中国中老年居民高血压、糖尿病和血脂异常共病现状及影响因素研究

Study on the status and influencing factors of comorbidity of hypertension,diabetes,and dyslipidemia among middle-aged and elderly Chinese adults

目的分析我国中老年居民高血压、糖尿病及血脂异常(三高)的共病现状及影响因素,为“三高共管”提供数据支撑。方法利用2018年中国慢性病及危险因素监测收集的相关信息,以134950名≥45岁的常住居民作为研究对象。对样本进行复杂加权后,分析不同特征居民三高患病及共病状况;采用多因素logistic回归模型探讨三高共病的影响因素。结果我国中老年居民高血压、糖尿病和血脂异常的患病率分别为46.0%(95%CI:45.1%~47.0%)、19.5%(95%CI:18.7%~20.2%)、43.3%(95%CI:42.3%~44.4%);高血压和糖尿病、高血压和血脂异常、糖尿病和血脂异常的共病率分别为12.3%(95%CI:11.7%~12.8%)、22.8%(95%CI:22.1%~23.4%)、11.6%(95%CI:11.1%~12.0%);三高共病率为7.6%(95%CI:7.2%~8.0%)。这些共病率均随年龄、BMI的增长呈上升趋势,城市高于农村,东北及华北地区较高(P<0.05)。高血压、糖尿病和高TC血症的共病率为1.9%(95%CI:1.7%~2.1%),高血压、糖尿病和高LDL-C血症的共病率为1.6%(95%CI:1.4%~1.7%),女性均高于男性(P<0.05)。多因素logistic回归分析结果表明:男性、年龄增长、城市、超重/肥胖、过量饮酒、身体活动不足、每日静态行为时间≥5 h和每日睡眠时间<7 h是三高共病的危险因素(P<0.05)。结论我国中老年居民三高共病情况较常见,且具有许多共同的危险因素。危险因素综合防控、“三高共管”是中老年人群健康促进的关键措施。

Objective To analyze the comorbidity status and influencing factors of hypertension,diabetes,and dyslipidemia among middle-aged and elderly Chinese adults and to provide support for the"co-management of three diseases".Methods Using the relevant information collected from the National Chronic Disease and Risk Factor Surveillance in China in 2018,134950 permanent residents aged≥45 years were selected as the research objects.After being weighed,the prevalence and comorbidity of hypertension,diabetes,and dyslipidemia in residents with different groups were compared;a multivariate logistic regression model was used to explore the influencing factors of comorbidity of the"three diseases".Results The prevalence of hypertension,diabetes,and dyslipidemia among middle-aged and elderly Chinese adults were 46.0%(95%CI:45.1%-47.0%),19.5%(95%CI:18.7%-20.2%),43.3%(95%CI:42.3%-44.4%),respectively.The comorbidity rates of hypertension and diabetes,hypertension and dyslipidemia,and diabetes and dyslipidemia were 12.3%(95%CI:11.7%-12.8%),22.8%(95%CI:22.1%-23.4%),11.6%(95%CI:11.1%-12.0%),respectively;the comorbidity rate of hypertension,diabetes,and dyslipidemia was 7.6%(95%CI:7.2%-8.0%).These comorbidity rates increased with age and BMI,which was more significant in the urban areas than rural areas and more outstanding in North and Northeast China(P<0.05).The comorbidity rate of hypertension,diabetes,and higher cholesterol was 1.9%(95%CI:1.7%-2.1%).The comorbidity rate of hypertension,diabetes,and higher low-density lipoprotein was 1.6%(95%CI:1.4%-1.7%),which was higher in women than in men(P<0.05).Multivariate logistic regression results showed that male,age,city,overweight/obesity,excessive drinking,physical inactivity,daily sedentary behavior time≥5 hours,and sleep duration<7 hours were risk factors for the comorbidity of the"three diseases".Conclusions The comorbidity of hypertension,diabetes,and dyslipidemia,is common among middle-aged and elderly adults in China;comprehensive prevention and control of risk factors and"co-management of three diseases"are critical measures for health promotion in middle-aged and elderly populations.