我国中老年人的肥胖和高血压流行现状及其关联性分析

发布时间：2018-04-19 23:12

本文选题：肥胖 + 高血压　；参考：《兰州大学》2017年硕士论文

【摘要】：目的通过对我国中老年人的肥胖和高血压流行现状分析,进一步探究肥胖与高血压患病的关联性,比较各肥胖指标对高血压患病风险的预测效果,筛选出对高血压患病预测能力较强的肥胖指标。以期为基层卫生机构制定针对于中老年人群更有效的肥胖和高血压的防控策略与措施提供基础研究依据。方法使用2013年中国健康与养老调查CHARLS(China Health And Retirement Longitudinal Study,CHARLS)追访数据,该调查采用按人口规模成比例概率抽样(Probabilities Proportional to Size,PPS),抽取全国范围内的10624户家庭中的18605名调查对象,剔除没有参加体格检查及户口为城乡居民统一户口者,最终纳入11365名研究对象。采用以下方法进行数据分析:首先使用卡方检验进行不同组间肥胖和高血压患病率差异的比较。其次,采用Pearson相关系数,分析各肥胖指标之间及其与收缩压、舒张压的相关性。第三,使用单因素方差比较不同组间血压值的差异,使用二分类logistic多元回归分析各肥胖指标与高血压患病风险的关系,并计算OR(Odds Ratio,OR)值。对各肥胖指标进行标化处理,进一步观察各肥胖指标每变化一个标准差与高血压患病风险的关联程度;第四,使用Logit回归和ROC(Receiver Operating Characteristic Curve,ROC)计算各肥胖指标的AUC值(Area Under Curve,AUC),比较它们对高血压患病风险的预测效果。结果1.调查地区中老年人的肥胖率为13.2%,且随着年龄的升高开始逐渐下降,其中男性为10.5%,女性为15.7%。研究对象的肥胖率在女性、婚姻状态为“已婚或同居”者、受教育程度较高者、户口类型为非农业者以及非吸烟和饮酒者中保持在较高水平。2.调查地区中老年人的中心型肥胖率为49.1%,其中男性为37.4%,女性为59.7%,同样呈现出随着年龄的升高而逐渐下降的趋势。研究对象的中心型肥胖率在年龄为45~64岁者、婚姻状况为“已婚或同居”者、受教育水平在初中以上者、户口类型为非农业者以及非吸烟和饮酒者中较高。3.调查地区中老年人的高血压患病率为30.0%,其中男性为30.6%,女性为29.4%。随着年龄的增长高血压患病率开始逐渐升高。研究对象的高血压患病率在婚姻状况为“已婚或同居”者、户口类型为非农业者、吸烟和饮酒者以及肥胖和中心型肥胖者中较高;受教育程度与高血压患病率呈反向关系。此外,男性民族为少数民族者的患病率较高。4.调整了年龄和性别后,发现各肥胖指标之间存在显著正相关(p值均(27)0.05),腰围与腰围身高比值的相关性最强(r=0.98),各肥胖指标与收缩压、舒张压也存在正相关,腰围身高比值与收缩压的相关性最强(r=0.22);随着各肥胖指标分组由低到高,高血压的患病风险均逐渐升高,其中,女性腰围身高比值最高分组是最低组的2.05倍(OR=2.05,95%CI=1.71~2.46)。与体质指数、腰围相比,腰围身高比值对于高血压患病风险的预测能力更强,其AUC值为0.611。结论1.调查地区中老年人肥胖的流行现状不容乐观,年龄在45~64岁、婚姻状况为“已婚或同居”、受教育程度在“初中毕业”及以下人群和非农业户口居民是肥胖流行的高危人群。2.调查地区中老年人高血压的患病率保持在很高水平上,高龄、婚姻状况为“非在婚”、民族为少数民族、受教育程度偏低、户口类型为非农业户口、有吸烟和饮酒习惯、肥胖和中心型肥胖人群均是高血压流行的高危人群。3.调查地区中老年人的肥胖与高血压存在很强的关联性,相较于与体质指数、腰围相比,腰围身高比值对于高血压的患病风险的预测能力更强,可作为中老年人的高血压高危人群的可行筛检指标。建议1.基层卫生机构应大力号召全民树立保持健康体重的生活理念,呼吁大众采取积极健康的生活方式,从根本上实现对高血压及其伴生疾病高发流行的有效防控。同时,应针对中老年超重人群积极地采取干预行动,以有效控制肥胖人口基数的进一步扩大。2.基层卫生机构应积极制定与落实中老年人高血压的防治策略与措施,提高高血压的控制率,减轻由其所造成的疾病经济负担。3.腰围身高比值可作为中老年人的高血压高危人群的可行筛检指标
[Abstract]:Objective to further explore the relationship between obesity and hypertension by analyzing the prevalence of obesity and hypertension in the middle and old people in China, and to compare the predictive effect of the obesity index on the risk of hypertension, and to screen out the obesity indicators that have a strong ability to predict the hypertension. A basic research basis was provided for more effective obesity and hypertension prevention and control strategies and measures. Methods using the 2013 China Health and pension survey CHARLS (China Health And Retirement Longitudinal Study, CHARLS), the survey was conducted in proportion to the population scale (Probabilities Proportional to Size), A total of 18605 respondents from 10624 families in the country were selected to eliminate unchecked physical examination and registered permanent residence for urban and rural residents, and the final inclusion of 11365 subjects. The following methods were used to carry out data analysis: first, the comparison of the prevalence rates of obesity and hypertension among different groups was compared with the chi square test. Secondly, Pearson correlation coefficient was used to analyze the correlation between obesity indexes and their systolic pressure and diastolic pressure. Third, using single factor variance to compare the difference of blood pressure between different groups, using two classified logistic multivariate regression analysis to analyze the relationship between the obesity index and the risk of hypertension, and calculate the value of OR (Odds Ratio, OR). The correlation between a standard deviation and the risk of hypertension was further observed. Fourth, Logit regression and ROC (Receiver Operating Characteristic Curve, ROC) were used to calculate the AUC value of each obesity index (Area Under Curve, AUC), and the results were compared to predict the risk of hypertension. 