The prevalence and influencing factors of dyslipidemia in aged 35-<75 years Zhuang minority adults in Guangxi
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摘要:
目的 了解广西壮族自治区35~＜75岁壮族居民血脂异常现状及影响因素，为心脑血管疾病防控提供科学依据。 方法 基于2018―2019年广西壮族自治区少数民族自然人群队列，开展基线问卷调查、体格检查和血液生化检测等，采用因子分析提取膳食模式，采用logistic回归分析模型分析血脂异常的影响因素。 结果 共纳入研究对象11 175名，平均年龄55.00(47.00, 64.00)岁，男性占45.30%，农村居民占85.70%，血脂异常患病率为30.26%。调整了性别、年龄和职业的影响后，吸烟(OR=1.47, 95% CI: 1.37~1.61)、超重(OR=1.43, 95% CI: 1.28~1.59)、肥胖(OR=1.78, 95% CI: 1.52~2.09)、腹型肥胖(OR=1.78, 95% CI: 1.59~1.99)、无高血压病史但检测为高血压(OR=1.22, 95% CI: 1.10~1.35)、有高血压病史但目前未治疗(OR=1.29, 95% CI: 1.12~1.48)、高尿酸血症(OR=1.82, 95% CI: 1.63~2.04)、高血糖和有糖尿病病史是血脂异常的危险因素；而消瘦为保护因素(OR=0.47, 95% CI: 0.37~0.61)。 结论 广西壮族自治区35~＜75岁壮族居民血脂异常发生水平较高，应加大对戒烟、控制体重等相关知识的健康宣教，加强对超重、肥胖、高血压、高血糖、高尿酸血症人群的血脂监测和控制。 Abstract:Objective To investigate the prevalence and influencing factors of dyslipidemia in Zhuang minority adults aged 35- < 75 years in Guangxi, providing scientific evidences for the prevention and control of cardiovascular and cerebrovascular diseases. Methods A structure questionnaire, physical examination and blood biochemical test were conducted based on the Guangxi minority population cohort. Factor analysis was used to explore the dietary patterns and the logistic regression analysis model was used to explore the influencing factors. Results A total of 11 175 subjects were included, the median age was 55.00(47.00, 64.00) years, 45.30% were males, 85.70% were rural residents, and the prevalence of dyslipidemia was 30.26%. After adjusted for the gender, age, and occupation, smoking (OR=1.47, 95% CI: 1.37-1.61), overweight (OR=1.43, 95% CI: 1.28-1.59), obesity (OR=1.78, 95% CI: 1.52-2.09), abdominal obesity (OR=1.78, 95% CI: 1.59-1.99), no hypertension history but being detected as high blood pressure in this study (OR=1.22, 95% CI: 1.10-1.35), ever diagnosed as hypertension but currently without medication (OR=1.29, 95% CI: 1.12-1.48), hyperuricemia (OR=1.82, 95% CI: 1.63-2.04), detected as hyperglycemia and ever diagnosed as diabetes were risk factors of dyslipidemia; while as a protective factor (OR=0.47, 95% CI: 0.37-0.61). Conclusions The prevalence of dyslipidemia in Zhuang minority adults was high. Smoking cessation, weight control, etc. should be focused on the health education. The blood aged 35- < 75 years lipid monitoring and control should be strengthened in those overweight, obesity, hypertension, hyperglycemia and hyperuricemia population. -
Key words:
- Dyslipidemia /
- Zhuang minority /
- Prevalence /
- Influencing factors
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表 1 研究对象的基本情况和临床指标特征
Table 1. The baseline and clinical characteristics of the study subjects
变量
Variable合计 ①
Total ①
(n=11 175)血脂异常组 ①
Dyslipidemia group ①
(n=3 381)血脂正常组 ①
Normal lipidemia group ①
(n=7 794)Z/χ2值value P值
