中国成年双生子高血压的分布特征  

A descriptive analysis on hypertension in adult twins in China

作　　者：汪昱彤 曹卫华[1] 吕筠[1] 余灿清[1] 王胜锋[1] 黄涛 孙点剑一 廖春晓[1] 庞元捷[1] 逄增昌[2] 俞敏[3] 汪华[4] 吴先萍[5] 董忠[6] 吴凡[7] 江国虹[8] 王晓节[9] 刘彧 邓健[11] 陆林[12] 高文静[1] 李立明[1] Wang Yutong;Cao Weihua;Lyu Jun;Yu Canqing;Wang Shengfeng;Huang Tao;Sun Dianjianyi;Liao Chunxiao;Pang Yuanjie;Pang Zengchang;Yu Min;Wang Hua;Wu Xianping;Dong Zhong;Wu Fan;Jiang Guohong;Wang Xiaojie;Liu Yu;Deng Jian;Lu Lin;Gao Wenjing;Li Liming(Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Qingdao Municipal Center for Disease Control and Prevention,Qingdao 266033,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,China;Beijing Center for Disease Prevention and Control,Beijing 100013,China;Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Tianjin Centers for Disease Control and Prevention,Tianjin 300011,China;Qinghai Center for Disease Prevention and Control,Xining 810007,China;Heilongjiang Provincial Center for Disease Control and Prevention,Harbin 150090,China;Handan Center for Disease Control and Prevention of Hebei Province,Handan 056001,China;Yunnan Center for Disease Control and Prevention,Kunming 650034,China)

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]青岛市疾病预防控制中心,青岛266033 [3]浙江省疾病预防控制中心,杭州310051 [4]江苏省疾病预防控制中心,南京210009 [5]四川省疾病预防控制中心,成都610041 [6]北京市疾病预防控制中心,北京100013 [7]上海市疾病预防控制中心,上海200336 [8]天津市疾病预防控制中心,天津300011 [9]青海省疾病预防控制中心,西宁810007 [10]黑龙江省疾病预防控制中心,哈尔滨150090 [11]河北省邯郸市疾病预防控制中心,邯郸056001 [12]云南省疾病预防控制中心,昆明650034

出　　处：《中华流行病学杂志》2023年第4期536-543,共8页Chinese Journal of Epidemiology

基　　金：公益性行业科研专项(201502006,201002007);国家自然科学基金(81973126,82073633);北京大学流行病与卫生统计学顶尖学科建设项目。

摘　　要：目的描述中国双生子登记系统(CNTR)成年双生子高血压的分布特征,探索高血压在我国双生子人群中的分布规律,为探索遗传和环境因素对高血压的作用提供线索。方法研究对象选自2010-2018年于CNTR进行登记的双生子,纳入≥18岁具有高血压患病信息的69220名(34610对)双生子进行分析。采用随机效应模型描述双生子中高血压患病的人群、地区分布特征。比较不同卵型间双生子的高血压同病率,估算遗传度。结果研究对象年龄为(34.1±12.4)岁。双生子人群高血压报告患病率为3.8%(2610/69220)。年长、居住于城镇、已婚、超重或肥胖者、当前吸烟或曾经吸烟、当前饮酒或曾经饮酒人群中高血压报告患病率更高(P<0.05)。同性别双生子对内分析发现,同卵双生子高血压同病率(43.2%)高于异卵双生子(27.0%),差异有统计学意义(P<0.001),高血压遗传度为22.1%(95%CI:16.3%~28.0%)。在不同性别、年龄、地区分层中,同卵双生子高血压同病率大于异卵双生子,在女性人群中,高血压的遗传度更高。结论本研究中双生子人群的高血压分布存在人群和地区差异。在不同性别、年龄和地区中均提示高血压受遗传因素的影响,但遗传效应大小可能不同。Objective To describe the distribution characteristics of hypertension among adult twins in the Chinese National Twin Registry(CNTR)and to provide clues for exploring the role of genetic and environmental factors on hypertension.Methods A total of 69220(34610 pairs)of twins aged 18 and above with hypertension information were selected from CNTR registered from 2010 to 2018.Random effect models were used to describe the population and regional distribution of hypertension in twins.To estimate the heritability,the concordance rates of hypertension were calculated and compared between monozygotic twins(MZ)and dizygotic twins(DZ).Results The age of all participants was(34.1±12.4)years.The overall self-reported prevalence of hypertension was 3.8%(2610/69220).Twin pairs who were older,living in urban areas,married,overweight or obese,current smokers or ex-smokers,and current drinkers or abstainers had a higher self-reported prevalence of hypertension(P<0.05).Analysis within the same-sex twin pairs found that the concordance rate of hypertension was 43.2%in MZ and 27.0%in DZ,and the difference was statistically significant(P<0.001).The heritability of hypertension was 22.1%(95%CI:16.3%-28.0%).Stratified by gender,age,and region,the concordance rate of hypertension in MZ was still higher than that in DZ.The heritability of hypertension was higher in female participants.Conclusions There were differences in the distribution of hypertension among twins with different demographic and regional characteristics.It is indicated that genetic factors play a crucial role in hypertension in different genders,ages,and regions,while the magnitude of genetic effects may vary.

关 键 词：高血压 双生子研究 同病率 现况研究 

分 类 号：R544.1[医药卫生—心血管疾病]