膳食模式、社会经济地位对心血管病10年风险的联合影响

陈阳阳; 那晓娜; 马晓川; 花语蒙; 朱珠; 周桂荣; 刘爱萍

doi:10.16462/j.cnki.zhjbkz.2021.05.011

膳食模式、社会经济地位对心血管病10年风险的联合影响

doi: 10.16462/j.cnki.zhjbkz.2021.05.011

1.
100191 北京，北京大学公共卫生学院社会医学与健康教育学系
2.
102300 北京，北京市门头沟区疾病预防控制中心

基金项目:

北京市门头沟区疾病预防控制中心资助课题 2016

详细信息

通讯作者:
刘爱萍，E-mail: apingliu@163.com

中图分类号: R181.1
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- 被引次数: 0
出版历程
- 收稿日期: 2020-11-02
- 修回日期: 2020-12-20
- 网络出版日期: 2021-06-16
- 刊出日期: 2021-05-10

Joint association of dietary pattern and socioeconomic status with the 10-year risk of cardiovascular disease

1.
Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China
2.
Mentougou District of Beijing Center for Disease Control and Prevention, Beijing 102300, China

Funds:

Subject of Center for Disease Control and Prevention of Mentougou District, Beijing 2016

More Information

Corresponding author: LIU Ai-ping, E-mail: apingliu@163.com

摘要

摘要: 目的探讨膳食模式与社会经济地位对心血管病10年风险的联合影响，为心血管病的防控提供参考。方法采用多阶段抽样方法，问卷调查2 431例北京市门头沟区居民。单因素分析探索膳食模式、社会经济地位、心血管病10年风险之间的相关关系，多因素Logistic回归分析模型分析前两者对心血管病10年风险的联合影响。结果北京市门头沟区常住居民心血管病10年中高风险比例为38.46%。高盐饮酒膳食模式(48.93%)和低社会经济地位(58.47%)的心血管病10年中高风险比例较高(均有P < 0.001)。调整因素后，以均衡膳食且高社会经济地位为参照，高盐饮酒膳食且低社会经济地位人群的心血管病10年中高风险比例最高(OR=6.841, 95% CI: 4.518~10.540, P < 0.001)。结论合理膳食需要联合考虑不同群体的社会经济地位，结合实际鼓励科学营养，以促进真实世界的心血管病防控。
- 心血管病10年风险 /
- 膳食模式 /
- 社会经济地位
Abstract: Objective To investigate the joint association of dietary pattern and socioeconomic status with the 10-year risk of cardiovascular disease, and to provide guidance for prevention and control of cardiovascular disease. Methods A questionnaire survey was conducted among 2 431 residents in the Mentougou District of Beijing, in which multi-stage sampling methods were used. Univariate analysis was performed to explore the relationships between dietary patterns, socioeconomic status, and the 10-year risk of cardiovascular disease. Furthermore, multivariable logistic regression was used to assess the joint association of both dietary pattern and socioeconomic status with the 10-year risk of cardiovascular disease. Results The proportion of the 10-year medium-to-high risk of cardiovascular disease among permanent residents in the Mentougou District of Beijing was 38.46%. People with high-salt-and-alcohol dietary pattern (48.93%) and low socioeconomic status (58.47%) had a higher proportion of 10-year medium-to-high risk of cardiovascular disease (all P < 0.001). After adjusting confounding factors, in comparison to people with both balanced dietary pattern and high socioeconomic status, the proportion of the 10-year medium-to-high risk of cardiovascular disease of people with both high-salt-and-alcohol dietary pattern and low socioeconomic status was highest (OR=6.841, 95% CI: 4.518~10.540, P < 0.001). Conclusions Balanced diet promotion should consider socioeconomic status. We ought to encourage a balanced diet combined with actual conditions of different socioeconomic status to prevent and control cardiovascular disease in the real world.
- 10-year risk of cardiovascular disease /
- Dietary pattern /
- Socioeconomic status

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图 1 不同社会经济地位的膳食模式分布情况

Figure 1. The dietary pattern distribution of different socioeconomic status

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图 2 不同膳食模式、社会经济地位的心血管病10年风险分布情况

Figure 2. The distribution of dietary pattern and socioeconomic status on the 10-year risk of cardiovascular disease

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表 1 17个食物组主成分分析的成分载荷结果

Table 1. Component loading results of principal component analysis for 17 food groups

食物	均衡DP	高热量DP	高蛋白DP	高盐饮酒DP
谷类	0.66	-0.11	0.04	0.08
薯类	0.26	0.06	0.40	0.10
新鲜蔬菜	0.60	0.04	0.13	-0.24
水果	0.54	0.21	0.11	-0.43
酱腌蔬菜	0.39	0.11	-0.09	0.45
畜禽肉类	0.52	0.10	0.25	0.02
水产品	0.02	0.12	0.73	-0.04
蛋类	0.06	0.04	0.76	0.00
奶类	0.12	0.09	0.34	-0.49
大豆及其制品	0.06	0.17	0.05	-0.17
坚果	0.20	0.36	0.17	-0.18
油脂	0.45	0.07	-0.01	0.08
甜点	-0.14	0.74	0.07	0.02
膨化食品	0.04	0.80	0.07	-0.03
油炸面食	0.15	0.67	-0.01	0.07
盐	-0.01	0.11	0.14	0.63
酒精	0.04	-0.05	0.05	0.34

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表 2 膳食模式、社会经济地位的分布特征比较[n(%)]

Table 2. Comparison of the distribution characteristics of dietary patterns and socioeconomic status [n(%)]

