云南滇西北高海拔地区成人高血压、糖尿病与血脂异常共病现状及影响因素

Current status and associated factors of comorbidity involving hypertension, diabetes, and dyslipidemia among adults in high-altitude areas of Northwestern Yunnan

  • 摘要:
    目的  分析云南滇西北高海拔多民族地区成人高血压、糖尿病与血脂异常共病现状及其相关因素。
    方法  采用多阶段分层随机抽样方法,在云南滇西北4个州市8个高海拔县区抽取1 988名成年居民,进行问卷调查、体格检查和实验室检查。采用描述性统计、卡方检验及二分类logistic回归分析高血压合并糖尿病、高血压合并血脂异常、糖尿病合并血脂异常及三病共病的相关因素(各模型均以未患病和单病患者为对照)。
    结果  调查对象中高血压、糖尿病和血脂异常患病率分别为33.1%(658/1 988)、10.3%(205/1 988)和23.7%(471/1 988),总体共病率为16.6%(95%CI:15.0%~18.3%);其中高血压合并糖尿病、高血压合并血脂异常、糖尿病合并血脂异常和三病共病患病率分别为6.9%(95%CI:6.0%~8.2%)、12.1%(95%CI:10.8%~13.7%)、4.7%(95%CI:3.9%~5.8%)和3.7%(95%CI:2.9%~4.6%)。多因素logistic回归分析显示,老年、藏族、白族、纳西族、有吸烟史及有饮酒史与4类共病均呈正相关;中年和肥胖与高血压合并血脂异常呈正相关;超重与高血压合并糖尿病呈正相关;傈僳族与糖尿病合并血脂异常呈正相关;健康促进生活方式合格及以上水平与4类共病均呈负相关(均P<0.05)。
    结论  云南滇西北高海拔多民族地区成人高血压、糖尿病、血脂异常共病负担较重,老年人及藏族、白族、纳西族居民为重点人群,应加强联合筛查和生活方式干预。

     

    Abstract:
    Objective To analyze the current status of comorbidity involving hypertension, diabetes, and dyslipidemia and its associated factors among adults living in high-altitude, multi-ethnic areas of northwestern Yunnan.
    Methods Using a multistage stratified random sampling method, 1 988 adult residents were selected from 8 high-altitude counties and districts across 4 prefectures and cities in northwestern Yunnan. Participants underwent questionnaire surveys, physical examinations, and laboratory tests. Descriptive statistics, chi-square tests, and binary logistic regression analyses were used to identify factors associated with hypertension combined with diabetes, hypertension combined with dyslipidemia, diabetes combined with dyslipidemia, and comorbidity involving all three conditions. In each model, participants without disease and those with a single disease were used as the control group.
    Results Among the participants, the prevalence rates of hypertension, diabetes, and dyslipidemia were 33.1% (658/1 988), 10.3% (205/1 988), and 23.7% (471/1 988), respectively, and the overall comorbidity rate was 16.6% (95%CI: 15.0%–18.3%). The prevalence rates of hypertension combined with diabetes, hypertension combined with dyslipidemia, diabetes combined with dyslipidemia, and comorbidity involving all three conditions were 6.9% (95%CI: 6.0%–8.2%), 12.1% (95%CI: 10.8%–13.7%), 4.7% (95%CI: 3.9%–5.8%), and 3.7% (95%CI: 2.9%–4.6%), respectively. Multivariable logistic regression analysis showed that older age, Tibetan ethnicity, Bai ethnicity, Naxi ethnicity, history of smoking, and history of alcohol consumption were associated with higher odds of all four types of comorbidity. Middle age and obesity were associated with higher odds of hypertension combined with dyslipidemia; overweight was associated with higher odds of hypertension combined with diabetes; Lisu ethnicity was associated with higher odds of diabetes combined with dyslipidemia. Adequate or higher levels of health-promoting lifestyle were associated with lower odds of all four types of comorbidity (all P<0.05).
    Conclusions Adults living in high-altitude, multi-ethnic areas of northwestern Yunnan have a substantial burden of comorbidity involving hypertension, diabetes, and dyslipidemia. Older adults and Tibetan, Bai, and Naxi residents should be regarded as key populations. Joint screening for hypertension, diabetes, and dyslipidemia and lifestyle interventions should be strengthened.

     

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