2015年中国十五省(自治区、直辖市)老年人心血管代谢性危险因素及人口影响因素

Prevalence of cardiometabolic risk factors and demographic role among Chinese elderly aged over 60 years in fifteen provinces (autonomous regions, municipalities) in 2015

目的分析中国60岁及以上老年人心血管代谢性危险因素的流行特征及聚集性,并探讨人口因素对其的影响。方法利用2015年"中国居民营养状况变迁的队列研究"中的血样检测、人口因素和体格测量数据,采用多阶段分层整群随机方法,抽取60岁及以上老年人共3276人作为研究对象,男性占比46.8%,平均年龄68岁。采用国际糖尿病联盟(IDF)标准判定心血管代谢性危险因素,包括中心性肥胖、血压升高、血糖升高、甘油三酯(TG)升高和高密度脂蛋白胆固醇(HDL-C)降低。具有2个及以上危险因素为危险因素聚集。采用多因素Logistic回归模型分析人口因素与各代谢性危险因素及聚集性的关联性。结果 2015年中国十五省(自治区、直辖市)老年人中,中心性肥胖、血压升高、血糖升高、TG升高和HDL-C降低的人群比例分别为57.8%、71.3%、25.0%、27.6%、40.1%。女性中心性肥胖(OR=4.70,95%CI 4.01～5.51)、TG升高(OR=1.60,95%CI 1.36～1.88)、HDL-C降低(OR=2.77,95%CI 2.38～3.23)的危险性高于男性,血压升高(OR=0.84,95%CI 0.72～0.99)的危险性低于男性;东部地区的老年人血压升高(OR=1.45,95%CI 1.20～1.76)、血糖升高(OR=1.38,95%CI 1.14～1.67)的危险性明显高于中部地区。性别、受教育程度、地区分布与代谢性危险因素聚集性存在关联(P<0.05),收入水平与代谢性危险因素及聚集性均呈正相关(P<0.05)。结论 2015年中国十五省(自治区、直辖市)老年人心血管代谢性危险因素中血压升高和中心性肥胖的问题较为突出,女性、东部地区、70岁及以上、高收入和高教育程度人群出现危险因素聚集的危险性相对较高,应展开重点防控。

OBJECTIVE To analyze the epidemiological characteristics and clustering of cardiometabolic risk factors in people 60 years old and above,and to explore the influence of population economic factors on them.METHODS The database of China Health and Nutrition Survey in 2015 was used.Basic information(age,gender),anthropometric data(height,weight and waist size),blood biochemical data and demographic data(occupation,income,education level and geographic location)were included.A multi-stage stratified cluster random sampling was adopted,the county,city,village and suburban village as the basic survey points.Twenty families were randomly selected from each survey site,and all family members were investigated.A total of 3276 people aged 60 years and above were selected as subjects,with the proportion of males was 46.8%,and the average age was 68 years.According to the definition of the metabolic syndrome released by the International Diabetes Federation(IDF)in 2005,there were five cardiometabolic risk factors,central obesity,raised triglycerides(TG),reduced high density lipoprotein-cholesterol(HDL-C),raised blood pressure and raised plasma glucose.Existing of 2 or more risk factors in a person at the same time was recognized as a risk factor clustering.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.RESULTS In elderly of 15 provinces(regions,municipalities)of China,the prevalence of central obesity,raised blood pressure,raised plasma glucose,raised TG and reduced HDL-C were 57.8%,71.3%,25.0%,27.6%and 40.1%respectively.Multivariate Logistic regression analysis showed there were more risk of central obesity(OR=3.66,95%C/3.16-4.26),raised TG(OR=1.60,95%CI 1.36-1.88)and reduced HDL-C(OR=2.77,95%C/2.38-3.23)in women than those in men,and less risk of raised blood pressure(OR=0.84,95%CI 0.0.72-0.99)in women than those in men.Elderly in the eastern region were significantly more likely to suffer from raised blood pressure(OR=1.45,95%CI 1.20-1.76)and raised plasma glucose(OR=1.38,95%C/1.14-1.67)than those in the mid region.A correlation was found between gender,education level,regions and metabolic risk factors(P<0.05).Income and metabolic risk factors clustering were positively correlated(P<0.05).CONCLUSION The problem of elevated blood pressure and central obesity in cardiometabolic risk factors were more prominent in the 15 provinces(regions,municipalities)of China.The elderly which was female,in eastern region,had high income or education level relatively had higher risk of risk factors clustering,which should be focused on prevention and control.