吸烟在社会经济地位和高TG血症关系中的中介效应分析

Mediating effect analysis of smoking on the association between socioeconomic status and hypertriglyceridemia

目的研究吸烟在社会经济地位(socioeconomic status,SES)与高TG血症之间的中介效应,为进一步防治高TG血症提供理论依据。方法选择基于2017年上海市开展的成人慢性病及危险因素监测的5557名研究对象,调查内容包括询问调查、身体测量和实验室检测。采用χ^(2)检验和Wilcoxon秩和检验分别分析定性资料和定量资料的组间差异。采用中介效应模型分析吸烟在SES和高TG血症之间的作用。结果SES与吸烟呈负相关(OR=0.86,95%CI:0.81~0.91,P<0.001),吸烟与高TG血症呈正相关(OR=1.29,95%CI:1.04~1.59,P=0.019);SES对高TG血症无直接作用,但吸烟在SES和高TG血症关系的作用差异有统计学意义(Z_(mediation)=-2.086,P=0.037)。结论吸烟在SES和高TG血症关系中存在完全中介效应,对于不同SES人群应有针对性地进行控烟和加强戒烟宣传,以更好地防控高TG血症。

Objective To examine the mediating effects of smoking on the relationship between socioeconomic status(SES)and hypertriglyceridemia,and to further provide the scientific basis for preventing and treating hypertriglyceridemia.Methods A total of 5557 adult residents from the Shanghai Chronic Disease and Risk Factors Surveillance in 2017 were included in the study.The participants were investigated with questionnaires,body measurements,and laboratory testing.The chi-square and Wilcoxon rank sum tests were used to explore the distributional differences in qualitative and quantitative data,respectively.Mediation effect analysis was adopted to study the effects of SES on hypertriglyceridemia mediated by smoking.Results SES was associated with smoking(OR=0.86,95%CI:0.81-0.91,P<0.001),and there was a positive association between smoking and hypertriglyceridemia(OR=1.29,95%CI:1.04-1.59,P=0.019);SES did not have a direct effect on hypertriglyceridemia,but smoking was found to have a mediating effect on the association between SES and hypertriglyceridemia(Z_(mediation)=-2.086,P=0.037).Conclusions The association between SES and hypertriglyceridemia was significantly completely mediated by smoking.Targeted tobacco control measures and campaigns should be carried out for better hypertriglyceridemia prevention.