上海市某社区≥40岁人群超重与肥胖及其脑卒中危险因素暴露水平的分析

摘要

目的 描述社区≥40岁人群超重与肥胖的人群分布并探讨其脑卒中危险因素暴露水平.方法 2003-2004年,在上海市奉贤区某社区整群抽取≥40岁人群11 791人,符合纳入标准且有应答者10 565人,设计统一的脑卒中危险因素调雀表,进行脑卒中常见危险因素现况调查,调查方法为面对面的询问方式,测晕身高、体重、血压等指标,进行脑血流动力学参数(CVHP)检测.描述该人群超重与肥胖的年龄、性别分布,并以60岁为截断点,分别按正常体重、超重、肥胖分成3组,比较脑卒中危险因素暴露的组问差异.进行多因素logistic回归分析.结果 男性超重与肥胖率为28.5%和4.1%,女性为26.3%和4.2%(P=0.045);超重组的收缩压和舒张压水平分别为(132.5±19.4)mm Hg和(83.9±10.5)mm Hg(I mm Hg=0.133 kPa),均低于肥胖组,高于正常体重组(P<0.05);在<60岁年龄组,心脏病、脑卒中家族史的暴露率以及≥60岁年龄组的糖尿病暴露率随BMI增加而显著升高;两个年龄组的高血压患病率和CVHP积分异常率均随BMI的增加而显著上升;多因素分析显示,与超霞和肥胖有关的独立因素分别是高血压、脑卒中家族史、心脏病史、积分值<75分、性别和年龄.结论 社区≥40岁人群中超重或肥胖的比例约占30%,脑卒中危险因素的整体暴露水平随着BMI的增加而上升,尤其在中年人群中更为明显.%Objective To describe the distribution of over weight and obesity to discover the level of exposure on risk factors of stroke among people aged 40 and over, in a community-based population.Methods From 2003 to 2004, people aged t≥40 years in a community of Fengxian district in Shanghai were selected by cluster sampling. Out of 11 791 individuals who were selected, 10 565 met the inclusion criteria and responded to the investigation. By face to face interview, a cross-sectional survey was carried out, using a questionnaire for risk factors of stroke. Height, weight and blood pressures were measured and cerebrovascular hemodynamic parameters (CVHP) were checked. Age and gender distribution of over weight and obesity in the population were described. Using 60 year as cut-off point, participants were grouped into three: normal, over weight and obesity by body mass index. Level of stroke risk factor exposure between groups was compared and logistic regression model was used for multiple analyses. Results Proportions of over weight and obesity were 28.5 percent and 4.1 percent in male and 26.3 percent and 4.2 percent in female (P=0.045 ). Systolic and diastolic blood pressure in over weight group were (132.5±19.4)ram Hg and (83.9±10.5)mm Hg(1 mm Hg= 0.133 kPa),which were higher than that in normal weight group and lower than that in obese group (P<0.05). Exposure rate of heart disease,family history of stroke in < 60 year old group and diabetes in ≥60 year group increased along with the increase of weight. Exposure rate of hypertension, abnormality of CVHP score in both age groups were also increased with the increase of weight. Data from multiple logistic regression indicated that hypertension,family history of stroke and heart disease, CVHP score below 75 points, sex and age were independent factors of over weight and obese. Conclusion The prevalence of over weight or obesity in a community-based population among aged 40 years or over was around 30 percent. The overall exposure rate of stroke risk factors were increasing along with the increase of weight, especially for those in the middle age.