周围绿地利用与高血压患者中心性肥胖的关联分析

Correlation between use of green space and central obesity among hypertensive patients

目的探讨高血压患者中心性肥胖与周围绿地利用的关系,为绿色处方管理高血压患者提供依据。方法于2019年11月至2020年1月采用多阶段分层随机抽样方法抽取深圳市基本公共卫生服务管理满1年的35岁及以上的1 116名高血压患者为研究对象。所有研究对象进行问卷调查、体格测量。采用SPSS 22.0软件进行t检验、Mann-Whitney U检验、Kruskal-Wallis H检验和χ^(2)检验。采用二元logistic回归模型分析绿地利用对高血压患者中心性肥胖的影响。结果深圳市基本公共卫生服务管理高血压患者中心性肥胖率为52.6%(587/1 116),利用周围绿地的人数976名(87.5%),每周利用绿地的频率中位数为6.0 d,四分位数间距为5.0 d,每天利用绿地的时间中位数为60.0 min,四分位数间距为77.5 min。二元logistic回归分析调整混杂因素后结果显示,不利用周围绿地与高血压患者发生中心性肥胖高风险相关(OR=1.531,95%CI:1.057-2.219)。每周利用绿地0-1 d与高血压患者发生中心性肥胖高风险相关(OR=1.532,95%CI:1.090-2.151)。每天利用绿地时间与中心性肥胖的关联没有统计学意义(P>0.05)。按性别分层后,在女性高血压患者中,不利用周围绿地与发生中心性肥胖高风险相关(OR=1.910,95%CI:1.122-3.254),每周利用绿地0-1 d与发生中心性肥胖高风险相关(OR=1.839,95%CI:1.104-3.061)。在男性高血压患者中,周围绿地利用与中心性肥胖的关联没有统计学意义(P>0.05)。结论绿地利用对控制高血压患者中心性肥胖具有积极意义,本研究为今后进一步开展绿地环境与高血压患者中心性肥胖间的关联研究提供基础证据。

Objective To explore the correlation between use of green space and central obesity among hypertensive patients,and to provide the evidence for green prescription management of hypertensive patients. Methods From November 2019 to January2020,the multi-stage stratified random sampling method was applied to select 1 116 hypertension patients (≥35 years old)managed by community public health service in Shenzhen city for 1 year as the subjects. The investigation was performed by questionnaire and physical examination. The t test,Mann-Whitney U test,Kruskal-Wallis H test and χ^(2) test were used to analyze the data. Binary logistic regression model was used to analyze the effects of green space use on central obesity of hypertensive patients. The used software was SPSS 22.0. Results The rate of central obesity was 52.6%(587/1 116) in hypertension patients managed by community public health service in Shenzhen city. The number of people using green space was 976(87.5%). The average frequency of using green space was 6.0 days(interquartile range was 5.0 days) per week,and the average time of using green space was 60.0 min(interquartile range was 77.5 min) per day. The results of binary logistic regression analysis after adjusting confounding factors showed that not using green space was associated with high risk for central obesity in hypertension patients(OR=1.531,95%CI:1.057-2.219);the use of green space for 0-1 day per week was associated with high risk for central obesity in hypertension patients(OR=1.532,95%CI:1.090-2.151). There was no statistical significance of the time between using green space every day and central obesity(P>0.05). After stratifying by gender,not using green space was associated with high risk for central obesity in female hypertension patients(OR=1.910,95%CI:1.122-3.254);the use of green space for 0-1 day per week was associated with high risk for central obesity in female hypertension patients(OR=1.839,95%CI:1.104-3.061). There was no correlation between use of green space and central obesity in male hypertension patients(P>0.05). Conclusion The green space use plays an important role for controlling the central obesity in hypertension patients,the present study provids the basic evidence for conducting the correlation study between green space and central obesity in hypertension patients in future.