Association between central obesity and cardiometabolic diseases or cardiometabolic comorbidity in residents aged 35−75 years in Inner Mongolia
-
摘要:
目的 分析内蒙古自治区(自治区)35~75岁居民中心型肥胖与心血管代谢性疾病和共病的关联。 方法 选择2015年9月至2017年6月“心血管病高危人群早期筛查与综合干预项目”中内蒙古招募的35~75岁居民为研究对象。采用SPSS 25.0和GraphPad Prism 5软件进行统计分析,采用统计描述、χ2检验和logistic回归分析中心型肥胖对心血管代谢性疾病(高血压、糖尿病、血脂异常)和共病的影响。 结果 内蒙古35~75岁居民中心型肥胖率为66.5%[95%置信区间(CI):66.2%~66.7%],年龄、性别标化率为64.6%。同一个体患有0、1、2和3种心血管代谢性疾病的构成比分别为28.8%、40.5%、23.8%和6.9%。 Logistic回归分析结果显示,轻度中心型肥胖和重度中心型肥胖者高血压、糖尿病、血脂异常、共病的患病风险分别是非中心型肥胖者的1.873和3.093倍、1.876和2.764倍、2.227和3.412倍、2.526和4.419倍(均P<0.001)。 结论 中心型肥胖是内蒙古严重的健康问题,是心血管代谢性疾病和共病的危险因素,可进一步加剧心血管疾病负担。 因此,应加强中心型肥胖的早期筛查和干预。 -
关键词:
- 心血管疾病 /
- 血管代谢性疾病 /
- 心血管代谢性疾病共病 /
- 中心型肥胖 /
- 内蒙古自治区
Abstract:Objective To analyze the association between central obesity and cardiometabolic diseases or cardiometabolic comorbidity in residents aged 35–75 years in Inner Mongolia autonomous region. Methods Residents aged 35–75 years recruited in “Early Screening and Comprehensive Intervention in Population at High Risk for Cardiovascular Diseases” in Inner Mongolia from September 2015 to June 2017 were selected for the study. Statistical analysis was performed by using software SPSS 25.0 and GraphPad Prism 5, mainly statistical description, χ2 test and logistic regression analysis, to understand impact of central obesity on cardiometabolic diseases (hypertension, diabetes, dyslipidemia) and cardiometabolic comorbidity. Results The prevalence rate of central obesity was 66.5% (95%CI: 66.2%–66.7%), and the standardized rate was 64.6% in residents aged 35–75 years in Inner Mongolia. The proportions of persons with 0, 1, 2 and 3 cardiometabolic diseases were 28.8%, 40.5%, 23.8% and 6.9%, respectively. The results of logistic regression analysis showed that the risk for hypertension, diabetes, dyslipidemia and cardiometabolic comorbidity were 1.873 times and 3.093 times, 1.876 times and 2.764 times, 2.227 times and 3.412 times, 2.526 times and 4.419 times higher in people with mild central obesity and severe central obesity than in those without central obesity (all P<0.001). Conclusions Central obesity is a serious health problem in Inner Mongolia, and it is a risk factor for cardiometabolic diseases or cardiometabolic comorbidity, Therefore, we should strengthen the early screening of central obesity and conduct intervention. -
表 1 内蒙古自治区不同特征35~75岁居民中心型肥胖情况
Table 1. 1Prevalence of central obesity in 35-75 years old residents aged with different characteristics in Inner Mongolia
