湘西土家族中老年高血压患者生活方式和膳食习惯与同型半胱氨酸的交互作用

The lifestyle and dietary habits in middle-aged and elderly hypertensive patients and their interactions with homocysteine in Tujia minority of Western Hunan

目的探讨湘西土家族中老年高血压患者的生活方式和膳食习惯及其与同型半胱氨酸的交互作用。方法采用典型整群随机抽样方法,对长期居住在湖南湘西永顺县某土家族乡镇的223名土家族中老年居民进行现况调查,对所有调查对象进行问卷调查、体格检查和实验室检查。然后把第一阶段确诊的81例高血压患者作为高血压组,其他142名健康人作为对照组。调查项目主要包括人口学基本情况、生活方式以及日常与特色膳食习惯等。分析高血压患者的相关生活方式和膳食习惯与同型半胱氨酸的交互作用。结果单因素分析结果显示,每周重体力活动时间、步行时间,腰围,体质量指数（BMI）,食用生冷食物、青豆、豆腐、黄豆、蛋类、泡菜和酸菜〉3次/周与高血压的发生有关。多因素非条件Logistic回归分析结果显示,重体力活动,高同型半胱氨酸血症,食用生冷食物、黄豆、蛋类和泡菜〉3次/周是高血压的影响因素[OR（95%CI）分别为0.426（0.198~0.915）,14.485（6.594~31.819）,2.388（1.164~4.899）,1.875（1.161~3.401）,0.503（0.295~0.857）,2.036（1.200~3.456）;均P〈0.05]。交互作用分析结果提示,无论有无重体力活动,以及在食用生冷食物、黄豆及泡菜或不食用蛋类的情况下,同型半胱氨酸升高患高血压的风险。结论高同型半胱氨酸血症以及经常食用生冷食物、黄豆和泡菜是湘西土家族中老年人群高血压的危险因素,而重体力活动和食用蛋类为保护因素。

Objective To explore the lifestyle and dietary habits in middle-aged and elderly hypertensive patients and their interactions with homocysteine（Hcy）in Tujia minority of Western Hunan. Methods A cross-sectional survey was conducted in 223 middle-aged and elderly residents in a Tujia minority rural town of Yongshun County in Western Hunan using typical cluster random sampling method. All the subjects received questionnaire survey,physical examination and laboratory tests.Eighty-one subjects diagnosed with hypertension were selected as the hypertension group and the other healthy subjects as the control group.Study items included demographic characteristics,life style and daily/characteristic dietary habits. The lifestyle and dietary habits in hypertensive subjects and their interactions with Hcy were analyzed. Results Univariate analysis showed that intensive physical activity time per week,walking time per week,waist circumference,body mass index（BMI）,eating raw or cold food3times/week,eating green beans3times/week,eating tofu3times/week,eating soybean3times/week,eating eggs3times/week,eating pickled vegetables3times/week and eating Chinese sauerkraut3times/week were statistically related to hypertension. Multivariate unconditioned logistic regression analysis showed that intensive physical activity,hyperhomocysteinemia（HHcy）,eating raw or cold food3times/week,eating soybean3times/week,eating eggs3times/week and eating pickled vegetables3times/week were statistically associated with hypertension[OR（95% CI）was 0.426（0.198-0.915）,14.485（6.594-31.819）,2.388（1.164-4.899）,1.875（1.161-3.401）,0.503（0.295-0.857）,2.036（1.200-3.456）respectively;all P0.05]. Interaction analysis showed that HHcy increased the risk of hypertension in subjects often eating cold food,soybean,pickled vegetables or not eating eggs regardless of intensive physical activity. Conclusion HHcy and often eating raw or cold food,soybean and pickled vegetables were risk factors for hypertension in the middle-aged and elderly residents in the Tujia minority area of Western Hunan,while heavy physical activity and eating eggs were protective factors.