value性别Gender 126.22 ＜0.001 男性Male 5 065(45.32) 1 804(53.35) 3 261(41.84) 女性Female 6 110(54.68) 1 577(46.65) 4 533(58.16) 年龄/岁Age / years 55.00(47.00, 64.00) 55.00(48.00, 65.00) 54.00(46.00, 64.00) -4.03 ＜0.001 年龄组/岁Age group/ years 23.93 ＜0.001 35~＜45 2 140(19.15) 559(16.53) 1 581(20.28) 45~＜55 3 379(30.24) 1 022(30.22) 2 357(30.24) 55~＜65 2 941(26.32) 936(27.68) 2 005(25.72) 65~＜75 2 715(24.29) 864(25.57) 1 851(23.76) 地区Region 23.99 ＜0.001 农村Rural 9 779(87.50) 2 880(85.18) 6 899(88.52) 城市Urban 1 396(12.50) 501(14.72) 895(11.48) 文化程度Educational level 27.28 ＜0.001 小学及以下Primary school or lower 6 134(54.89) 1 755(51.91) 4 379(56.18) 初中Junior high school 3 410(30.51) 1 055(31.20) 2 355(30.22) 高中(含中专/技校) Senior high school (including technical school) 1 289(11.53) 443(13.10) 846(10.85) 大专及以上College or above 342(3.07) 128(3.79) 214(2.75) 职业Occupation 43.34 ＜0.001 农林牧渔劳动者/工人Laborers in agriculture, forestry, husbandry and fishery/workers 7 679(68.72) 2 210(65.37) 5 469(70.16) 行政管理/专业技术人员Administrative staffs/technical professionals 281(2.51) 99(2.93) 182(2.34) 销售/服务业/私营业主Sales staffs/pervice personnels/private business owners 436(3.90) 108(3.20) 328(4.20) 家务/待业/下岗/退休Domestic workers/unemployed/laid off/retired 2 272(20.33) 787(23.28) 1 485(19.05) 其他Others 507(4.54) 177(5.23) 330(4.24) 婚姻状况Marital status 8.13 0.016 已婚Married 9 885(88.46) 2 955(87.40) 6 930(88.93) 丧偶/分居/离婚Widowed/separated/divorced 1 150(10.29) 371(10.97) 779(9.99) 未婚Unmarried 140(1.25) 55(1.63) 85(1.08) 吸烟Smoking 75.03 ＜0.001 是Yes 2 110(18.88) 803(23.75) 1 307(16.77) 否No 9 065(81.12) 2 578(76.25) 6 487(83.23) 饮酒Drinking 31.97 ＜0.001 是Yes 1 441(12.89) 528(15.62) 913(11.71) 否No 9 734(87.11) 2 853(84.38) 6 881(88.29) 慢性病史Diagnosed with non-communicable diseases 34.23 ＜0.001 是Yes 3 931(35.18) 1 325(39.20) 2 606(33.44) 否No 7 244(64.82) 2 056(60.80) 5 188(66.56) BMI/(kg·m-2) 23.30(21.00, 25.60) 24.50(22.40, 26.70) 22.80(20.60, 25.00) -24.73 ＜0.001 BMI分组BMI groups 525.31 ＜0.001 消瘦Lose weight 667(5.97) 75(2.22) 592(7.60) 正常Normal weight 5 777(51.70) 1 366(40.40) 4 411(56.59) 超重Overweight 3 670(32.84) 1 430(42.30) 2 240(28.74) 肥胖Obesity 1 061(9.49) 510(15.08) 551(7.07) WC /cm 82.00(75.00, 88.00) 86.00(80.00, 91.00) 80.00(74.00, 86.00) -28.39 ＜0.001 SBP/mmHg 128.00(116.00, 143.00) 132.00(119.00, 147.00) 126.00(114.00, 141) -12.86 ＜0.001 DBP/mmHg 81.00(74.00, 89.00) 84.00(76.00, 92.00) 80.00(73.00, 88.00) -13.75 ＜0.001 GLU /(mmol·L-1) 4.64(4.36, 4.92) 4.69(4.43, 5.20) 4.63(4.34, 4.86) -13.92 ＜0.001 TG /(mmol·L-1) 1.17(0.82, 1.75) 2.13(1.34, 3.04) 0.99(0.75, 1.34) -57.37 ＜0.001 TC /(mmol·L-1) 5.00(4.40, 5.65) 5.80(4.73, 6.51) 4.84(4.30, 5.33) -37.39 ＜0.001 LDL-C /(mmol·L-1) 2.89(2.36, 3.42) 3.25(2.41, 4.19) 2.81(2.34, 3.25) -22.64 ＜0.001 HDL-C /(mmol·L-1) 1.37(1.12, 1.64) 1.13(0.93, 1.46) 1.44(1.25, 1.69) -38.72 ＜0.001 SUA /(μmol·L-1) 326.00(263.00, 391.00) 363.00(301.00, 430.00) 313.00(259.00, 372.00) -24.63 ＜0.001 注：WC, 腰围；SBP, 收缩压；DBP, 舒张压；GLU，血糖；TG, 三酰甘油；TC，总胆固醇；LDL-C，低密度脂蛋白；HDL-C, 高密度脂蛋白；SUA, 血清尿酸。
①以M(P25, P75)或人数(占比/%)表示。
Note：WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; GLU, blood glucose; TG, triglyceride; TC, total cholesterol; LDL-C, low-density Lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; SUA, serum uric acid.
① M(P25, P75) or number of people (proportion/%).
