云南省大姚县≥35岁农村居民肥胖相关慢性病疾病负担

Disease burden of four obesity-related chronic diseases among rural residents aged 35 years and over in Dayao county of Yunnan province

目的分析云南省大姚县居民高血压、糖尿病、冠心病和脑卒中4种肥胖相关慢性病疾病负担,为采取相应的预防控制措施提供参考依据。方法采用分层随机抽样方法于2015年1月对在云南省大姚县抽取的2 479名≥35岁农村居民进行问卷调查和体格检查,采用伤残调整生命年(DALY)评价4种肥胖相关慢性病的疾病负担。结果云南省大姚县≥35岁农村居民肥胖和中心性肥胖患病率分别为6.9%和39.9%,高血压、糖尿病、冠心病和脑卒中4种相关慢性病患病率分别为40.4%、6.1%、5.5%和1.9%;高血压、糖尿病、冠心病和脑卒中每千人口DALY值分别为2.0、3.4、32.4和24.0;男性居民糖尿病、冠心病和脑卒中的每千人口DALY值分别为3.7、34.9和27.2,高于女性居民的3.0、30.2和21.0,高血压的每千人口DALY值为1.9,低于女性居民的2.1;多因素logistic回归分析结果显示,在调整了性别、年龄、文化程度、婚姻状况、家庭年人均收入、疾病家族史、吸烟等混杂因素后,肥胖居民患高血压、糖尿病、冠心病和脑卒中的风险为非肥胖居民的2.1、3.5、4.8和6.1倍,中心性肥胖居民患高血压、糖尿病、冠心病和脑卒中的风险为非肥胖居民的2.3、2.4、1.9和5.2倍(均P<0.05);4种肥胖相关慢性病的总DALY值为17 453.6,其中15.9%归因于肥胖,41.2%归因于中心性肥胖。结论减少肥胖和中心性肥胖的发生有助于降低高血压、糖尿病、冠心病和脑卒中4种肥胖相关慢性病的疾病负担。

Objective To analyze disease burden of hypertension, diabetes, coronary heart disease, and stroke among rural adult residents in Dayao county of Yunnan province. Methods Stratified random sampling was used to select a representative sample of 2 479 rural residents aged 35 years and over from Dayao county. Disability adjusted life years （DALY） was used as the measurement indicator of disease burden. Results Among the participants, the prevalence of hypertension, diabetes, coronary heart disease （ CHD ）, stroke, obesity, and central obesity was 40.4%, 6. 1%, 5.5 %, 1.9% ,4. 6% ,and 39. 9% ,respectively. The DALY/1 000 due to hypertension,diabetes,CHD,and stroke was 2. 0,3.4, 32.4 and 24.0, respectively. The DALY/1 000 for diabetes, CHD, and stroke were 3.7,34.9, and 27.2 in the males, which were higher than those in the females（3.0,30. 2,and 21.0）. The DALY/1000 for hypertension was 1.9 in the males, which was lower than tha in the females （2. 1 ）. After adjusting for gender, age, education level, marital status, family income per capita, familial disease history, smoking, and other confounding factors, obese people had 3.5,4. 8,2. 1, and 6. 1 times increased risk for hypertension, diabetes, CHD, and stroke, while the central obese people had 2. 3,2. 4, 1.9, and 5.2 times increased risk for hypertension, diabetes, CHD, and stroke compared to the non-obese （ all P 〈 0. 05 ）. The total DALY for the 4 obesity-related diseases was 17 453.6,of which,15.9% was attributed to obesity and 41.2% to central obesity. Conclusion Reducing the prevalence of obesity and central obesity is helpful to decrease disease burden of hypertension, diabetes, CHD, and stroke among rural adult residents in Dayao county.