德清农村居民糖尿病和高血压共患病率及其危险因素

常睿; 董晓莲; 王玉琢; 陈跃; 张一鸣; 朱建福; 陈芸; 姜庆五; 付朝伟

doi:10.16462/j.cnki.zhjbkz.2019.06.005

德清农村居民糖尿病和高血压共患病率及其危险因素

doi: 10.16462/j.cnki.zhjbkz.2019.06.005

1.
200032 上海, 复旦大学公共卫生学院流行病学教研室
2.
313299 德清, 德清县疾病预防控制中心慢病科
3.
K1N 6N5 渥太华, 渥太华大学流行病学与公共卫生学院流行病学教研室

基金项目:

国家自然科学基金 81473038

上海市公共卫生重点学科建设计划 15GWZX0801

上海市公共卫生高端海外研修计划 GWTD2015S04

详细信息

通讯作者:
付朝伟, E-mail: fcw@fudan.edu.cn

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2019-01-05
- 修回日期: 2019-04-20
- 刊出日期: 2019-06-10

The prevalence and risk factors of diabetes and hypertension in Deqing rural community

1.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
2.
Deqing Municipal Center for Disease Prevention and Control, Zhejiang 313299, China
3.
School of Epidemiology and Public Health, University of Ottawa, Ottawa K1N 6N5, Canada

Funds:

National Natural Science Foundation of China 81473038

Construction Plan of Key Disciplines of Public Health in Shanghai 15GWZX0801

Shanghai Public Health High-end Overseas Research Program GWTD2015S04

More Information

Corresponding author: FU Chao-wei, E-mail: fcw@fudan.edu.cn

摘要

摘要: 目的了解德清农村居民糖尿病和高血压共患病情况并探究其危险因素。方法采用横断面研究，在浙江省德清县随机整群抽取8个乡镇作为研究现场，共调查29 306名成人居民。调查内容包括：人口学信息、社会经济学特征、行为和生活方式、慢性病家族史，进行血压、血糖的测量。结果在研究人群中，2型糖尿病患病率为3.34%，高血压患病率为28.72%，其中2.01%人群共患糖尿病和高血压，共患率在70~79岁均达到较高水平。无序多元Logistics回归结果显示：糖尿病家族史(OR=4.94，95%CI：3.24~7.54，P < 0.001)、拥有伴侣(OR=2.17，95%CI：1.18~4.00，P=0.013)是仅糖尿病患病的可能危险因素，体重指数(body mass index，BMI) < 24 kg/m²(OR=0.48，95%CI：0.39~0.59，P < 0.001)是糖尿病的可能保护因素；BMI < 24 kg/m²(OR=0.60，95%CI：0.56~0.64，P < 0.001)、完成义务教育(OR=0.54，95%CI：0.49~0.59，P < 0.001)、运动(OR=0.77，95%CI：0.69~0.86，P < 0.001)是高血压患病的保护因素，饮酒(OR=1.18，95%CI：1.08~1.29，P < 0.001)是仅高血压患病的可能危险因素；BMI < 24 kg/m²(OR=0.26，95%CI：0.21~0.31，P < 0.001)、完成义务教育(OR=0.50，95%CI：0.35~0.72，P < 0.001)、饮茶(OR=0.80，95%CI：0.64~0.99，P=0.045)是两病共患的保护因素，农民(OR=1.35，95%CI：1.04~1.76，P=0.024)、糖尿病家族史(OR=4.21，95%CI：2.71~6.57，P < 0.001)、高血压家族史(OR=1.86，95%CI：1.31~2.64，P=0.001)是两病共患的危险因素。结论德清地区农村居民糖尿病患病水平低于全国平均水平，高血压患病水平与全国平均水平接近，也有一定的共患病水平。女性、年龄>60岁、农民、糖尿病家族史、高血压家族史、超重或肥胖人群是可能的高危因素，需要进一步的干预和控制。
- 糖尿病 /
- 高血压 /
- 危险因素 /
- 农村社区
Abstract: Objective This study aimed to describe the prevalence of both type 2 diabetes (T2D) and hypertension, and to explore possible risk factors. Methods A Cross-sectional study was conducted in eight towns cluster-sampled randomly from Deqing County, Zhejiang Province. Totally. 29 306 subjects aged ≥ 18 years old were recruited into this survey. Information on general information, life styles, health status and family history of chronic diseases was collected. Physical examinations including height, weight, blood pressure, etc. were done. Fasting plasma glucose was also tested. Results The prevalence of only T2DM, only hypertension and both of them was 3.34%, 28.72%, and 2.01%, respectively. Such prevalence of both reached a peak at the age of 70-79 years old.Family history of diabetes mellitus(OR=4.94, 95% CI: 3.24-7.54, P < 0.001) and having a spouse(OR=2.17, 95% CI: 1.18-4.00, P=0.013) were possible risk factors of diabetes mellitus, body mass index(BMI) < 24 kg/m²(OR=0.48, 95% CI: 0.39-0.59, P < 0.001) was the possible protective factor of diabetes mellitus, BMI < 24 kg/m²(OR=0.60, 95% CI: 0.56-0.64, P < 0.001), completing compulsory education(OR=0.54, 95% CI: 0.49-0.59, P < 0.001) and exercise(OR=0.77, 95% CI: 0.69-0.86, P < 0.001) were protective factors of hypertension, drinking(OR=1.18, 95% CI: 1.08-1.29, P < 0.001) was the possible risk factor of hypertension. BMI < 24 kg/m²(OR=0.26, 95% CI: 0.21-0.31, P < 0.001), completing compulsory education(OR=0.50, 95% CI: 0.35-0.72, P < 0.001) and drinking tea(OR=0.80, 95% CI: 0.64-0.99, P=0.045) were protective factors of these two diseases. Farmers(OR=1.35, 95% CI: 1.04-1.76, P=0.024), family history of diabetes(OR=4.21, 95% CI: 2.71-6.57, P < 0.001) and family history of hypertension(OR=1.86, 95% CI: 1.31-2.64, P=0.001) were risk factors for the co occurrence of two diseases. Conclusions The prevalence of diabetes among adults in Deqing County was relatively lower than other places. The prevalence of hypertension was close to the level of other regions. Age, overweight, alcohol consumption, family history of diabetes and hypertension were the risk factors of diabetes and hypertension. Diabetes mellitus was a high-risk group of hypertension. Further means should be taken to strengthen the self-management and treatment of this group. Further intervention action should be taken to promote health and quality of life.
- Diabetes /
- Hypertension /
- Risk factor /
- Rural community

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图 1 不同疾病患病率年龄分布

Figure 1. Age distribution of prevalence of different diseases

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表 1 高血压和糖尿病居民不同年龄性别共患情况[n(%)]

Table 1. Prevalence of hypertension and diabetes among different age groups[n(%)]

	年龄(岁)	男	女	合并	χ²值	P值
糖尿病	18~	1(0.18)	0(0.00)	1(0.08)	1.24	0.266
	30~	6(0.63)	5(0.39)	11(0.49)	0.67	0.415
	40~	37(1.51)	51(1.60)	88(1.56)	0.07	0.798
	50~	85(2.69)	172(3.98)	257(3.43)	9.16	0.002
	60~	126(3.98)	258(6.30)	384(5.29)	19.23	＜0.001
	70~	64(3.57)	122(6.36)	186(5.01)	15.17	＜0.001
	≥80	20(2.52)	31(3.36)	51(2.97)	1.05	0.305
高血压	18~	43(7.76)	33(4.81)	76(6.13)	4.64	0.031
	30~	105(11.10)	98(7.63)	203(9.01)	7.91	0.005
	40~	378(15.45)	516(16.17)	894(15.86)	0.53	0.466
	50~	774(24.47)	1 240(28.66)	2 014(26.89)	16.34	＜0.001
	60~	1 104(34.88)	1 657(40.49)	2 761(38.04)	23.85	＜0.001
	70~	783(43.65)	929(48.41)	1 712(46.11)	8.47	0.004
	≥80	356(44.84)	401(43.49)	757(44.11)	0.31	0.576
高血压人群中共患	18~	1(2.33)	0(0.00)	1(1.32)	0.78	0.378
	30~	0(0.00)	2(2.04)	2(0.99)	2.16	0.141
	40~	15(3.97)	13(2.52)	28(3.13)	1.51	0.219
	50~	39(5.04)	96(7.74)	135(6.70)	5.57	0.018
	60~	75(6.79)	171(10.32)	246(8.91)	10.15	0.001
	70~	49(6.26)	97(10.44)	146(8.53)	9.53	0.002
	≥80	15(4.21)	16(3.99)	31(4.10)	0.02	0.877
糖尿病人群共患	18~	1(100.00)	-	1(100.00)	-	-
	30~	0(0.00)	2(40.00)	2(18.18)	2.93	0.087
	40~	15(40.54)	13(25.49)	28(31.82)	2.24	0.135
	50~	39(45.88)	96(55.81)	135(52.53)	2.25	0.134
	60~	75(59.52)	171(66.28)	246(64.06)	1.68	0.195
	70~	49(76.56)	97(79.51)	146(78.49)	0.22	0.642
	≥80	15(75.00)	16(51.61)	31(60.78)	2.79	0.095

