摘要
目的了解河南省郏县老年女性糖尿病患者妊娠次数和生活方式与心血管疾病(CVD)患病的关系,为制定个体化CVD预防策略提供科学依据。方法于2023年7月1日—8月31日采用整群抽样方法在河南省郏县15个乡镇卫生院/社区卫生服务中心抽取21379名≥65岁且在该地区居住≥6个月的就诊患者进行问卷调查。排除生活方式信息不全、男性和非糖尿病患者后最终纳入4133例老年女性糖尿病患者进行分析。应用多因素非条件logistic回归模型分析该地区老年女性糖尿病患者妊娠次数和生活方式与CVD患病的关系。结果河南省郏县纳入分析的4133例老年女性糖尿病患者中,患CVD者1712例,CVD患病率为41.4%;妊娠≤2次者1099例(26.6%),3次者1190例(28.8%),≥4次者1844例(44.6%);生活方式不健康者2183例(52.8%),健康者1950例(47.2%)。在调整年龄、民族、文化程度、婚姻状况和家庭年收入等混杂因素后,多因素非条件logistic回归分析结果显示,河南省郏县生活方式不健康老年女性糖尿病患者CVD患病风险为生活方式健康老年女性糖尿病患者的1.521倍(95%CI=1.341~1.726);交互作用分析结果显示,妊娠≤2次但生活方式不健康老年女性糖尿病患者CVD患病风险为妊娠≤2次且生活方式健康老年女性糖尿病患者的1.432倍(95%CI=1.121~1.829),妊娠3次且生活方式不健康老年女性糖尿病患者CVD患病风险为妊娠≤2次且生活方式健康老年女性糖尿病患者的1.571倍(95%CI=1.237~1.996),妊娠≥4次且生活方式不健康老年女性糖尿病患者CVD患病风险为妊娠≤2次且生活方式健康老年女性糖尿病患者的1.674倍(95%CI=1.340~2.091)。结论妊娠次数和不健康的生活方式存在相乘协同作用,可增加河南省郏县老年女性糖尿病患者CVD的患病风险。
Objective To understand the relationships of the number of pregnancies and lifestyle with the prevalence of cardiovascular diseases(CVD)among elderly female diabetic patients in Jiaxian county,Henan province and provide a scientific basis for developing individualized CVD prevention strategies.Methods From July 1 to August 31,2023,a cluster sampling method was employed to conduct a questionnaire survey among 21379 patients aged≥65 years who had lived in Jiaxian county,Henan province for at least six months and treated in 15 township hospitals or community health service centers.After individuals with incomplete lifestyle information,males,and non-diabetic patients were excluded,a total of 4133 elderly female diabetic patients were included in the final analysis.A multivariable unconditional logistic regression model was adopted to examine the associations of the number of pregnancies and lifestyle with the prevalence of CVD among these patients.Results Among the 4133 elderly female diabetic patients included in the analysis from Jiaxian county,Henan province,1712 were diagnosed with CVD,resulting in a CVD prevalence of 41.4%.A total of 1099(26.6%),1190(28.8%),and 1844(44.6%)patients had≤2,3,and≥4 pregnancies,respectively.Regarding lifestyle,2183(52.8%)patients were classified as having an unhealthy lifestyle,while 1950(47.2%)had a healthy lifestyle.After adjustment for confounding factors such as age,ethnicity,education background,marital status,and annual household income,multivariable unconditional logistic regression analysis showed that the elderly female diabetic patients with an unhealthy lifestyle had a 1.521-fold higher risk of CVD compared to those with a healthy lifestyle(OR=1.521,95%CI:1.341–1.726).Interaction analysis further revealed that compared to the patients with≤2 pregnancies and a healthy lifestyle,those with≤2 pregnancies and an unhealthy lifestyle had a 1.432-fold higher risk of CVD(OR=1.432,95%CI:1.121–1.829),those with 3 pregnancies and an unhealthy lifestyle had a 1.571-fold higher risk(OR=1.571,95%CI:1.237–1.996),and those with≥4 pregnancies and an unhealthy lifestyle had a 1.674-fold higher risk(OR=1.674,95%CI:1.340–2.091).Conclusions A multiplicative interaction was observed between the number of pregnancies and unhealthy lifestyle,contributing to an elevated risk of CVD among elderly female diabetic patients in Jiaxian county,Henan province.
作者
齐雯哲
焦筱雨
马铭泽
冯宜飞
张东杰
李广樱
吴建
苗豫东
叶贝珠
施李正
QI Wenzhe;JIAO Xiaoyu;MA Mingze;FENG Yifei;ZHANG Dongjie;LI Guangying;WU Jian;MIAO Yudong;YE Beizhu;SHI Lizheng(College of Public Health,Zhengzhou University,Zhengzhou 450001,China;School of Public Health and Tropical Medicine,Tulane University,New Orleans 70112,the United States)
出处
《中国公共卫生》
北大核心
2025年第12期1441-1444,共4页
Chinese Journal of Public Health
基金
教育部人文社科规划基金项目(24YJAZH174)。
