-0.005×家庭年均收入+0.113×男性+1×女性+0.358×农民+0.576×工人+0.718×行政/专业技术人员+0.037×私营业主/其他人员+0.439×退休/失业/家务人员+1×商业/服务业人员+0.327×顺义西部地区-0.027×顺义中部地区+1×顺义东部地区+0.223×吸烟+0.009×BMI+0.098×SBP+0.028×DBP,预测Objective To examine the proportion of people at high risk of cardiovascular diseases(CVD)among 35-75 years old community residents in Shunyi district of Beijing and to construct a prediction model of CVD risk for providing references to CVD prevention and control.Methods Using stratified random sampling,we recruited 16520 permanent community residents aged 35-75 years in Shunyi district of Beijing.A questionnaire survey and physical examination were conducted to detect individuals at high CVD risk among the residents from March 2017 to October 2019.Multivariate logistic regression analysis was adopted to construct a model for predicting high CVD risk and receiver operating characteristic curve(ROC)was used to evaluate the efficacy of the prediction model.Results Of the 16279 participants completing the survey and examination,22.84%(3718)were assessed with a high CVD risk.Compared to those in the participants not with high CVD risk,significantly higher body mass index(BMI,27.06±3.62 vs.26.40±3.60 kg/m2),systolic blood pressure(SBP,158.46±19.39 vs.131.70±14.18 mm Hg),diastolic blood pressure(DBP,90.36±12.38 vs.79.94±9.05 mm Hg),fasting blood glucose(FPG,6.78±1.96 vs.6.27±1.58 mmol/L),total cholesterol(TC,4.92±1.28 vs.4.63±0.91 mmol/L),triglyceride(TG,1.78±1.03 vs.1.59±0.93 mmol/L),and low-density lipoprotein cholesterol(LDL-C,2.86±1.15 vs.2.46±0.73)were detected in the participants at high CVD risk(all P<0.001).Unconditional multivariate logistic regression analysis showed that the risk factors for with high CVD risk include aged≥40 years and smoking;while,female gender,with the education of college and above,engaged in business or service industry or being private owners,having an average annual income of more than 50000 yuan RMB,and living in the east or central part of Shunyi district are protective factors against high CVD risk.The constructed model for high CVD risk prediction is expressed as following:Y=-19.315+0.013×age+0.009×education level-0.005×annual family income+0.113×male gender+1

关 键 词：心血管病(CVD) 高危人群 检出情况 高危预测模型 建立 

分 类 号：R181.37[医药卫生—流行病学]