中国全科医学 ›› 2024, Vol. 27 ›› Issue (12): 1438-1444.DOI: 10.12114/j.issn.1007-9572.2023.0625

• 论著 • 上一篇    下一篇

新疆哈萨克族血脂异常、高血压和糖尿病共病现状及影响因素研究

金梦龙1, 秦晓英2, 马力亚·阿米提3, 加孜呢·努尔拜4, 李建新5, 曹杰5, 罗思富1, 刘成1, 张雨晨1, 盖敏涛1, 李艳鹏1, 鲁向锋5, 付真彦1,*()   

  1. 1.830000 新疆维吾尔自治区乌鲁木齐市,新疆医科大学第一附属医院心血管病中心 新疆医科大学省部共建中亚高发病成因与防治国家重点实验室
    2.836100 新疆维吾尔自治区阿勒泰地区,富蕴县卫生健康委员会
    3.836100 新疆维吾尔自治区阿勒泰地区,富蕴县吐尔洪乡中心卫生院
    4.836100 新疆维吾尔自治区阿勒泰地区,富蕴县杜热镇中心卫生院
    5.100037 北京市,北京协和医学院 国家心血管病中心 中国医学科学院阜外医院流行病研究部
  • 收稿日期:2023-10-25 修回日期:2023-11-27 出版日期:2024-04-20 发布日期:2024-01-23
  • 通讯作者: 付真彦

  • 作者贡献:金梦龙负责数据收集、采集、清洗、统计学分析、绘制图表和论文起草;秦晓英、马力亚·阿米提、加孜呢·努尔拜负责动员、组织、协调研究对象和调查实施;李建新、曹杰、鲁向锋负责提出研究思路,设计研究方案;罗思富、刘成、张雨晨、盖敏涛、李艳鹏负责数据收集、采集、指标化验与检测;付真彦负责最终版本修订,对论文负责。
  • 基金资助:
    国家重点研发计划(2021YFC2500600,2021YFC2500605); 自治区重点研发计划项目(2022B03022-4); 省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目(SKL-HIDCA-2022-XXG3); 国家创新研究群体培育项目(XYD2021C002); 国家自然科学基金资助项目(81970380)

Status and Influencing Factors of Dyslipidemia, Hypertension and Diabetes Comorbidities among Kazakhs in Xinjiang

JIN Menglong1, QIN Xiaoying2, MALIYA Amiti3, JIAZINI Nuerbai4, LI Jianxin5, CAO Jie5, LUO Sifu1, LIU Cheng1, ZHANG Yuchen1, GAI Mintao1, LI Yanpeng1, LU Xiangfeng5, FU Zhenyan1,*()   

  1. 1. Department of Cardiology and State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia/First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
    2. Health Commission of Fuyun County, Altay 836100, China
    3. Tuerhong Township Center Hospital of Fuyun County, Altay 836100, China
    4. Dure Town Center Hospital of Fuyun County, Altay 836100, China
    5. Department of Epidemiology, Fuwai Hospital/National Center for Cardiovascular Diseases/Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
  • Received:2023-10-25 Revised:2023-11-27 Published:2024-04-20 Online:2024-01-23
  • Contact: FU Zhenyan

