浏阳市成年人主要慢性病患病情况及对健康状况自我评价的影响

Prevalence of major chronic diseases and its impact on self-evaluation of health status among adults in Liuyang City

目的探讨浏阳市成年人主要慢性病患病情况及对健康状况自我评价的影响。方法利用"中国慢性病前瞻性研究"(CKB)浏阳市项目点59 916名30～79岁常住居民有效基线调查数据,通过logistic回归分析调查对象健康状况自我评价情况及其主要影响因素。结果共分析调查对象59 916人,平均年龄(51. 57±10. 54)岁,文化程度以高中为主,占58. 6%,67. 4%的居民年收入在2～4万之间。92. 88%的人健康状况自我评价好,7. 12%评价较差。调查人群高血压、糖尿病、慢阻肺患病率分别为33. 7%、3. 46%、7. 36%,高血压、糖尿病患病率女性均高于男性(均P<0. 01),慢阻肺患病率男性高于女性(P<0. 01)。高血压知晓率、糖尿病知晓率分别为36. 70%和55. 00%。健康状况自评情况在不同年龄组、性别、婚姻状况、医保情况、是否患慢性病之间等构成比差异有统计学意义(均P<0. 01)。糖尿病对健康状况自我评价为差的风险最大(OR=2. 95,95%CI:2. 61～3. 33),其次为慢阻肺(OR=2. 59,95%CI:2. 35～2. 84),高血压(OR=1. 55,95%CI:1. 44～1. 67)。男女性慢性病患者均认为糖尿病对自我健康状况影响最大(女:OR_(糖尿病)=3. 04,OR_(慢阻肺)=2. 69,OR_(高血压)=1. 39,男:OR_(糖尿病)=2. 84,OR_(慢阻肺)=2. 59,OR_(高血压)=1. 83)。年龄大、单身是影响自我健康状况好的危害因素。有医保、收入越高、体重指数大是自我健康状况的保护因素。结论慢性病患者其健康状况自我评价明显差于正常人群;糖尿病对居民健康状况自我评价影响最大,高血压的危险性可能被低估。需加强健康生活方式行为干预。

Objective To explore the prevalence of major chronic diseases and its impact on self-rating health status among adults in Liuyang City. Methods We analyzed the effective baseline data of 59,916 permanent residents who were aged 30-79 years and had been enrolled into the China Kadiore Biobank( CKB) study in Liuyang City. Logistic regression analysis was conducted to investigate the surveyed subjects’ self-rated health status and its major influencing factors. Results A total of 59,916 residents were surveyed,with the average age of( 51.57±10.54) years. Most of the residents( 58.6%) had an educational background of senior high school. 67.4% of the residents had an annual income of $ 20,000-40,000,92.88% were in good health in their self-evaluation and 7.12% were poorly evaluated. The prevalence rates of hypertension,diabetes and chronic obstructive pulmonary disease( COPD) in the residents were 33.7%,3.46% and 7.36% respectively. The prevalence rates of hypertension and diabetes were higher in females than in males( both P<0.01),while the prevalence rate of COPD was higher in males than in females( P<0.01).The awareness rates of hypertension and diabetes were 36.70% and 55.00% respectively. The self-rated health status revealed that the proportions of good and poor health status showed statistically significant differences in the residents with different ages,genders,marital status and medical insurance status and with or without chronic diseases( all P< 0.01). The biggest risk factor influencing poor self-rated health status was diabetes( OR = 2.95,95%CI: 2.61-3.33),followed by COPD( OR = 2.59,95%CI: 2.35-2.84)and hypertension( OR = 1.55,95%CI: 1.44-1.67). Both male and female patients with chronic diseases thought that diabetes had the greatest negative influence on their self-assessment of health status( female: ORdiabetes= 3. 04,ORCOPD= 2. 69,ORhypertension=1. 39; male: ORdiabetes= 2.84,ORCOPD= 2. 59,ORhypertension= 1. 83). Old age and bachelordom were the risk factors for good self-health evaluation,while having social medical insurance,having a higher income and having a higher BMI were the protective factors for good self-health evaluation. Conclusions Self-health evaluation of the chronic disease patients is significantly inferior to that of normal people. Diabetes has the greatest impact on the residents’ self-health evaluation,and the risk of hypertension may be underestimated. Therefore,healthy lifestyle behavior intervention needs to be intensified.