分组 调查数[人(%)] 非中心型肥胖a 轻度中心型肥胖a 重度中心型肥胖a χ2值 P值 性别 73.967 <0.001 男性 29 070(41.9) 35.1(34.2~36.0) 37.6(36.7~38.5) 27.3(26.4~28.3) 女性 40 299(58.1) 32.3(31.5~33.1) 40.4(39.7~41.2) 27.3(26.4~28.1) 民族 124.221 <0.001 汉 62 300(89.8) 34.0(33.3~34.6) 39.3(38.7~39.9) 26.7(26.0~27.4) 蒙 6 019(8.7) 29.4(27.3~31.5) 38.1(36.1~40.1) 32.5(30.4~34.6) 其他 1 050(1.5) 27.5(22.4~32.7) 40.7(36.0~45.3) 31.8(26.8~36.8) 年龄组(岁) 215.168 <0.001 35~ 11 629(16.7) 41.1(39.7~42.5) 37.6(36.2~39.1) 21.3(19.7~22.9) 45~ 23 431(33.8) 33.0(31.9~34.0) 41.2(40.2~42.1) 25.9(24.8~27.0) 55~ 23 578(34.0) 30.6(29.6~31.7) 39.3(38.3~40.3) 30.1(29.0~31.1) 65~75 10 731(15.5) 32.7(31.2~34.3) 36.6(35.1~38.1) 30.7(29.2~32.3) 居住地 702.793 <0.001 农村 47 945(69.1) 36.6(35.9~37.3) 37.8(37.1~38.5) 25.6(24.8~26.3) 城镇 21 424(30.9) 26.5(25.3~27.6) 42.4(41.4~43.4) 31.1(30.0~32.3) 家庭年收入(万元) 213.545 <0.001 <1 33 149(47.8) 35.9(35.1~36.8) 38.1(37.3~39.0) 26.0(25.0~26.9) 1~ 22 709(32.7) 31.8(30.7~32.9) 40.2(39.2~41.2) 28.0(26.9~29.1) ≥5 7 919(11.4) 28.5(26.6~30.3) 41.1(39.4~42.8) 30.4(28.6~32.2) 不知道 5 592(8.1) 32.9(30.7~35.0) 39.2(37.2~41.3) 27.9(25.7~30.1) 教育水平 901.127 <0.001 初等及以下 41 568(59.9) 37.0(36.2~37.7) 37.6(36.8~38.3) 25.5(24.6~26.3) 中等 6 562(9.5) 36.2(34.3~38.2) 40.2(38.3~42.1) 23.6(21.4~25.7) 高等及以上 13 662(19.7) 24.6(23.1~26.0) 43.3(42.0~44.6) 32.1(30.7~33.5) 不知道 7 577(10.9) 28.1(26.2~30.0) 40.2(38.4~41.9) 31.7(29.9~33.6) 农民 468.128 <0.001 是 32 617(47.0) 37.6(36.7~38.5) 36.8(35.9~37.6) 25.6(24.7~26.6) 否 36 752(53.0) 29.8(29.0~30.7) 41.4(40.6~42.2) 28.8(27.9~29.6) 在婚 45.032 <0.001 是 63 258(91.2) 33.8(33.2~34.4) 39.2(38.6~39.8 ) 27.0(26.3~27.6 ) 否 6 111(8.8) 30.3(28.2~32.4) 39.2(37.3~41.2 ) 30.5(28.4~32.6 ) 医疗保险 22.653 <0.001 是 60 181(86.8) 33.7(33.0~34.3) 39.2(38.6~39.8) 27.1(26.4~27.8) 否 9 188(13.2) 31.0(29.3~32.7) 39.4(37.8~41.0) 28.5(26.8~30.3) CVD史 134.228 <0.001 是 3 412(4.9) 25.9(23.0~28.8) 39.4(36.8~42.0) 34.7(32.0~37.4) 否 65 957(95.1) 33.9(33.3~34.5) 39.2(39.6~39.8) 26.9(26.3~27.6) 吸烟 196.524 <0.001 是 17 335(25.0) 37.8(36.6~39.0) 36.4(35.2~37.6) 25.8(24.5~27.1) 否 52 034(75.0) 32.0(31.3~32.7) 40.2(39.5~40.8) 27.8(27.1~28.5) 饮酒 33.767 <0.001 是 18 740(27.0) 32.4(31.2~33.6) 38.9(37.8~40.0) 28.7(27.5~29.9) 否 50 111(72.2) 33.9(33.2~34.6) 39.3(38.7~40.0) 26.7(26.0~27.5) 不清楚 518(0.8) 29.5(22.3~36.8) 40.9(34.3~47.5) 29.5(22.3~36.8) 合计 69 369(100.0) 33.5(32.9~34.1) 39.2(38.6~39.8) 27.3(26.7~27.9) − − 标化率 − 35.2(35.1~35.3) 38.6(38.0~39.2) 26.0(25.4~26.6) − − 注:a. 括号外数字表示患病率,括号内数据表示患病率的95%置信区间; CVD. 心血管疾病 表 2 内蒙古自治区35~75岁居民的心血管代谢性疾病和共病患病情况