特征	膳食模式					社会经济地位
特征	均衡 (n=566)	高热量 (n=486)	高蛋白 (n=633)	高盐饮酒 (n=746)	χ²/F值	高 (n=987)	中 (n=647)	低 (n=797)	χ²/F值
性别					129.721^a				17.854^a
男	313(29.61)	134(12.68)	217(20.53)	393(37.18)		466(44.09)	292(27.63)	299(28.29)
女	253(18.41)	352(25.62)	416(30.28)	353(25.69)		521(37.92)	355(25.84)	498(36.24)
年龄(x±s, 岁)	47.12±13.86	46.07±14.49	50.34±13.94	50.23±12.66	14.717^a	40.53±12.56	51.03±12.56	56.94±10.05	444.020^a
现居住地					37.874^a				546.239^a
城市	370(23.30)	326(20.53)	463(29.16)	429(27.02)		877(55.23)	425(26.76)	286(18.01)
农村	196(23.25)	160(18.98)	170(20.17)	317(37.60)		110(13.05)	222(26.33)	511(60.62)
婚姻状况					18.231^b				150.325^a
已婚	480(23.23)	405(19.60)	537(25.99)	644(31.17)		791(38.29)	563(27.25)	712(34.36)
未婚	62(29.25)	53(25.00)	45(21.23)	52(24.53)		161(75.94)	36(16.98)	15(7.08)
丧偶/离异	18(16.07)	16(14.29)	35(31.25)	43(38.39)		18(16.07)	36(32.14)	58(51.79)
是否吸烟					87.548^a				8.884
目前吸烟	170(28.52)	84(14.09)	94(15.77)	248(41.61)		213(35.74)	171(28.69)	212(35.57)
已戒烟	8(25.00)	4(12.50)	10(0.33)	10(31.25)		12(37.50)	7(21.88)	13(40.62)
从未吸烟	388(21.52)	398(22.07)	529(29.34)	488(27.07)		762(42.26)	469(26.01)	572(31.72)
体力活动					22.322^b				15.865^b
低	63(31.34)	35(17.34)	36(17.91)	67(33.33)		103(51.24)	52(25.87)	46(22.89)
中	55(16.72)	79(24.01)	87(26.44)	108(32.83)		144(43.77)	83(25.23)	102(31.00)
高	447(23.65)	369(19.52)	509(26.93)	565(29.89)		733(38.78)	510(26.98)	647(34.23)
BMI (kg/m²)	25.94±4.10	24.74±3.55	25.05±3.92	25.43±3.66	10.105^a	24.68±3.93	25.73±3.99	25.78±3.46	23.780^a
注：^a表示P < 0.001；^b表示P < 0.01。

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表 3 Logistic回归变量赋值表

Table 3. Logistic regression variable assignment table

变量	赋值情况
CVD风险	低危=0，中高危=1
DP	均衡DP=1，高热量DP=2，高蛋白DP=3，高盐饮酒DP=4
SES	高SES=1，中SES=2，低SES=3
DP与SES	均衡DP与高SES=1，均衡DP与中SES=2，均衡DP与低SES=3，高热量DP与高SES=4，高热量DP与中SES=5，高热量DP与低SES=6，高蛋白DP与高SES=7，高蛋白DP与中SES=8，高蛋白DP与低SES=9，高盐饮酒DP与高SES=10，高盐饮酒DP与中SES=11，高盐饮酒DP与低SES=12
婚姻状况	已婚=1，未婚=2，丧偶或离异=3
BMI(kg/m²)	连续型变量
体力活动水平	高=1，中=2，低=3
注：因变量CVD风险计算时已考虑性别、年龄、城市或农村、腰围、TC、HDL-C、当前收缩压水平、是否服用降压药、是否患有糖尿病、现在是否吸烟，是否有心血管病家族史等，故上述因素不在回归分析里再做调整。

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表 4 膳食模式、社会经济地位与心血管病10年风险的Logistic回归结果

Table 4. Logistic regression results of dietary pattern, socioeconomic status and 10-year risk of cardiovascular disease

变量	模型1	模型2	模型3	模型4
变量	OR(95% CI)值	OR(95% CI)值	OR(95% CI)值	变量	OR值(95% CI)值
膳食模式				膳食模式*社会经济地位
均衡	1.000		1.000	均衡*高	1.000
高热量	0.673(0.509~0.888)^b		0.699(0.522~0.933)^a	均衡*中	3.129(1.939~5.100)^c
高蛋白	0.900(0.700~1.157)		0.945(0.727~1.230)	均衡*低	6.614(4.152~10.708)^c
高盐饮酒	1.540(1.217~1.951)^c		1.337(1.045~1.711)^a	高热量*高	0.719(0.420~1.217)
社会经济地位				高热量*中	1.800(1.038~3.111)^a
高		1.000	1.000	高热量*低	5.215(3.173~8.689)^c
中		2.586(2.050~3.268)^c	2.478(1.961~3.137)^c	高蛋白*高	1.190(0.749~1.902)
低		4.936(3.955~6.180)^c	4.640(3.701~5.823)^c	高蛋白*中	3.355(2.092~5.441)^c
				高蛋白*低	4.537(2.863~7.289)^c
				高盐饮酒*高	2.113(1.338~3.371)^b
				高盐饮酒*中	3.808(2.449~6.006)^c
				高盐饮酒*低	6.841(4.518~10.540)^c
注：^a表示P < 0.05；^b表示P < 0.01；^c表示P < 0.001。模型1表示CVD风险~DT；模型2表示CVD风险~SES；模型3表示CVD风险~(DP+SES)；模型4表示CVD风险~(DP*SES)；所有模型均调整BMI、婚姻状况、体力活动水平。

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