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表 2 广西壮族自治区35~＜75岁壮族居民各类食物的因子载荷及膳食模式
Table 2. The factor loading of each specific food and the four dietary patterns in Zhuang residents aged 35- < 75 years in Guangxi
食物类型Food types 畜肉蔬菜模式
Livestock meat and vegetables dietary pattern主食模式
Staple food dietary pattern非传统模式
Non-traditional dietary pattern水产禽肉模式
Aquatic and poultry and eggs dietary pattern大米Rice 0.09 -0.55 ① 0.23 0.06 面食Cooked wheaten food 0.02 0.68 ① 0.28 0.12 杂粮Grains 0.03 0.73 ① 0.21 0.06 甜食Desserts -0.11 0.28 0.43 0.12 畜肉类及其制品Livestock meat and products 0.72 ① 0.05 -0.04 0.05 家禽及其制品Poultry meat and products 0.29 0.01 -0.01 0.68 ① 水产/海鲜品Aquatic/seafood products 0.04 -0.04 0.06 0.79 ① 蛋类及其制品Eggs and egg products -0.07 0.17 0.18 0.66 ① 新鲜蔬菜Fresh vegetables 0.64 ① -0.12 -0.09 0.03 新鲜水果Fresh fruit 0.45 0.04 0.24 0.30 坚果类Nuts -0.15 0.04 0.58 ① 0.18 腌制蔬菜/腌制肉Pickled vegetables/pickled meat -0.19 -0.18 0.55 ① 0.18 乳类及其制品Dairy and dairy product 0.21 0.23 0.56 ① 0.01 凉茶/饮料类Herbal tea/beverage 0.28 0.07 0.59 ① -0.14 注：①表明该类食物的因子负荷绝对值＞0.50，基于这些食物对膳食模式进行命名。
Note：① The values in bold indicate that the absolute factor load of the food group exceeds 0.50, and the dietary pattern is named based on these foods.
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表 3 广西壮族自治区35~＜75岁居民血脂异常影响因素的多因素logistic回归分析
Table 3. The multivariable logistic regression of the influencing factors of dyslipidemia in Zhuang residents aged 35-<75 years in Guangxi
变量
Variableβ值
value调整OR值
Adjust OR value (95% CI)P值
value性别Gender 女性Female 1.00 男性Male 0.20 1.22(1.10~1.36) ＜0.001 年龄组/岁Age group/ years 35~＜45 1.00 45~＜55 0.20 1.22(1.07~1.40) 0.003 55~＜65 0.26 1.30(1.13~1.50) ＜0.001 65~＜75 0.27 1.30(1.13~1.51) ＜0.001 职业Occupation 农林牧渔劳动者/工人Laborers in agriculture, forestry, husbandry and fishery/workers 1.00 家务/待业/下岗/退休Domestic workers/unemployed/laid off/retired 0.20 1.21(1.10~1.35) ＜0.001 其他Others 0.27 1.31(1.07~1.60) 0.009 吸烟Smoking 否No 1.00 是Yes 0.38 1.47(1.30~1.66) ＜0.001 BMI分组BMI group 正常Normal weight 1.00 消瘦Lose weight -0.75 0.47(0.37~0.61) ＜0.001 超重Overweight 0.35 1.43(1.28~1.59) ＜0.001 肥胖Obesity 0.55 1.78(1.52~2.09) ＜0.001 腹型肥胖Abdominal obesity 否No 1.00 是Yes 0.58 1.78(1.59~1.99) ＜0.001 高血压Hypertension 无高血压病史且检测血压正常No history of hypertension and being detected as normal blood pressure 1.00 无高血压病史但检测为高血压No history of hypertension but being detected as hypertension 0.20 1.22(1.10~1.35) ＜0.001 有高血压病史且正在治疗Had a history of hypertension and currently with medication 0.04 1.04(0.84~1.28) 0.729 有高血压病史但目前未治疗Had a history of hypertension but currently without medication 0.25 1.29(1.12~1.48) ＜0.001 高血糖Hyperglycemia 无糖尿病病史且检测血糖正常No history of diabetes and being detected as normal blood glucose 无糖尿病病史但检测为高血糖No history of diabetes but being detected as hyperglycemia 0.68 1.98(1.70~2.30) ＜0.001 有糖尿病病史且正在治疗Had a history of diabetes and currently with medication 1.18 3.26(2.21~4.80) ＜0.001 有糖尿病病史但目前未治疗Had a history of diabetes but currently without medication 0.60 1.81(1.39~2.37) ＜0.001 高尿酸血症Hyperuricemia 否No 1.00 是Yes 0.61 1.82(1.63~2.04) ＜0.001
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