成年后体重改变与晚年高血压、糖尿病的相关性研究

发布时间：2018-04-30 05:41

本文选题：成年早期 + 体重改变　；参考：《广州医科大学》2017年硕士论文

【摘要】：目的:体重的变化是影响慢性疾病发病的重要因素,其对疾病的影响相对滞后,从体重开始明显增加到出现相应疾病可能需要数年甚至十年以上,成年早期的体重改变可能会增加晚年时期罹患高血压、糖尿病等慢性疾病的风险,尤其是对于生活在一个经历过改革开放,生活条件、生活方式明显改变的国家的人们,生活条件的改善导致体型发生变化,进而可能会增加晚年罹患高血压、糖尿病的风险,而目前对于这方面的研究较少。为此,本研究利用《广州生物库队列研究》(Guangzhou biobank cohort study,GBCS)三期基线资料,探讨成年后体重变化、出现体重变化的年龄等与晚年高血压、糖尿病的相关性。方法:基于“广州生物库队列研究”(GBCS)平台,选取其中28926例50岁以上广州中老年人为研究对象,通过问卷调查收集一般人口学资料,成年后(18岁)体重改变,保持最重体重的年龄等。利用协方差分析探讨成年后体重改变、体质指数(晚年体型)与收缩压、舒张压、平均动脉压、脉压差、空腹血糖等的相关性。采用多因素Logistic回归模型,分析调整年龄、吸烟、饮酒、体力活动、教育程度、职业、居住地、体质指数后成年后体重变化、保持最重体重时的年龄等与高血压、糖尿病的关系。结果:研究对象平均年龄男性64.3±6.7岁,女性61.0±7.0岁,高血压患病率男性(46.3%)高于女性(42.6%),糖尿病患病率男女基本一致(13.0%和13.6%)。成年后体重改变、体质指数与血压、血糖水平密切相关,二者对男性收缩压、舒张压、平均动脉压的影响具有交互作用,对女性舒张压、平均动脉压的影响具有交互作用。男女高血压患病风险均随其成年后体重的增加而增加(趋势检验P0.01),与体重基本不变组比,成年后体重增加20Kg以上组晚年高血压患病风险最高,风险比分别为男性1.92(95%CI:1.55,2.38)和女性1.49(1.29,1.73)。保持最重体重的年龄与高血压患病风险相关,以40至49岁达到最重体重组晚年高血压患病风险最高,风险比分别为男性1.83(95%CI:1.17,2.85),女性1.69(1.41,2.03)。仅女性成年后体重减少与晚年患高血压风险下降有关。男女糖尿病患病风险均随其成年后体重增加而增加(趋势检验P0.01),与体重基本不变组比,成年后体重增加20Kg以上组晚年患糖尿病风险最高,风险比分别为男性2.84(95%CI:2.02,3.99)和3.30(2.61,4.17)。保持最重体重的年龄也与糖尿病患病风险相关,以40至49岁达到最重体重组晚年糖尿病患病风险最高,风险比分别为男性4.32(95%CI:1.72,10.8),女性3.29(2.41,4.49)。男女成年后体重减少仅与晚年自报已患糖尿病有关,与基线调查新发现糖尿病无关。结论:成年后体重增加可增加晚年高血压、糖尿病的患病风险,且患病风险有随体重增加而增加的趋势,以40至49岁达到最重体重组晚年高血压、糖尿病患病风险最高,出现明显增重到发生高血压、糖尿病可能相隔10至20年。研究结果提示肥胖的防治工作应提前,同时应关注40~49岁年龄段人群的健康问题,保持一个相对匀称的体型和相对稳定的体重对预防慢性疾病的发生至关重要。
[Abstract]:Objective: the change of body weight is an important factor affecting the incidence of chronic diseases. Its impact on the disease is relatively lagging. It may take years or even more than ten years to increase the weight from the beginning of the body weight to the corresponding disease. The early adult weight change may increase the risk of chronic diseases such as high blood pressure and diabetes in the late years, especially in the late years. For people living in a country that has experienced reform and opening up, living conditions, and a significant change in life style, the improvement of living conditions leads to a change in body shape, which may increase the risk of hypertension and diabetes in the late years, and there are few studies on this. For this reason, this study uses the Guangzhou biologic database cohort study ( Guangzhou Biobank Cohort study, GBCS) three phase baseline data, to explore the relationship between body weight change, age of body weight change and age of hypertension and diabetes in late years. Methods: Based on the "Guangzhou biologic database cohort study" (GBCS) platform, 28926 of the subjects aged 50 and above were selected and investigated by questionnaire. The correlation between body weight change, body mass index (late year shape) and systolic pressure, diastolic pressure, mean arterial pressure, poor pulse pressure, and fasting blood glucose were investigated by covariance analysis. The multiple factor Logistic regression model was used to analyze age, smoking, and the correlation between body mass index (body mass index) and systolic pressure, diastolic pressure, mean arterial pressure, poor pulse pressure, and fasting blood glucose. The relationship between alcohol consumption, physical activity, education, occupation, residence, body mass index after adult weight change and the age of the heaviest weight was associated with hypertension and diabetes. Results: the average age of the male was 64.3 + 6.7 years, the female was 61 + 7 years old, the male (46.3%) of the hypertensive patients (46.3%) was higher than that of the female (42.6%), and the prevalence rate of diabetes was in the male and female basis. This Agreement (13% and 13.6%). Body weight change after adult, body mass index is closely related to blood pressure and blood glucose level. The two have interaction effect on male systolic pressure, diastolic pressure and mean arterial pressure. The influence on diastolic pressure and mean arterial pressure has interaction. The risk of male and female hypertension is all with the increase of weight after adult. The increase (trend test P0.01), compared with the basic body weight group, was the highest risk of high blood pressure in later years of adult body weight gain and more than 20Kg. The risk ratio was 1.92 (95%CI:1.55,2.38) and 1.49 (1.29,1.73) for women respectively. The age of maintaining the heaviest weight was associated with the risk of hypertension, and reached the most heavy body of high blood pressure from 40 to 49 years old. The risk was the highest, the risk ratio was 1.83 (95%CI:1.17,2.85) and 1.69 (1.41,2.03) for women. Only female adult weight loss was associated with lower risk of hypertension in later years. The risk of diabetes in both men and women increased with the increase of adult weight (trend test P0.01), compared with the basic body weight group, and the weight of adult increased by 20Kg. The highest risk of diabetes in the upper group was 2.84 (95%CI:2.02,3.99) and 3.30 (2.61,4.17), respectively. The age of maintaining the heaviest weight was also associated with the risk of diabetes, and the highest risk of diabetes in the most severe reorganized age of 40 to 49 years was 4.32 (95%CI:1.72,10.8) and 3.29 (2.41,4.49) for women respectively. The weight loss of men and women is associated with diabetes in the later years and is not related to diabetes in the later years. Conclusion: the increase in weight can increase the risk of late age and diabetes, and the risk of diabetes increases with the increase of weight, from 40 to 49 years old to the heaviest body of late years of high blood pressure, diabetic patients. The highest risk of disease, a significant increase in weight to high blood pressure, and diabetes may be separated from 10 to 20 years. The results of the study suggest that the prevention and treatment of obesity should be ahead of time. At the same time, we should pay attention to the health problems of the 40~49 age group, and maintain a relatively symmetrical body shape and relatively stable weight to prevent the occurrence of chronic diseases.

【学位授予单位】：广州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1;R587.1

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