摘要
目的探讨中老年人生活方式指数随时间的发展轨迹特征及其与血压变化的关系。方法基于社区生活方式干预研究队列,2010年1月-2012年3月在广州市2个社区纵向收集50~79岁中老年人的基线及之后6、12和24个月的生活方式(吸烟、饮酒、膳食、体力活动和BMI)和血压测量数据,并计算健康生活方式指数(health lifestyle index, HLI)。采用组基础模型(group-based trajectory model, GBTM)识别HLI的发展轨迹,通过混合线性模型分析HLI轨迹组与血压变化的关系。结果共有393人纳入分析,其中,男性130人,年龄(58.6±7.3)岁。GBTM识别出3种HLI发展轨迹:"持续低水平组"(组1,26.7%)和"中水平-轻度改善组"(组2,52.7%)及"高水平-快速改善组"(组3,20.6%)。调整混杂因素后,与组1相比,随访期间组2的血压变化均无统计学意义(均有P>0.05);而组3表现出明显的血压下降,SBP在6、12和24个月的降低值分别为-5.2mm Hg、-8.1mm Hg和-6.7 mm Hg(均有P<0.01),DBP在12和24个月的降低值分别为-4.7mm Hg和-2.9 mm Hg(均有P<0.05)。结论中老年人的HLI随时间变化存在高、中和低三种轨迹组;高水平HLI轨迹组干预期间的血压降低优于中、低水平组,应针对不同轨迹组人群制定差异性的生活方式干预对策。
Objective To investigate trajectories of lifestyle index and their association with blood pressure change in the middle-aged and older adults. Methods A community-based lifestyle intervention trial for adults aged 50-79 was conducted in two communities in Guangzhou from January 2010 to March 2012. Data of lifestyle factors(including smoking, alcohol drinking, diet, physical activity and BMI) and blood pressure(BP) were collected at baseline and 6, 12 and 24 months. Lifestyle indicators were used to generate a healthy lifestyle index(HLI). Trajectories of HLI were identified using a group-based trajectory modelling approach. Linear mixed models were performed to examine the association between HLI trajectories and blood pressure change after adjusting for covariates. Results A total of 393 individuals were included, of which 130 were males(33.1%) and the mean age was(58.6±7.3) years. Three distinct HLI trajectories were identified: persistently low(Group 1, 26.7%), moderate and slightly improved(Group 2, 52.7%) and high and rapidly improved(Group 3, 20.6%). Compared with Group 1, there was no apparent change in blood pressure in Group 2(all P >0.05) during follow-up. While significant reductions in SBP(6 months:-5.2 mm Hg;12 months:-8.2 mm Hg;24 months:-6.7 mm Hg;all P<0.01) and DBP(12 months:-4.7 mm Hg;24 months:-2.9 mm Hg;all P<0.05) were observed in Group 3. Conclusions Three distinct HLI trajectories(high, medium and low) were identified in the middle-aged and older adults. BP reductions during intervention period were greater in the high-level trajectory group compared with the medium-and low-level group. Specific lifestyle intervention measures targeting different trajectory groups should be developed.
作者
张冠荣
林爱华
ZHANG Guan-rong;LIN Ai-hua(Statistics Section,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China;Department of Medical Statistics,School of Public Health,Sun Yat-Sen University,Guangzhou 510080,China)
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2022年第1期99-104,共6页
Chinese Journal of Disease Control & Prevention
基金
广东省医学科研基金(A2019266)。
关键词
生活方式指数
发展轨迹
组基础模型
血压
干预研究
Lifestyle index
Trajectory
Group-based trajectory model
Blood pressure
Intervention study
