职业和健康相关行为与高同型半胱氨酸血症的相关性

Association between occupational and health-related behaviors with hyperhomocysteinemia

[背景]高同型半胱氨酸血症(HHcy)与高血压、糖尿病等多种慢性病存在关联。健康相关行为如吸烟、饮酒、缺乏锻炼等是心脑血管疾病、二型糖尿病和某些癌症等慢性非传染性疾病发生的重要原因。[目的]了解上海市松江区新桥社区成年人血浆总同型半胱氨酸(Hcy)的人群分布特征和HHcy的罹患情况,并探究职业因素和健康相关行为与HHcy的关系。[方法]采用随机整群抽样的方法抽取上海市松江区新桥社区20~74周岁的常住居民进行横断面调查,描述Hcy的人群分布特征,采用多因素logistic回归分析HHcy与职业和健康相关行为之间的关联。[结果]共纳入研究对象8207名,Hcy均值为(15.29±7.33)μmol·L^(-1),男性高于女性[男性(18.09±9.42)μmol·L^(-1),女性(13.34±4.48)μmol·L^(-1),P<0.001];HHcy罹患率为32.47%(2665/8207),男性罹患率为52.64%(1172/3366),女性为18.45%(893/4841),男性高于女性(P<0.001),轻度罹患者多于中重度罹患者(轻度2418人,中重度247人,P<0.001)。多因素logistic回归分析显示,调整性别、年龄、体重指数、血清肌酐和慢性病患病后,与脑力劳动相比,从事体力脑力结合或体力劳动为主的职业与HHcy呈正相关,OR(95%CI)为1.19(1.03~1.38)、1.29(1.07~1.56);体育锻炼与HHcy呈负相关,OR(95%CI)为0.88(0.79~0.99);吸烟与HHcy呈正相关,OR(95%CI)为1.48(1.29~1.71)。[结论]上海市松江区新桥社区成年人HHcy罹患率较高。从事体力脑力结合或体力劳动为主的职业以及吸烟可能会促进HHcy的发生,体育锻炼可能会预防HHcy的发生。

[Background]Hyperhomocysteinemia(HHcy)is associated with a variety of chronic diseases such as hypertension and diabetes mellitus.Health-related behaviors such as smoking,alcohol drinking,and insufficient physical exercise are closely related to many chronic diseases including cardiovascular diseases,type 2 diabetes,and some cancers.[Objective]This study investigates the distributional features of plasma total homocysteine(Hcy)and the prevalence of HHcy among adults in Xinqiao Community,Songjiang District of Shanghai,and explores the association of occupational and health-related behavioral factors with HHcy.[Methods]A community-based cross-sectional study using randomized cluster sampling was conducted among adults aged 20-74 years in Xinqiao Community,Songjiang District of Shanghai.Distributional features of Hcy was described.Multiple logistic regression models were used to evaluate the association between occupational and health-related behavioral factors and HHcy.[Results]Among 8207 participants,the mean plasma Hcy concentration was(15.29±7.33)μmol·L^(-1),higher in males[(18.09±9.42)μmol·L^(-1)]than in females[(13.34±4.48)μmol·L^(-1)](P<0.001).The overall prevalence rate of HHcy was 32.47%(2665/8207),the rate was higher in males(52.64%,1172/3366)than in females(18.45%,893/4841)(P<0.001),and mild HHcy cases(n=2418)were more than moderate and severe cases(n=247)(P<0.001).The multiple logistic regression analysis results showed that,after adjusting for sex,age,body mass index,serum creatinine,and chronic disease prevalences,the prevalence rate of HHcy was positively associated with mentalmanual or manual occupations versus mental occupations,OR(95%CI):1.19(1.03-1.38)and 1.29(1.07-1.56)respectively;HHcy was negatively associated with physical exercise,OR(95%CI):0.88(0.79-0.99);HHcy was positively associated with smoking,OR(95%CI):1.48(1.29-1.71).[Conclusion]The prevalence rate of HHcy is relatively high in adults in Xinqiao Community in Songjiang District of Shanghai.Mentalmanual or manual occupations may promote HHcy,while physical exercise may protect against the disease.