摘要: 背景 心血管疾病是我国居民的首要死亡原因,高血压、高血糖和血脂异常("三高")是心血管疾病的重要危险因素,因此国家提出实施"三高"共管,但目前缺乏关于新疆哈萨克族"三高"共病情况的相关研究。目的 调查哈萨克族血脂异常、高血压和糖尿病患病率及共病情况,探索三者共病的影响因素。方法 本研究为横断面研究。2022年3—6月,在新疆阿勒泰地区富蕴县,选取杜热镇和吐尔洪乡两个人口较多且以哈萨克族为主的乡镇,调查该地区18岁以上哈萨克族常住居民,通过问卷调查(一般信息、吸烟饮酒史、患病情况等)、体格检查(腰围、臀围、身高、体质量、血压、心率等)和实验室检查(总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、三酰甘油和空腹血糖等)收集患者信息,使用多因素Logistic回归分析探究哈萨克族"三高"共病的相关影响因素。结果 共纳入4 835名哈萨克族居民,男、女各占48.2%(2 231/4 835)和51.8%(2 504/4 835),平均年龄(45.8±12.7)岁。血脂异常、高血压和糖尿病标化患病率分别为37.9%、21.1%和4.0%。血脂异常患者中高胆固醇、高低密脂蛋白胆固醇、低高密度脂蛋白胆固醇和高三酰甘油血症人群的标化患病率分别为24.1%、24.8%、10.0%和7.3%。"三高"共病的标化患病率为11.8%。单因素Logistic回归分析显示,性别、年龄、BMI、腰围、臀围、心率、婚姻状况和文化程度是"三高"共病的影响因素(P<0.05);多因素Logistic回归分析显示,性别、年龄、婚姻状况、BMI和心率是"三高"共病的影响因素(P<0.05)。结论 哈萨克族血脂异常患病率高于高血压和糖尿病,血脂异常以高胆固醇血症为主。血脂异常与高血压共病在"三高"共病中最为常见,应将老年人、男性和高BMI人群作为"三高"共管的重点人群。

关键词: 血脂异常, 高血压, 糖尿病, 慢性病共病, 哈萨克族, 影响因素分析

Abstract:

Background

Cardiovascular disease is the leading cause of death among Chinese residents, hypertension, hyperglycemia and hyperlipidemia are important risk factors for cardiovascular disease. Therefore, China proposes to implement the co-management of these three diseases. At present, there is a lack of relevant research on the three diseases comorbidities of the Kazakhs in Xinjiang.

Objective

To investigate the prevalence and status of dyslipidemia, hypertension and diabetes comorbidities among Kazakhs, and explore the related factors.

Methods

Kazakh residents over 18 years old from Dure Town and Tuerhong Township with large populations mainly consist of Kazakh in Fuyun County, Altay Prefecture, Xinjiang from March to June in 2022 were selected to conduct the cross-sectional study. Patient information was collected through questionnaires (general information, history of smoking, alcohol consumption, and diseases), physical examination (waist circumference, hip circumference, height, weight, blood pressure, heart rate, etc.), and laboratory tests (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triacylglycerol, and fasting blood glucose, etc.). Multivariate Logistic regression analysis was used to explore the factors related to dyslipidemia, hypertension and diabetes comorbidities among Kazakhs.

Results

A total of 4 835 Kazakh residents were included, 48.2% (2 231/4 835) and 51.8% (2 504/4 835) were male and female respectively, with an average age of (45.8±12.7) years. The standardized prevalence of dyslipidemia, hypertension and diabetes mellitus were 37.9%, 21.1% and 4.0%, respectively. The standardized prevalence of hypercholesterolemia, high low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol and hypertriacylglycerolemia in the dyslipidemic population was 24.1%, 24.8%, 10.0% and 7.3%, respectively. The standardized prevalence of comorbidities was 11.8%. Univariate Logistic regression analysis showed that gender, age, BMI, waist circumference, hip circumference, heart rate, marital status, and education level were correlated with the comorbidities (P<0.05). Multivariate Logistic regression analysis showed that gender, age, marital status, BMI and heart rate were correlated with three diseases comorbidities (P<0.05) .

Conclusion

The prevalence of dyslipidemia is higher than that of hypertension and diabetes, and dyslipidemia is dominated by hypercholesterolemia. The comorbidities of dyslipidemia and hypertension are the most common among the three diseases comorbidities, and the elderly, males and people with high BMI should be prioritized for the three diseases co-management.

Key words: Dyslipidemia, Hypertension, Diabetes mellitus, Multiple chronic conditions, Kazakh, Root cause analysis