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华东地区45-75岁农村高血压人群吸烟与叶酸水平的相关性研究

发布时间:2018-04-22 02:37

  本文选题:吸烟 + 叶酸 ; 参考:《安徽医科大学》2017年硕士论文


【摘要】:目的探讨中国农村地区高血压患者不同吸烟状态对叶酸水平的影响及其可能的影响因素。方法2008年5月,在江苏省连云港市及安徽省安庆市的农村地区进行流行病学调查,选取45岁以上无脑卒中和心肌梗死病史的高血压受试者,通过问卷调查的方式收集患者吸烟状况和其他相关变量,通过化学发光免疫分析方法测定血清叶酸水平,同型半胱氨酸、空腹血糖、血脂等生化指标水平,在中国广州南方医院肾脏病国家临床研究中心中心实验室使用自动临床分析仪(美国Beckman Coulter公司)进行测定。采用多元线性回归模型来获得比值比(Odds Ratio,OR)及其标准误(Standard Error,SE),来分析吸烟与叶酸水平之间的关系。结果本研究共选取8384名男性高血压患者,平均年龄为(61.0±7.6)岁。其中,从不吸烟者2583名,占总人数的30.8%,曾经吸烟者1393名,占16.6%,吸烟者4408名,占52.6%。我们可以发现吸烟者叶酸水平最低(7.6±3.6)ng/m L,曾经吸烟为8.1±3.7 ng/m L,不吸烟者叶酸水平为8.3±4.0ng/m L(P0.001)。同时吸烟者有更低的维生素B12含量、空腹血糖含量以及体质量指数(P0.001)。以不吸烟组作为对照组,在调整了年龄、血压、体质量指数、血脂、血糖等相关影响因素后,曾经吸烟者(β=-0.19,SE=0.12,P=0.116)叶酸水平略有下降,但不显著,而吸烟人群(β=-0.94,SE=0.09,P0.001)叶酸水平显著下降,并且随着吸烟支数与吸烟年限的增加,叶酸水平下降越多。在不同的年龄分层中,吸烟均会显著降低叶酸水平(年龄60岁,β=-0.63,SE=0.13,P0.001;年龄≥60岁,β=-1.20,SE=0.13,P0.001),而在年龄大于60岁的人群中,叶酸下降更多(交互作用P值0.001)。按不同的体质量指数分层,低体质量指数的人群中受吸烟的影响最大,叶酸水平显著降低(β=-3.16,SE=0.64,P0.001),而随着体质量指数的逐渐增加,叶酸下降有减弱的趋势(交互作用P值0.001)。在低同型半胱氨酸水平中,吸烟对叶酸水平影响最大(β=-1.15,SE=0.37,P=0.002)。与不吸烟不饮酒人群相比,既吸烟又饮酒人群的叶酸水平呈下降趋势(β=-0.49,SE=0.12,P0.001)。结论本研究发现农村中老年高血压人群中吸烟状态和叶酸水平存在负相关,与从不吸烟组相比,吸烟者叶酸水平显著降低。而在高年龄组、低体重组、低同型半胱氨酸组中叶酸下降更为明显。因此控制吸烟、合理膳食、健康运动是提高该地区人群叶酸水平的重要措施,对中国农村地区的心血管防治工作具有重要的公共卫生意义。
[Abstract]:Objective to investigate the influence of smoking status on folic acid level in rural areas of China. Methods Epidemiological investigation was carried out in rural areas of Lianyungang City, Jiangsu Province and Anqing City, Anhui Province in May 2008. Hypertensive subjects aged over 45 years with no history of stroke and myocardial infarction were selected. Smoking status and other related variables were collected by questionnaire. Serum folic acid, homocysteine, fasting blood glucose, blood lipid and other biochemical indexes were measured by chemiluminescence immunoassay. Automatic clinical analyzer (Beckman Coulter) was used in the laboratory of the National Center for Clinical Research of Renal Disease in Guangzhou South Hospital, China. The multivariate linear regression model was used to obtain the ratio ratio odds ratio (OR) and its standard error (Standard Errora) to analyze the relationship between smoking and folic acid level. Results A total of 8384 male patients with hypertension were selected. The mean age was 61.0 卤7.6 years. Of these, 2583 were non-smokers (30.8 percent of the total), 1393 were former smokers (16.6 percent), and 4408 were smokers (52.6 percent). It was found that the lowest folic acid level was 7.6 卤3.6)ng/m / L in smokers, 8.1 卤3.7 ng/m / L in smokers and 8.3 卤4.0ng/m / L in nonsmokers (P 0.001). Smokers also had lower levels of vitamin B 12, fasting blood glucose and body mass index (P 0.001). After adjusting the related factors such as age, blood pressure, body mass index, blood lipid and blood sugar, the folic acid level of former smokers (尾 -0.19) decreased slightly, but not significantly, while the level of folic acid in smoking population (尾 -0.94Se 0.09P 0.001) decreased significantly. And with the increase of smoking number and smoking years, folic acid level decreased more. In different age stratification, smoking significantly decreased folic acid levels (age 60, 尾 -0.63Se 0.13P 0.001; age 鈮,

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