CAJ | 학술논문

目的采用限制性立方样条模型,探讨男性吸烟与高血压病的剂量-反应关系.方法采用与人口规模成比例的整群抽样方法,于2012年5至8月对江苏省昆山市18岁以上38 520名户籍居民进行问卷调查和体格测量.采用logistic回归模型和限制性立方样条模型,分析男性吸烟数量、年限及吸烟指数与高血压病的关系.结果总吸烟率为22.6％(8 691/38 520),其中男性吸烟率为46.1％(8 499/18 454).调整年龄、性别、体质指数、教育、家庭月收入、城区或郊区、体力活动强度、锻炼情况后,多因素logistic回归分析显示,男性现在吸烟(OR=1.16,95％ CI:1.05～1.28)和过去吸烟(OR=1.32,95％ CI:1.07 ～ 1.63)与高血压病有关;进一步调整饮酒状态之后,仅过去吸烟与高血压病有关(OR=1.28,95％ CI:1.04～1.58).限制性立方样条模型分析显示,男性吸烟数量与高血压病呈线性剂量-反应关系(非线性检验,P =0.604 1),吸烟年限与高血压病呈非线性剂量-反应关系(非线性检验,P ＜0.000 1),吸烟指数与高血压呈非线性剂量-反应关系(非线性检验,P=0.009 9).结论男性长期大剂量吸烟与高血压病有关.
목적 채용한제성립방양조모형,탐토남성흡연여고혈압병적제량-반응관계.방법 채용여인구규모성비례적정군추양방법,우2012년5지8월대강소성곤산시18세이상38 520명호적거민진행문권조사화체격측량.채용logistic회귀모형화한제성립방양조모형,분석남성흡연수량、년한급흡연지수여고혈압병적관계.결과 총흡연솔위22.6％(8 691/38 520),기중남성흡연솔위46.1％(8 499/18 454).조정년령、성별、체질지수、교육、가정월수입、성구혹교구、체력활동강도、단련정황후,다인소logistic회귀분석현시,남성현재흡연(OR=1.16,95％ CI:1.05～1.28)화과거흡연(OR=1.32,95％ CI:1.07 ～ 1.63)여고혈압병유관;진일보조정음주상태지후,부과거흡연여고혈압병유관(OR=1.28,95％ CI:1.04～1.58).한제성립방양조모형분석현시,남성흡연수량여고혈압병정선성제량-반응관계(비선성검험,P =0.604 1),흡연년한여고혈압병정비선성제량-반응관계(비선성검험,P ＜0.000 1),흡연지수여고혈압정비선성제량-반응관계(비선성검험,P=0.009 9).결론 남성장기대제량흡연여고혈압병유관.
Objective To estimate the dose response relationship between cigarette smoking and hypertension in men based on restricted cubic spline method.Methods Under the proportion to the population size,38 520 subjects were randomly selected from May to August 2012 with cluster sampling method in urban and rural areas of Kunshan,China.Each participant received face-to-face interview with the standardized questionnaire,and physical examination.Restricted cubic spline was employed to estimate the dose response relation of cigarette smoking on the risk of hypertension.Results The overall prevalence of cigarette smoking was 22.6％ (8 691/38 520),prevalence of cigarette smoking in men was 46.1％ (8 499/18 454).Multiple logistic regression analysis showed that current smoking (OR =1.16,95％ CI:1.05-1.28) and previous cigarette smoking (OR =1.32,95％ CI:1.07-1.63) were associated with hypertension after adjusted confounding factors (age,sex,body mass index,education,family income per month,urban or rural areas,physical activity and physical exercise) in men.After further adjusting drinking status,only previous cigarette smoking was associated with hypertension (OR =1.28,95 ％ CI:1.04-1.58).The restricted cubic spline model indicated a linear dose-response relation between hypertension and cigarette smoking per day in men (non-linearity test P =0.604 1).However,a non-linear dose response relation was found between duration of smoking (non-linearity test P ＜ 0.000 1),smoking index (non-linearity test P =0.009 9) and hypertension.Conclusion Long-term and heavy cigarette smoking is associated with hypertension in men.