Table 2. Prevalence of cardiometabolic diseases or cardiometabolic comorbidity in residents aged 35 - 75 years in Inner Mongolia
危险因素 合计 非中心型肥胖 轻度中心型肥胖 重度中心型肥胖 χ2值 P值 高血压 3 269.324 <0.001 是 55.8(55.3~56.3) 42.3(41.4~43.3) 57.5(56.8~58.3) 69.9(69.1~70.7) 否 44.2(43.6~44.7) 57.7(56.8~58.5) 42.5(41.5~43.4) 30.1(28.9~31.3) 糖尿病 1 784.620 <0.001 是 19.5(18.9~20.2) 11.7(10.5~12.9) 20.4(19.3~21.4) 28.0(26.8~29.2) 否 80.5(80.1~80.8) 88.3(87.9~88.8) 79.6(79.1~80.1) 72.0(71.3~72.8) 血脂异常 3 278.491 <0.001 是 33.6(33.0~34.2) 20.3(19.2~21.5) 36.1(35.1~37.0) 46.3(45.2~47.3) 否 66.4(66.0~66.8) 79.7(79.1~80.3) 63.9(63.2~64.6) 53.7(52.7~54.7) 共病 4 637.161 <0.001 是 30.8(30.2~31.4) 15.9(14.7~17.1) 32.6(31.6~33.5) 46.5(45.4~47.5) 否 69.2(68.8~69.6) 84.1(83.6~84.6) 67.4(66.8~68.1) 53.5(52.6~54.5) 注:括号外数据表示患病率,括号内数据表示患病率的95%置信区间 -
[1] Wang YF, Zhao L, Gao LW, et al. Health policy and public health implications of obesity in China[J]. Lancet Diabetes Endocrinol, 2021, 9(7): 446–461. DOI: 10.1016/S2213−8587(21)00118−2. [2] Pan XF, Wang LM, Pan A. Epidemiology and determinants of obesity in China[J]. Lancet Diabetes Endocrinol, 2021, 9(6): 373–392. DOI: 10.1016/S2213−8587(21)00045−0. [3] GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1204–1222. DOI: 10.1016/S0140−6736(20)30925−9. [4] 金璐, 邵姜超, 刘文昊, 等. 烟台市成年居民肥胖流行现状及影响因素分析[J]. 中国卫生统计,2022,39(4):607–609. DOI:10.3969/j.issn.1002−3674.2022.04.031.Jin L, Shao JC, Liu WH, et al. Analysis of the prevalence and influencing factors of obesity among adult residents in Yantai[J]. Chin J Health Stat, 2022, 39(4): 607–609. DOI: 10.3969/j.issn.1002−3674.2022.04.031. [5] 吴超群, 李希, 路甲鹏, 等. 中国居民心血管疾病危险因素分布报告[J]. 中国循环杂志,2021,36(1):4–13. DOI:10.3969/j.issn.1000−3614.2021.01.002.Wu CQ, Li X, Lu JP, et al. Report on geographical disparity of cardiovascular risk factors in China[J]. Chin Circul J, 2021, 36(1): 4–13. DOI: 10.3969/j.issn.1000−3614.2021.01.002. [6] 王燕逍翔, 白建军, 宇传华. 基于全球视角的中国心血管病疾病负担现状及趋势[J]. 公共卫生与预防医学,2021,32(6):6–11. DOI:10.3969/j.issn.1006−2483.2021.06.002.Wang YXX, Bai JJ, Yu CH. Status and trend of cardiovascular disease burden in China from a global perspective[J]. J Pub Health Prev Med, 2021, 32(6): 6–11. DOI: 10.3969/j.issn.1006−2483.2021.06.002. [7] Xu XQ, Bao H, Tian ZX, et al. Prevalence, awareness, treatment, and control of hypertension in Northern China: a cross-sectional study[J]. BMC Cardiovasc Disord, 2021, 21(1): 525. DOI: 10.1186/s12872−021−02333−7. [8] 中国肥胖问题工作组. 中国成人超重和肥胖症预防与控制指南(节录)[J]. 