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

作　　者：王凤华 魏茂提 杨宁[2] 孙佳禾 张媛荔 Wang Fenghua;Wei Maoti;Yang Ning;Sun Jiahe;Zhang Yuanli(Department of Clinical Epidemiology,TEDA International Cardiovascular Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Tianjin 300457,China;Department of Hypertension,TEDA International Cardiovascular Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Tianjin 300457,China;Department of Cardiology,TEDA International Cardiovascular Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Tianjin 300457,China;Department of Medical Education,TEDA International Cardiovascular Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Tianjin 300457,China)

机构地区：[1]中国医学科学院北京协和医学院泰达国际心血管病医院临床流行病学中心,天津300457 [2]中国医学科学院北京协和医学院泰达国际心血管病医院高血压科,天津300457 [3]中国医学科学院北京协和医学院泰达国际心血管病医院心血管内科,天津300457 [4]中国医学科学院北京协和医学院泰达国际心血管病医院医教部,天津300457

出　　处：《中华流行病学杂志》2024年第9期1224-1232,共9页Chinese Journal of Epidemiology

基　　金：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)。

摘　　要：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χ^(2)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146832例研究对象,其中男性61994例(42.22%),女性84838例(57.78%),总人群年龄为(56.83±8.84)岁。55485例(37.79%)单纯患1种疾病,36942例(25.16%)共患2种疾病,9683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�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 146832 participants were included in this study,including 61994 males(42.22%)and 84838 females(57.78%),with an age of(56.83±8.84)years.The number of people with only one disease was 55485(37.79%),the number of people with two diseases was 36942(25.16%),and the number of people with three diseases was 9683(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 hy

关 键 词：高血压 糖尿病 血脂异常 共病 

分 类 号：R195.4[医药卫生—卫生统计学]