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表 2 基本信息及疾病相关危险因素分析[n(%)]

Table 2. Basic information and risk factors for Disease[n(%)]

	合计	不患病人数	糖尿病					高血压					共患
	合计	不患病人数	人数	P值	OR(95% CI)值	调整后P值	调整后OR(95% CI)值	人数	P值	OR(95% CI)值	调整后P值	调整后OR(95% CI)值	人数	P值	OR(95% CI)值	调整后P值	调整后OR(95% CI)值
性别
男	12 862(43.89)	9 174(71.33)	145(1.13)	0.003	0.73(0.60~0.90)	0.028	0.71(0.53~0.96)	3 349(26.04)	0.002	0.92(0.87~0.97)	0.454	0.97(0.90~1.05)	194(1.51)	< 0.001	0.61(0.51~0.72)	0.030	0.77(0.61~0.97)
女	16 444(56.11)	11 303(68.74)	244(1.49)					4 479(27.28)					395(2.41)
年龄 > 60岁
是	12 687(43.29)	7 259(57.22)	198(1.56)	< 0.001	1.89(1.55~2.31)	< 0.001	1.95(1.53~2.48)	4 807(37.89)	< 0.001	2.90(2.75~3.06)	< 0.001	2.63(2.46~2.81)	423(3.33)	< 0.001	4.65(3.88~5.57)	< 0.001	3.98(3.21~4.93)
否	16 619(56.71)	13 241(79.67)	191(1.15)					3 021(18.18)					166(1.00)
伴侣
是	27 279(93.08)	18 535(67.95)	358(1.36)	0.054	1.67(0.99~2.80)	0.013	2.17(1.18~4.00)	6 915(26.27)	< 0.001	0.73(0.66~0.81)	0.287	0.94(0.84~1.05)	518(1.97)	0.001	0.62(0.47~0.82)	0.404	0.87(0.64~1.20)
否	2 027(6.92)	1 295(63.89)	15(0.74)					659(32.51)					58(2.86)
超重肥胖
是	9 107(31.08)	5 635(61.88)	171(1.88)	< 0.001	2.08(1.69~2.56)	< 0.001	2.33(1.85~2.94)	2 964(32.55)	< 0.001	1.61(1.52~1.69)	< 0.001	1.67(1.56~1.79)	337(3.70)	< 0.001	3.57(3.03~4.17)	< 0.001	3.85(3.23~4.76)
否	20 199(68.92)	14 865(73.59)	218(1.08)					4 864(24.08)					252(1.25)
义务教育
是	5 854(19.98)	4 950(84.56)	52(0.89)	< 0.001	0.49(0.36~0.65)	0.071	0.73(0.52~1.03)	812(13.87)	< 0.001	0.36(0.33~0.39)	< 0.001	0.54(0.49~0.59)	40(0.68)	< 0.001	0.23(0.16~0.31)	< 0.001	0.50(0.35~0.72)
否	23 452(80.02)	15 324(65.34)	330					(1.43)6 933(29.97)					546(2.36)
农民
是	7 807(26.64)	6 166(78.98)	89(1.14)	0.002	1.45(1.14~1.84)	0.124	1.26(0.94~1.68)	1 465(18.77)	< 0.001	1.87(1.75~1.99)	< 0.001	1.26(1.16~1.36)	502(2.33)	< 0.001	2.48(1.97~3.12)	0.024	1.35(1.04~1.76)
否	21 499(73.36)	14 334(66.67)	300(1.40)					6 363(29.60)					87(1.11)
低收入
是	4 296(14.66)	2 893(67.34)	63(1.47)	0.243	1.18(0.90~1.54)	0.327	1.16(0.86~1.57)	1 235(28.75)	< 0.001	1.14(1.061~.23)	0.433	1.03(0.95~1.12)	105(2.44)	0.011	1.32(1.07~1.64)	0.125	1.20(0.95~1.53)
否	25 010(85.34)	17 607(70.40)	326(1.30)					6 593(26.36)					484(1.94)
吸烟
是	6 588(22.48)	4 875(74.00)	80(1.21)	0.138	0.83(0.65~1.06)	0.328	1.20(0.83~1.72)	1 556(23.62)	< 0.001	0.79(0.740~.85)	< 0.001	0.84(0.76~0.91)	77(1.17)	< 0.001	0.48(0.38~0.61)	0.004	0.62(0.45~0.86)
否	22 718(77.52)	15 609(68.71)	309(1.36)					6 272(27.63)					512(2.26)
饮酒
是	5 424(18.51)	3 824(70.50)	50(0.92)	0.004	0.64(0.48~0.87)	0.125	0.75(0.51~1.08)	1 467(27.05)	0.889	1.00(0.94~1.07)	< 0.001	1.18(1.08~1.29)	83(1.53)	0.005	0.71(0.57~0.90)	0.172	1.23(0.91~1.65)
否	23 882(81.49)	16 660(69.76)	339(1.42)					6 361(26.65)					506(2.12)
运动
是	2 606(8.89)	1 961(75.25)	34(1.30)	0.865	0.97(0.68~1.39)	0.705	1.08(0.74~1.57)	565(21.68)	< 0.001	0.75(0.68~0.83)	< 0.001	0.77(0.69~0.86)	46(1.77)	0.290	0.85(0.62~1.15)	0.407	0.87(0.63~1.21)
否	26 700(91.11)	16 438(61.57)	294(1.25)					6 273(26.74)					455(1.94)
饮茶
是	11 125(37.96)	7 990(71.82)	124(1.11)	0.005	0.73(0.59~0.91)	0.400	0.90(0.70~1.16)	2 835(25.48)	< 0.001	0.89(0.84~0.94)	0.316	1.03(0.97~1.10)	176(1.58)	< 0.001	0.67(0.56~0.80)	0.045	0.80(0.64~0.99)
否	18 181(62.04)	12 510(68.81)	265(1.46)					4 993(27.46)					413(2.27)
糖尿病家族史
是	463(1.58)	281(60.69)	25(5.40)	< 0.001	4.94(3.24~7.54)	< 0.001	6.77(4.21~10.90)	120(25.92)	0.302	1.12(0.90~1.39)	0.025	0.74(0.57~0.96)	37(7.99)	< 0.001	4.82(3.39~6.87)	< 0.001	4.21(2.71~6.57)
否	28 843(98.42)	20 219(70.10)	364(1.26)					7 708(26.72)					552(1.91)
高血压家族史
是	2 125(7.25)	1 006(47.34)	13(0.61)	0.158	0.67(0.38~1.17)	0.035	0.50(0.27~0.95)	1 049(49.36)	< 0.001	3.00(2.74~3.28)	< 0.001	3.73(3.36~4.15)	532(1.96)	< 0.001	2.08(1.57~2.75)	0.001	1.86(1.31~2.64)
否	27 181(92.75)	19 494(71.72)	376(1.38)					6 779(24.94)					57(2.68)

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