中国老年人心血管代谢性共病的患病情况及影响因素研究

Prevalence and influencing factors of cardiometabolic multmorbidity in Chinese elderly

目的 了解中国老年人心血管代谢性共病(CMM)的患病情况及影响因素,为预防控制CMM提供科学依据。方法 利用2018年中国健康与养老追踪调查(CHARLS)数据,采用多阶段分层随机抽样方法选取中国28个省(自治区、直辖市)的7 864名60岁及以上的老年人进行问卷调查,调查内容包括个人基本信息、社会经济特征、健康状况与功能等。采用Stata 16.0软件进行t检验、χ^(2)检验、Kruskal-Wallis H检验和多因素logistic回归分析。结果 研究对象的平均年龄为(68.8±6.6)岁,其中CMM患者2 669名,患病率为33.94%,年龄标化患病率为33.96%。多因素logistic回归分析结果显示,高龄(OR=1.03,95%CI:1.02~1.04)、女性(OR=1.41,95%CI:1.19~1.65)、小学及以下文化程度(OR=1.31,95%CI:1.15~1.48)、初中及以上文化程度(OR=1.66,95%CI:1.41~1.95)、居住在城镇(OR=1.41,95%CI:1.26~1.58)、西部地区(OR=1.18,95%CI:1.04~1.33)、家庭人均年收入高(OR=1.21,95%CI:1.02~1.44)、过去吸烟(OR=1.43,95%CI:1.21~1.70)、超重(OR=2.33,95%CI:2.07~2.61)、肥胖(OR=4.09,95%CI:3.47~4.80)、有抑郁症状(OR=1.21,95%CI:1.08~1.35)、健康自评差(OR=1.78,95%CI:1.68~1.89)的老年人CMM患病风险高,均有统计学意义(P<0.05,P<0.01)。结论 中国老年人CMM的患病率较高,需关注高龄、文化程度较高、居住在城镇和西部地区、家庭人均年收入高、过去吸烟、超重肥胖、有抑郁症状、健康自评差的老年人。

Objective To understand the prevalence and influencing factors of cardiometabolic multmorbidity(CMM) in Chinese elderly,and provide the scientific basis for prevention and control of CMM. Methods Data from the China Health and Retirement Longitudinal Study(CHARLS) in 2018 were used,the multi-stage and stratified random sampling method was used to select 7 864residents (≥60 year old) from 28 provinces in China as the subjects. The investigation was conducted with questionnaire(including the individual basic information,social-economic feature,health condition and function). The t test, χ^(2)test,KruskalWallis H test and multivariate logistic regression were used to analyze the data. The used software was Stata 16.0. Results The average age of 7 864 subjects was(68.8±6.6) years old. There were 2 669 patients with CMM,the morbidity was 33.94%,and the age-standardized morbidity was 33.96%. The multivariate logistic regression showed that the subjects with high age(OR=1.03,95%CI:1.02-1.04),female(OR=1.41,95%CI:1.19-1.65),≤ primary school education level(OR=1.31,95%CI:1.15-1.48),≥ junior middle school(OR=1.66,95%CI:1.41-1.95),living in urban area(OR=1.41,95%CI:1.26-1.58),western area(OR=1.18,95%CI:1.04-1.33),high family income(OR=1.21,95%CI:1.02-1.44),smoking history(OR=1.43,95%CI:1.21-1.70),overweight(OR=2.33,95%CI:2.07-2.61),obesity(OR=4.09,95%CI:3.47-4.80),depressive symptoms(OR=1.21,95%CI:1.08-1.35),poor self-rated health(OR=1.78,95%CI:1.68-1.89) had high risk of CMM(P<0.05,P<0.01). Conclusion The morbidity of CMM in Chinese elderly is higher. It should pay attention to elderly with high age,high education level,living in urban and western areas,high family income,smoking history, overweight and obesity,depressive symptoms and poor self-rated health.