摘要
目的探讨体质指数(body mass index,BMI)水平及动态变化与高血压、糖尿病、血脂异常共病发生的风险,为慢性非传染性疾病(慢性病)共病防控提供参考依据。方法数据来自2010年建立的贵州省自然人群队列,采用分层随机整群抽样的方法,对12个县(市、区)的48个乡镇共9280人进行调查。2016―2020年,完成了随访调查。排除基线高血压、糖尿病、血脂异常共病和随访时数据缺失的调查对象,最终4688例进入分析。采用Cox比例风险回归模型分析BMI值、不同BMI变化值及BMI变化情况(保持正常BMI、持续超重肥胖、正常BMI变为超重肥胖、超重肥胖变为正常BMI)与高血压、糖尿病、血脂异常共病之间的关系,计算HR值和95%CI。结果不同地区、性别、年龄、民族、教育水平、吸烟、饮酒、膳食得分人群高血压、糖尿病、血脂异常共病差异均有统计学意义(均P<0.05)。共病发生风险随着BMI值的升高而增加(HR=1.046,95%CI:1.031~1.061),且超重(HR=1.293,95%CI:1.124~1.487)、肥胖(HR=2.130,95%CI:1.706~2.658)人群发生风险高于BMI正常人群。BMI减少1.0 kg/m2以下时共病发生风险降低21.3%,BMI增加5.0 kg/m2及以上时,共病发生风险增加42.9%(HR=1.429,95%CI:1.108~1.845)。持续超重肥胖(HR=2.301,95%CI:1.962~2.697)、正常BMI变为超重肥胖(HR=1.698,95%CI:1.451~1.987)人群共病发生风险较保持正常BMI的人群分别增加2.301倍、1.698倍。结论BMI水平及动态变化与高血压、糖尿病、血脂异常共病密切相关,控制和降低BMI至正常水平是预防3种疾病共病必要和有效的方法。
Objective To investigate body mass index(BMI)level and its dynamic changes and the risk of comorbidity of hypertension,diabetes and dyslipidemia,and provide the reference for prevention and control of chronic disease comorbidity.Methods The data used in the study were from the natural cohort of Guizhou province established in 2010.In order to obtain the cohort,stratified random cluster sampling method was employed to investigate a total of 9280 people from 48 towns in 12 counties(cities,districts).A follow-up survey was completed from 2016 to 2020.The subjects with baseline hypertension,diabetes,dyslipidemia comorbidities and with incomplete data during follow-up were excluded.A total of 4688 patients were ultimately included into this study.Cox proportional hazard regression model was used to analyze the relationship between BMI values,different change values of BMI and changes in BMI(maintaining normal BMI,continuing overweight and obesity,changing from the normal BMI to the overweight and obesity,changing from the overweight and obesity to the normal BMI)and hypertension,diabetes,dyslipidemia comorbidity.Risk ratio(HR)and 95%CI were calculated.Results Among the groups distinguished by region,gender,age,ethnic group,education level,smoking,drinking and dietary score,differences in comorbidity of hypertension,diabetes and dyslipidemia were significant statistically(all P<0.05).The risk of comorbidity increased with the increase of BMI value(HR=1.046,95%CI:1.031-1.061).Moreover,the risk of comorbidity among the groups of overweight(HR=1.293,95%CI:1.124-1.487)and obesity(HR=2.130,95%CI:1.706-2.658)was higher than that among the groups having normal BMIs.The risk for the group with BMIs lowered by 1.0 kg/m2 or less to undergo comorbidity was decreased by 21.3%,whereas the risk for the group with BMI increased by 5.0 kg/m2 or more to undergo comorbidity was increased by 42.9%(HR=1.429,95%CI:1.108-1.845).For the patients who kept overweight(HR=2.301,95%CI:1.962-2.697)and the patients who had normal BMI but became ove
作者
周婕
吴延莉
王艺颖
余丽莎
张骥
余杨文
李雪娇
龙梦雅
刘涛
ZHOU Jie;WU Yanli;WANG Yiying;YU Lisha;ZHANG Ji;YU Yangwen;LI Xuejiao;LONG Mengya;LIU Tao(Guizhou Center for Disease Control and Prevention,Guiyang 550004,China;School of Public Health,the Key Laboratory of Environmental Pollution Monitoring and Disease Control,Ministry of Education,Guizhou Medical University,Guiyang 550025,China)
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2023年第12期1421-1429,共9页
Chinese Journal of Disease Control & Prevention
基金
贵州省科技计划(黔科合支撑[2018]2819)
贵州省卫生健康委员会省级重点建设学科项目。
关键词
体质指数
共病
发生风险
前瞻性研究
Body mass index
Comorbidity
Occurrence risk
Prospective study
