新疆南疆居民心血管代谢性共病的关联因素及累计效应分析  

Analysis of the associated factors and cumulative effects of cardiometabolic multimorbidity among residents in southern Xinjiang

作　　者：陈思林 地力木拉提·木合塔尔 马儒林[1,2] 杨波 武学莲 简乐瑶 李嘉航 程静 郭淑霞 郭恒[1,2] Chen Silin;Muhetaer Dilimulati;Ma Rulin;Yang Bo;Wu Xuelian;Jian Leyao;Li Jiahang;Cheng Jing;Guo Shuxia;Guo Heng(Department of Preventive Medicine,School of Medicine,Shihezi University,Shihezi 832000,China;Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security,the Xinjiang Production and Construction Corps,Shihezi 832000,China)

机构地区：[1]石河子大学医学院预防医学系,石河子832000 [2]重要新发传染病防控与公共卫生安全兵团重点实验室,石河子832000

出　　处：《中华预防医学杂志》2025年第3期292-301,共10页Chinese Journal of Preventive Medicine

基　　金：新疆生产建设兵团重点领域科技攻关计划(2021AB030);天山英才科技创新团队:中亚地区高发疾病防治应用研究创新团队(2023TSYCTD0020)。

摘　　要：目的分析新疆南疆居民心血管代谢性共病(CMM)的关联因素其累积效应。方法采用分层随机整群抽样方法,于2016年在新疆第三师51团进行问卷调查、体格检查和实验室检测。采用多因素logistic回归、多因素线性回归、非限制性立方样条和网络分析的方法,研究生活方式(吸烟、饮酒、体育活动),社会经济(职业、受教育程度、婚姻状况)和临床因素(腰围、BMI、家族史)与CMM的关联。结果共纳入12773名研究对象。新疆南疆居民心血管代谢疾病患病率52.49%,其中血脂异常、高血压、冠心病、糖尿病、脑卒中患病率依次为31.14%、29.95%、6.78%、6.26%、2.47%,CMM患病率为19.06%。多因素logistic回归分析显示,临床因素和社会经济因素与CMM患病的关联随着评分的增加,其OR值分别从1分的1.75和1.07上升到3分的4.41和1.93;生活方式因素与CMM患病的关联仅在较高评分中存在(OR=1.26,95%CI:1.07~1.62)。将各分组得分作为连续性变量带入模型进行趋势性检验显示,患病风险随临床因素、社会经济因素和生活方式因素数量的上升而增加(均P<0.05)。限制性立方样条分析显示,关联因素总数量与CMM患病存在非线性关系(P_(总体)<0.05、P_(非线性)<0.05)。网络分析显示,高血压(强度=0.42)为5种疾病的“核心节点”;分析3类影响因素时,高血压(强度=0.68)、血脂异常(强度=0.47)、冠心病(强度=0.37)、临床因素(强度=0.53)为网络中的“核心节点”;分析9种关联因素时,腰围异常(强度=0.90),BMI异常(强度=0.84)为网络中的“关键因素”,高血压(强度=0.68)、血脂异常(强度=0.52)为网络中的“关键疾病”。结论南疆居民CMM患病率高且多种因素存在累积效应;共病网络中高血压,血脂异常为关键疾病,BMI异常,腰围异常为关键关联因素。Objective To analyze the associated factors and cumulative effects of cardiometabolic multimorbidity(CMM)among residents in southern Xinjiang.Methods A stratified random cluster sampling method was used to conduct questionnaire surveys,physical examinations and laboratory tests among the personnel of the 51st Brigade,3rd Division,Xinjiang,in 2016.The multivariate logistic regression,multivariate linear regression,restricted cubic spline,and network analysis methods were used to study the association of lifestyle(smoking,alcohol consumption and physical activity),socioeconomic(occupation,education and marital status)and clinical factors(waist circumference,body mass index and family history)with CMM.Results A total of 12773 study subjects were included.The prevalence of cardiovascular metabolic diseases among residents in southern Xinjiang was 52.49%.Specifically,the prevalence rates of dyslipidemia,hypertension,coronary heart disease,diabetes,and stroke were 31.14%,29.95%,6.78%,6.26%,and 2.47%,respectively,and the prevalence of CMM was 19.06%.Multivariate logistic regression analysis revealed that the associations between clinical and socioeconomic factors and CMM significantly increased with higher scores.Specifically,the OR rose from 1.75(clinical factors)and 1.07(socioeconomic factors)on a score of 1 to 4.41 and 1.93 on a score of 3,respectively.The association between lifestyle factors and CMM was only observed at higher scores(OR=1.26,95%CI:1.07~1.62).The trend test using the scores of each group as continuous variables in the model showed that the risk of disease increased with the accumulation of clinical,socioeconomic and lifestyle factors(all P<0.05).Restricted cubic spline analysis demonstrated a non-linear relationship between the total number of associated factors and CMM(P_(overall)<0.05 and P_(non-linear)<0.05).Network analysis identified hypertension(strength=0.42)as the“core node”among the five diseases.When analyzing the three types of influencing factors,hypertension(strength=0.68),dyslipide

关 键 词：共病 心血管代谢危险因素 网络分析 横断面研究 

分 类 号：R54[医药卫生—心血管疾病]