营养学报,2004,26(1):1–4. DOI: 10.13325/j.cnki.acta.nutr.sin.2004.01.001.Chinese Working Group on Obesity. Guidelines for prevention and control of overweight and obesity in Chinese adults (excerpt)[J]. Acta Nutrim Sin, 2004, 26(1): 1–4. DOI: 10.13325/j.cnki.acta.nutr.sin.2004.01.001. [9] Zhang P, Wang R, Gao C S, et al. Types of obesity and its association with the clustering of cardiovascular disease risk factors in Jilin province of China[J]. Int J Environ Res Public Health, 2016, 13(7): 685. DOI: 10.3390/ijerph13070685. [10] 胡晶晶, 赵佳, 谢梦, 等. 上海市杨浦区居民中心型肥胖与心血管疾病危险因素及聚集性的关系[J]. 上海预防医学,2020,32(1):36–40. DOI: 10.19428/j.cnki.sjpm.2020.18979.Hu JJ, Zhao J, Xie M, et al. Relationship between central obesity and cardiovascular disease risk factors and resident aggregation in Yangpu district, Shanghai[J]. Shanghai J Prev Med, 2020, 32(1): 36–40. DOI: 10.19428/j.cnki.sjpm.2020.18979. [11] 尤莉莉, 乌云高娃, 吴和平, 等. 内蒙古某地区男性超重肥胖和饮酒对血尿酸的影响[J]. 中国慢性病预防与控制,2013,21(6):659–662. DOI:10.16386/j.cjpccd.issn.1004−6194.2013.06.027.You LL, Wuyun GW, Wu HP, et al. The effects of overweight, obesity and drinking on serum uric acid in male residents of Inner Mongolian[J]. Chin J Prev Contr Chron Dis, 2013, 21(6): 659–662. DOI: 10.16386/j.cjpccd.issn.1004−6194.2013.06.027. [12] He X, Liu C, Chen YL, et al. Overweight without central obesity, cardiovascular risk, and all-cause mortality[J]. Mayo Clin Proc, 2018, 93(6): 709–720. DOI: 10.1016/j.mayocp.2018.01.027. [13] Shirasawa T, Ochiai H, Yoshimoto T, et al. Associations between normal weight central obesity and cardiovascular disease risk factors in Japanese middle-aged adults: a cross-sectional study[J]. J Health Popul Nutr, 2019, 38(1): 46. DOI: 10.1186/s41043−019−0201−5. [14] Lecaire TJ, Klein BEK, Howard KP, et al. Risk for end-stage renal disease over 25 years in the population-based WESDR cohort[J]. Diabetes Care, 2014, 37(2): 381–388. DOI: 10.2337/dc13−1287. [15] 赵冬. 心血管疾病危险因素的研究: 过去、现在和未来[J]. 中国循环杂志,2021,36(1):1–3. DOI:10.3969/j.issn.1000−3614.2021.01.001.Zhao D. Research on risk factors of cardiovascular disease: past, present and future[J]. Chin Circul J, 2021, 36(1): 1–3. DOI: 10.3969/j.issn.1000−3614.2021.01.001. [16] 中国心血管病风险评估和管理指南编写联合委员会. 中国心血管病风险评估和管理指南[J]. 中华预防医学杂志,2019,53(1):13–35. DOI:10.3760/cma.j.issn.0253−9624.2019.01.004.The Joint Task Force for Guideline on the Assessment and Management of Cardiovascular Risk in China. Guideline on the assessment and management of cardiovascular risk in China[J]. Chin J Prev Med, 2019, 53(1): 13–35. DOI: 10.3760/cma.j.issn.0253−9624.2019.01.004. -