糖尿病和血脂异常对老年人高血压患病的交互作用分析

    Study on the interactive effects of diabetes and dyslipidemia on the prevalence of hypertension in the elderly

    • 摘要:
      目的: 探讨老年人糖尿病与血脂异常的交互作用与高血压发病的关系,为高血压的防治提供科学依据。
      方法: 采用多阶段分层随机整群抽样方法,在安徽省蚌埠市龙子湖区收集6 934名年龄在65岁及以上老年人的问卷调查、体格检查和血生化指标数据。使用多因素logistic回归分析,通过调整可能的混杂因素分析糖尿病、血脂异常对高血压患病的影响,运用相乘和相加模型进行糖尿病与血脂异常交互作用的评估。
      结果: 蚌埠市老年居民糖尿病、血脂异常和高血压的患病率分别为25.2%、38.8%、61.9%。高血压合并糖尿病的患病率为19.1%、高血压合并血脂异常的患病率为25.7%、糖尿病合并血脂异常的患病率为9.4%。在多因素logistic回归模型调整年龄、饮食习惯、锻炼情况、中心性肥胖和BMI等混杂因素后,发现糖尿病(OR = 2.082,95%CI:1.835~2.363)和血脂异常(OR = 1.235,95%CI:1.110~1.373)会增加老年人高血压的发病风险(P < 0.01)。交互作用结果提示,糖尿病和血脂异常不存在相乘交互作用(OR = 0.973,95%CI:0.754~1.256),两者存在相加交互作用,相对超额危险度、交互作用归因比和交互作用指数分别为4.346(95%CI:2.485~6.206)、0.649(95%CI:0.576~0.722)、4.210(95%CI:3.379~5.243)。
      结论: 糖尿病和血脂异常可能存在相加交互作用,当两者同时出现时,老年人高血压患病风险会显著增加。

       

      Abstract:
      Objective To analyze the interaction between diabetes and dyslipidemia on the prevalence of hypertension in the elderly, and provide the scientific basis for theprevention and treatment of hypertension.
      Methods Based on a multi-stage stratified randomized whole-group sampling method, 6934 people aged over 65 years were selected in Longzihu District Bengbu City Anhui Province. The data of questionnaires, physical measurements and relevant blood biochemical tests were collected. Multivariate logistic regression analysis models were used to analyze the effects of diabetes mellitus and dyslipidemia on the prevalence of hypertension after adjusting confounding factors. The multiplicative and additive models were used to analyze the interaction effect of diabetes and dyslipidemia.
      Results The prevalence of diabetes, dyslipidemia, and hypertension among elderly residents in Bengbu were 25.2%, 38.8% and 61.9%, respectively. The prevalence of hypertension complicated with diabetes mellitus, hypertension complicated with dyslipidemia and diabetes complicated with dyslipidemia were 19.1%, 25.7% and 9.4%, respectively. The results of multivariate logistic regression analysis showed that after adjusting sex, age, dietary habits, exercise status, central obesity and BMI, the diabetes (OR = 2.082, 95%CI:1.835 ~ 2.363) and dyslipidemia (OR = 1.235, 95%CI:1.110 ~ 1.373) increased the risk of hypertension (P < 0.01). The interaction results suggested that there was no multiplicative interaction between diabetes mellitus and dyslipidemia (OR = 0.973, 95%CI: 0.754 ~ 1.256), but additive interaction at coexist. The relative excess risk, interaction attribution ratio and interaction index were 4.346 (95%CI: 2.485 ~ 6.206), 0.649 (95%CI: 0.576 ~ 0.722) and 4.210 (95%CI: 3.379 ~ 5.243), respectively.
      Conclusions There may be additive interaction between diabetes and dyslipidemia, and when the two occur simultaneously, the risk of hypertension in the elderly will be significantly increased

       

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