CAJ | 학술논문

目的分析中国成年人高血压的区域聚集性及危险因素,探讨多水平模型在高血压危险因素研究中的应用.方法采用多阶段随机抽样方法,于2000-2001年从中国10地区共抽得年龄在35～74岁之间的15 540人作为研究对象,采用MLwiN 2.02软件对数据进行二水平logistic回归模型拟合.结果高血压的患病存在地区聚集现象,方差成分系数为3.1%.在调整了年龄和性别的影响后,全身型肥胖人群(BMI≥28 kg/m2)和超重人群(BMI 24～27.9 kg/m2)分别为BMI正常人群(18.5～23.9 kg/m2)患高血压风险的4.50(95%CI:4.00～5.06)和2.26(95%CI:2.07～2.46)倍;中心型肥胖人群(男性腰围≥85 cm或女性≥80 cm)为正常腰围人群患高血压风险的2.62(95%CI:2.42～2.83)倍;片油三酯、总胆固醇、血糖、低密度脂蛋门胆固醇含量升高或者高密度脂蛋白胆固醇含量降低者患病风险分别为正常者高血压患病风险的2.10(95%CI:1.89～2.33)、2.08(95%CI:1.84～2.35)、1.85(95%CI:1.60～2.14)、1.58(95%CI:1.38～1.81)和1.49(95%CI:1.32～1.69)倍,饮酒人群为不饮酒人群患高血压风险的1.15(95%CI:1.05～1.27)倍.结论高血压的发生不仪与个体肥胖、血糖升高、血脂异常和饮酒等危险因素有关,还受所居住区域环境因素的影响;在高血压的一级预防中,既要关注高危人群,还要重视以一般人群为基础的群体预防控制工作.
목적 분석중국성년인고혈압적구역취집성급위험인소,탐토다수평모형재고혈압위험인소연구중적응용.방법 채용다계단수궤추양방법,우2000-2001년종중국10지구공추득년령재35～74세지간적15 540인작위연구대상,채용MLwiN 2.02연건대수거진행이수평logistic회귀모형의합.결과 고혈압적환병존재지구취집현상,방차성분계수위3.1%.재조정료년령화성별적영향후,전신형비반인군(BMI≥28 kg/m2)화초중인군(BMI 24～27.9 kg/m2)분별위BMI정상인군(18.5～23.9 kg/m2)환고혈압풍험적4.50(95%CI:4.00～5.06)화2.26(95%CI:2.07～2.46)배;중심형비반인군(남성요위≥85 cm혹녀성≥80 cm)위정상요위인군환고혈압풍험적2.62(95%CI:2.42～2.83)배;편유삼지、총담고순、혈당、저밀도지단문담고순함량승고혹자고밀도지단백담고순함량강저자환병풍험분별위정상자고혈압환병풍험적2.10(95%CI:1.89～2.33)、2.08(95%CI:1.84～2.35)、1.85(95%CI:1.60～2.14)、1.58(95%CI:1.38～1.81)화1.49(95%CI:1.32～1.69)배,음주인군위불음주인군환고혈압풍험적1.15(95%CI:1.05～1.27)배.결론 고혈압적발생불의여개체비반、혈당승고、혈지이상화음주등위험인소유관,환수소거주구역배경인소적영향;재고혈압적일급예방중,기요관주고위인군,환요중시이일반인군위기출적군체예방공제공작.
Objective To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension. Methods Multi-stage random sampling technique was used to choose 15 540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software. Results The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI≥28 kg/m2) were 4.50(95%CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95%CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference≥85 cm in male or 80 cm in female) were 2.62 (95%CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (Ors) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33) , 2.08 (95% CI: 1.84-2.35) , 1.85 (95% CI: 1.60-2.14) , 1.58 (95% CI: 1.38-1.81), 1.49(95%CI: 1.32-1.69) and 1.15(95%CI: 1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.