健康危险因素对健康状况影响效应分析

Effects of health risk factors on health status among physical examinees

目的量化分析健康危险因素对健康状况的影响效应。方法采用多元多水平方法(MVML)探索4 926名参加体检人员不同时间(2008—2010年)在体质指数(BMI)、吸烟、饮酒、体育锻炼和蔬菜、水果摄入等可控因素上的变化对脂蛋白、甘油三酯(TG)、总胆固醇(TC)等多个相关测量指标变化的影响。结果随着BMI增加,TG、TC、低密度脂蛋白(LDL)明显增加,而高密度脂蛋白(HDL)明显降低;男性组BMI平均每增加1 kg/m2,TG增加10.14 mg/d L,TC增加1.72 mg/d L,LDL增加1.91 mg/d L,而HDL则降低1.01 mg/d L;女性组,BMI平均每增加1kg/m2,TG增加8.50 mg/d L,TC增加0.93 mg/d L,LDL增加1.40 mg/d L,而HDL则降低1.27 mg/d L;参加体育锻炼能明显降低TC、TG和LDL;经常吸烟、饮酒的男性的TC、TG和LDL明显升高;男性组蔬菜、水果摄入不足者的TC、TG水平较高。结论健康危险因素对健康状况有影响,可通过选择性干预措施有效改善我国居民健康状态。

Objective To evaluate the effects of health behaviors on the health status. Methods Data on yearly physical examination of 4 926 physical examinees from January 2008 to December 2010 were collected from a health management center in Beijing. Multivariate multilevel （MVML） model was used to explore the changes in lipoprotein, triglycerides（TG）, total cholesterol （TC） and other related indicators resulted from the changes in body mass index （BMI）, smoking, alcohol consumption, physical activity, and vegetable/fruit consumption for the same individual at different times. Results We evaluated the effects of controllable health risk behaviors on health status. With the increas- ing of BMI, TG, TC, and low density lipoprotein（LDL） increased significantly, but high density lipoprotein（HDL） signifi- cantly reduced. For the males ,with an average BMI increase of 1 kg/m2 ,the average increments of TG（ 10. 14 mg/dL）, TC（ 1.72 mg/dL）, and LDL（ 1.91 mg/dL）, and a decrease of HDL （1.01 mg/dL）were observed;for the females, an average increase of BMI of 1 kg/m2 was associated with the increases of TG （8.50 mg/dL） , TC （ 1 mg/dL） , and LDL （1.40 mg/dL）and a decrease of HDL （1.27 mg/dL）. The examinees participating physical exercise frequently had significantly lower TC, TG, and LDL. For the males, regular smoking and alcohol drinking could significantly increase TC,TG,and LDL, and the examinees with deficience of vegetables and fruit intake showed higher TC and TG level. Conclusion The results of the study indicate that health risk factors have impacts on health status, which may provide evidence for health management and effective health promotion in Chinese residents through evidence-based selective interventions.