1. the obesity rate of middle aged and elderly people in the survey area was 13.2%, and gradually decreased with age, among which men were 10.5%. The obesity rate of women for 15.7%. research was in women, marriage was "married or cohabitation", with higher education level, the type of household registered for non-agricultural and non-smoking and drinkers was higher. The central obesity rate of the middle-aged and elderly people in the level.2. survey area was 49.1%, of which 37.4% were male and 59.7% for women. The central obesity rate of the subjects was 45~64 years old, the marital status was "married or cohabiting", and the education level was in junior high school. The prevalence rate of high blood pressure in middle aged and elderly people in non - agricultural and non-smoking and drinkers was 30%, of which 30.6% of men were in men. The incidence of hypertension in women was increasing with age of 29.4%.. The prevalence rate of hypertension in the study was "married or cohabitation" in marriage. Non agricultural people, smoking and drinkers and obese and central obesity were higher; the degree of education and the prevalence of hypertension had a reverse relationship. In addition, the prevalence rate of the male ethnic minority was higher by.4. adjustment of age and sex, there was a significant positive correlation between the obesity indicators (P value (27)), waist circumference and waist circumference height. The correlation was strongest (r=0.98), and there was a positive correlation between the index of obesity and systolic pressure and diastolic pressure. The correlation between the height ratio of waist circumference and systolic pressure was the strongest (r=0.22); with the groups from low to high, the risk of hypertension increased gradually, and the highest group of female waist height was 2.05 times as high as that of the lowest group (OR=2.05 95%CI=1.71~2.46). Compared with body mass index and waist circumference, the ratio of waist height to high blood pressure is more effective in predicting the risk of hypertension. The AUC value of 0.611. conclusion 1. is that the prevalence of obesity in middle-aged and elderly people is not optimistic, the age is 45~64, marriage is "married or cohabitation", and the education degree is "junior high school" and below. People and non-agricultural residents are high risk population of obesity epidemic in.2. survey area, the prevalence rate of hypertension in middle age and elderly population remains high, age, marriage status is "non marriage", ethnic minority is minority, the education degree is low, household registration is non agricultural account, smoking and drinking habits, obesity and central obesity people. Groups are high risk population of hypertension epidemic in.3. survey area, there is a strong association between obesity and hypertension in the middle aged and elderly people. Compared with the body mass index, the waist circumference is more predictive of the risk of hypertension than the waist circumference. It can be used as a feasible screening indicator for high risk population of middle aged and elderly people. 1. basis is recommended. The health organization should energetically call on the whole people to establish a life concept of maintaining a healthy weight, and call on the public to adopt a positive and healthy lifestyle to realize the effective prevention and control of high blood pressure and its associated diseases. At the same time, intervention should be taken actively to control the base number of the obese people in the middle and old age. To further expand the.2. grass-roots health institutions should actively formulate and implement the prevention and treatment strategies and measures for high blood pressure in the middle-aged and the elderly, improve the control rate of hypertension and reduce the ratio of.3. waist height to the economic burden caused by the disease, which can be used as a feasible screening index for high risk population of middle aged and elderly people.

【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1;R589.2

【参考文献】