江苏省社区居民吸烟与肥胖交互作用对血脂异常的关联分析

Association analysis of smoking and obesity on dyslipidemia prevalence among community population in Jiangsu province

目的探讨吸烟与肥胖之间交互作用对血脂异常发病的影响。方法在江苏省6个项目实施地区中,共纳入35～75岁居民83 530人,使用国家心血管项目管理办公室统一设计问卷,以面访形式获取调查对象相关信息,并进行血压、身高、体重及腰围测量,采集空腹静脉血检测空腹血糖、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)。运用logistic回归模型分析血脂异常的危险因素,利用加法模型评价吸烟与肥胖的交互作用对血脂异常的影响。结果血脂异常患病率为37.16%,调整年龄、性别、文化程度、家庭收入、农民、婚姻状况等因素后,与对照人群相比,高血压(OR=1.43,95%CI:1.38～1.47)、吸烟(OR=1.06,95%CI:1.02～1.11)、肥胖(OR=1.09,95%CI:1.08～1.09)和糖尿病(OR=1.44,95%CI:1.39～1.49)是罹患血脂异常的危险因素。交互分析中,吸烟与肥胖对血脂异常的加法交互作用有统计学意义,两者同时存在时OR值为2.06(95%CI:1.90～2.24),SI值为2.33(95%CI:1.90～2.86)。结论吸烟与肥胖同时存在会增加血脂异常的患病风险,两者对血脂异常患病存在相加交互作用。

Objective To investigate the effect of interaction between smoking and obesity on the prevalence of dyslipidemia. Methods A total of 83 530 participants aged between 35 to 75 years were recruited under the framework of the China PEACE-MPP investigation from 6 project populations of Jiangsu province. Questionnaires designed by the National Office of Cardiovascular Project Management were used to collect relevant information of the participants by interview. Blood pressure, height, weight and waist circumference were measured. Fasting venous blood samples were collected to analyze levels of fasting blood glucose, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C). Logistic regression model was used to analyze the risk factors of dyslipidemia;while additive model was used to evaluate the effect of the interaction between smoking and obesity on dyslipidemia. Results The prevalence of dyslipidemia was 37.16%.After adjusting for age, gender, educational level, family income, farmers, marital status and other factors, compared with the control group, hypertension ( OR =1.43, 95% CI : 1.38-1.47), smoking ( OR =1.06, 95% CI :1.02-1.11), obesity ( OR = 1.09, 95% CI :1.08-1.09) and diabetes ( OR =1.44, 95% CI :1.39-1.49) were risk factors of dyslipidemia. In the interaction analysis, the additive interaction between smoking and obesity on the dyslipidemia was statistically significant;the OR value was 2.06 (95% CI :1.90-2.24) and SI value was 2.33(95% CI : 1.90-2.86) upon co-existence. Conclusion The co-existence of smoking and obesity increases the risk of dyslipidemia. There is an additive interaction between smoking and obesity on dyslipidemia.