南京社区老年体检人群主要慢性代谢病变化趋势研究

Study on the change trend of major chronic metabolic diseases in the older population undergoing physical examination in Nanjing Community

目的分析南京社区老年体检人群主要慢性代谢病变化趋势,为社区老年人群慢性代谢病防控策略提供参考。方法基于国家基本公共卫生服务项目———老年人健康管理,随机选取南京市2个区,每个区覆盖所有街道,每个街道覆盖所有居委会/村委会。2018-2021年连续追踪65岁及以上健康体检人群,通过问卷调查、身体测量和实验室检测收集同一人群体检数据,采用广义估计方程(generalized estimating equation,GEE)模型分析社区老年人群主要慢性代谢病变化趋势。结果最终19314例老年人纳入研究,其中男性8222例(42.57%),女性11092例(57.43%)。经GEE分析,社区老年人群糖尿病、血脂异常、非酒精性脂肪肝和慢性肾脏病患病率呈现上升趋势,差异均有统计学意义(均P<0.01);与2018年相比,2019年的超重、肥胖和高血压患病率分别是2018年的1.035倍(95%CI:1.010~1.061)、1.105倍(95%CI:1.076~1.135)和1.187倍(95%CI:1.148~1.226),2021年的超重、肥胖和高血压患病率分别是2018年的1.038倍(95%CI:1.010~1.067)、1.205倍(95%CI:1.170~1.241)和1.308倍(95%CI:1.264~1.354)。结论南京社区老年体检人群糖尿病、血脂异常、非酒精性脂肪肝和慢性肾脏病等主要慢性病患病率总体呈现上升趋势。南京市慢性代谢病防控形势较为严峻,应及时制定和优化一级预防策略。

Objective To analyze the change trend of major chronic metabolic diseases in the older medical examination population in Nanjing community,and to provide reference for the prevention and control strategies of chronic metabolic diseases in the community older population.Methods Based on the national basic public health service program-health management for the older adults,two districts in Nanjing were randomly selected,with both district covering all streets and each street covering all neighborhood/village committees.From 2018-2021,the health checkups for the population aged 65 years and above were continuously tracked and the data were collected through questionnaires,body measurements,and laboratory tests.Generalized estimating equation(GEE)model was used to analyze the change trend of major chronic metabolic diseases among older population in the community.Results Finally 19314 older adults were included in the study,including 8222(42.57%)males and 11092(57.43%)females.GEE analysis showed that the prevalence of diabetes,dyslipidemia,non-alcoholic fatty liver disease,and chronic kidney disease in the older population showed an increasing trend,and the differences were statistically significant(all P<0.01).The prevalence of overweight,obesity,and hypertension in 2019 were 1.035(95%CI:1.010-1.061),1.105(95%CI:1.076-1.135),and 1.187 times(95%CI:1.148-1.226)of that in 2018,respectively.And the prevalence of overweight,obesity,and hypertension in 2021 were 1.038(95%CI:1.010-1.067),1.205(95%CI:1.170-1.241),and 1.308 times(95%CI:1.264-1.354)of that in 2018.Conclusions The prevalence of major chronic metabolic diseases such as diabetes,dyslipidemia,non-alcoholic fatty liver disease and chronic kidney disease in the older population in Nanjing showes an overall upward trend.The prevention and control situation of chronic metabolic diseases in Nanjing is relatively severe,and primary prevention strategies should be developed and optimized in a timely manner.