中国成人社会经济地位与代谢综合征发病的关系

发布时间：2018-06-18 08:28

本文选题：社会经济地位 + 教育程度　；参考：《北京协和医学院》2015年硕士论文

【摘要】：研究背景代谢综合征(Metabolic Syndrome, MS),作为心血管疾病等慢性疾病的重要危险因素,已成为全球性公共卫生问题。近年来,我国MS患病率逐年增高,严重威胁到我国人群的健康,造成了巨大的疾病负担。国外已有大量的流行病学研究证实社会经济地位(Socioeconomic Status, SES)是MS重要的危险因素。而国内相关的研究证据较为缺乏,且都是一些局部地区的横断面调查,结果也并不一致。本研究利用大样本的前瞻性随访研究的数据,探讨中国成年人群SES与MS发病风险的关系。研究方法本研究以参加中国心血管病流行病学多中心协作研究和中国心血管健康多中心合作研究的27020名35-74岁成人作为研究对象。基线调查分别开始于1 998年和2000-2001年,收集研究对象的人口学特征、社会经济状况和生活方式等资料,并进行体格检查和生化指标检测。2007-2008年进行随访调查,收集MS患病情况和其他相关信息。最终有12608名(男性6112名,女性6496名)研究对象符合要求并纳入分析。本研究使用受教育水平、收入水平和职业类型作为SES的衡量指标,并且依据三者的评分构建SES复合指标,用三分位法将其分成低(4)、中(4-8)和高(8)三个组。应用二分类logistic回归模型分析受教育水平、收入水平、职业类型以及SES复合指标与MS发病风险的关系。研究结果本研究平均随访8.1年,共新发2716例MS(男性1151例,女性1 565例)。多因素调整后,在女性中,以未上学者作为参照,小学、初中、高中/中专和大专及以上者MS发病风险的相对危险度(Relative Ratio, RR)及其95%置信区间(Confidence Interval, CI)分别为1.19(0.99-1.44)、1.13(0.92-1.41)、0.81(0.63-1.04)和0.54(0.38-0.75),P趋势0.001；受教育水平与男性MS发病风险的关系无统计学意义。多因素调整后,在男性中,与家庭人均月收入300元者相比,收入水平为300-499元、500-799元、800-1199元、1200元者MS发病风险的RR (95%CI)分别为1.20(1.01-1.43)、1.35(1.11-1.62)、1.37(1.07-1.74)和1.58(1.15-2.15),P趋势0.001；收入水平与女性MS发病风险的关系无统计学意义。多因素调整后,在女性中,以无业者为对照,农民、工人/服务人员、退休人员、个体经营者/技术人员和管理者/干部MS发病风险的RR(95%CI)分别为0.69(0.55-0.86)、0.83(0.66-1.05)、1.03(0.82-1.30)、0.69(0.54-0.88)和0.62(0.48-0.81),P趋势=0.001；在男性中,职业类型与MS发病风险的关系无统计学意义。多因素调整后,与低SES者相比,中、高SES者MS发病风险的RR(95%CI)在男性中分别为1.46(1.20-1.76)和1.52(1.21-1.91),P趋势=0.003；在女性中分别为1.01(0.87-1.17)和0.75(0.61-0.92),P趋势=0.004。研究结论受教育水平、收入水平、职业类型以及SES复合指标与MS的发病风险密切相关,且存在性别差异。预防和控制MS等心血管疾病危险因素要考虑人群的SES水平特点,从而采取更有效的措施防控措施。
[Abstract]:Background Metabolic Syndrome (MSM), as an important risk factor for chronic diseases such as cardiovascular diseases, has become a global public health problem. In recent years, the prevalence of MS in China has been increasing year by year, which has seriously threatened the health of Chinese population and caused a huge burden of disease. A large number of epidemiological studies abroad have confirmed that socioeconomic status (SESs) is an important risk factor for MS. But the domestic related research evidence is relatively lack, and is some local area cross-sectional investigation, the result is also not consistent. In this study, we investigated the association between SES and MS risk in Chinese adults by using large sample prospective follow-up data. Methods in this study, 27020 adults aged 35 to 74 were enrolled in a multi-center collaborative study on cardiovascular epidemiology in China and a multi-center study on cardiovascular health in China. The baseline survey, which began in 1998 and 2000-2001, collected the demographic characteristics, social and economic status and lifestyle of the subjects, and carried out a follow-up survey between 2008 and 2008. Collect MS prevalence and other relevant information. Finally, 12608 subjects (6112 males and 6496 females) met the requirements and were included in the analysis. In this study, the education level, income level and occupation type were used as the index of SES, and the composite index of SES was constructed according to their scores. The composite index was divided into three groups by using the three-position method. Two classification logistic regression model was used to analyze the relationship between education level, income level, occupation type and the risk of MS. Results the average follow-up was 8.1 years. A total of 2716 cases (male 1151, female 1 565) were newly developed MSS. After multivariate adjustment, the relative risk of MS risk in primary school, junior middle school, high school / secondary school, junior high school and above were 1.190.9-1.441.130.92-1.410.61 ~ (0.63-1.04) and 0.54g / 0.38-0.750.75P trend respectively, after multivariate adjustment, the relative risk of MS risk was 1.190.9-1.44 (r) and 0.54 (0.38-0.75) P trend. There was no significant correlation between education level and male risk of MS. After multivariate adjustment, the RR 95CIs of MS risk in men with an income level of 300-499 Yuan / 500-799 Yuan / $800-1199 Yuan / RMB1200 were 1.20 / 1.01-1.43 / 1.35 / 1.351.11-1.62n / 1.371.07-1.74) and 1.581.15-2.15 / 1 / 1 respectively (P = 0.001), compared with the average monthly income of 300 yuan / month in the household (RMB300-499 / RMB500-799 / RMB1200). There was no significant correlation between income level and female risk of MS. After multifactorial adjustment, the RRG95CIIs of MS risk for farmers, workers / service workers, retirees, self-employed managers / technicians and managers / cadres were 0.69, 0.55-0.86, 0.830.66-1.05N 1.030.362-1.300.690.54-0.88 among women, and 0.62A0.48-0.81P trend for men, respectively. There was no significant correlation between occupational type and MS risk. After multifactorial adjustment, the RRG95 CI of MS in middle and high SES patients were 1.46 ~ 1.20-1.76) and 1.52 ~ 1.21-1.91 ~ (-1) P trend 0.003 in men, and 1.01T 0.87-1.17) and 0.750.61-0.92P trend 0.004 in women respectively, compared with those with low SES, the RRG95 CI in middle and high SES patients were 1.46 ~ 1.20 ~ 1.76) and 1.52 ~ 1.21 ~ 1.91 ~ (-1) P trend respectively, and 0.750.61-0.92P trend was 0.004 in women. Conclusion the educational level, income level, occupation type and SES compound index are closely related to the risk of MS, and there are gender differences. In order to prevent and control cardiovascular disease risk factors such as MS, the characteristics of SES level should be taken into account, and more effective measures should be taken to prevent and control cardiovascular diseases.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R589

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