Article(id=1321170098971324883, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170080579301694, articleNumber=null, orderNo=null, doi=10.11847/zgggws1144622, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1712160000000, receivedDateStr=2024-04-04, revisedDate=1725033600000, revisedDateStr=2024-08-31, acceptedDate=1732118400000, acceptedDateStr=2024-11-21, onlineDate=1792921097747, onlineDateStr=2026-10-25, pubDate=1736438400000, pubDateStr=2025-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921097747, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921097747, creator=13701087609, updateTime=1792921097747, updator=13701087609, issue=Issue{id=1321170080579301694, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='1', pageStart='1', pageEnd='128', issueExtLink='null', onlineDate='null', pubDate='1736438400000', pubDateStr='2025-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921093363, creator='13701087609', updateTime=1792921093363, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=32, endPage=41, ext={EN=ArticleExt(id=1321170099218788820, articleId=1321170098971324883, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=The detection rate of high-risk groups for different subtypes of cardiovascular diseases and its influencing factors in Shaanxi province, columnId=1320427696342020970, journalTitle=Chinese Journal of Public Health, columnName=Epidemiological Research, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the detection rate of different subtypes of cardiovascular disease (CVD) high-risk populations in Shaanxi province and their influencing factors, so as to provide a scientific basis for the prevention and control of CVD.

Methods

From December 2015 to December 2022, a convenience sampling method was used to recruit 168 742 permanent residents aged ≥35 years from 12 project sites in 5 cities of Shaanxi province: Baoji city (Fengxiang county, Jintai district, Mei county), Hanzhong city (Chenggu county, Hantai district), Shangluo city (Shangzhou district, Zhen'an county), Weinan city (Chengcheng county, Tongguan county, Pucheng county), and Xianyang city (Sanyuan county, Jingyang county). Questionnaires, physical examinations, and laboratory tests were conducted. The detection rates of different subtypes of CVD high-risk populations in Shaanxi province were calculated, and a multifactorial unconditional logistic regression model was used to analyze the influencing factors of the detection of different subtypes of CVD high-risk populations.

Results

Among the 168 379 permanent residents aged ≥35 years finally included in the analysis in Shaanxi province, 60 197 were identified as high-risk for CVD, with a detection rate of 35.75%. Among them, 8 611, 27 047, 28 995, 6 632, 3 310, and 5 737 individuals were identified as having a history of CVD, hypertension, diabetes, dyslipidemia, heavy smoking, and World Health Organization (WHO) assessed risk, respectively, with detection rates of 5.11%, 16.06%, 17.22%, 3.94%, 1.97%, and 3.41%, respectively. Multifactorial unconditional logistic regression analysis showed that age ≥45 years, smoking, alcohol consumption, snoring, daytime fatigue or sleepiness, overweight with normal waist circumference (WC), normal body mass index (BMI) with high WC, both high BMI and WC, and a family history of hypertension, diabetes, CVD, and hypercholesterolemia were risk factors for the detection of high-risk CVD populations, while female sex and middle and high socioeconomic status (SES) were protective factors. Age ≥45 years, snoring, fatigue and sleepiness, overweight with normal WC, normal BMI with high WC, both high BMI and WC, and a family history of hypertension, diabetes, CVD, and cancer were risk factors for the detection of high-risk CVD history populations, while female sex, smoking, alcohol consumption, and a family history of hypercholesterolemia were protective factors. Female sex, age ≥45 years, alcohol consumption, snoring, fatigue and sleepiness, overweight with normal WC, normal BMI with high WC, both high BMI and WC, and a family history of hypertension and hypercholesterolemia were risk factors for the detection of high-risk hypertension populations, while high SES, smoking, and a family history of diabetes were protective factors. Age ≥45 years, sleep snoring, fatigue and drowsiness, excessive BMI with normal WC, normal BMI with excessive WC, both excessive BMI and WC, family history of hypertension, family history of diabetes were risk factors for the diabetes subtype, and female, moderate and high SES and smoking were protective factors. Age ≥55 years, smoking, sleep snoring, excessive BMI with normal WC, normal BMI with excessive WC, both BMI and WC, family history of hypertension, family history of diabetes, and family history of hypercholesterolemia were risk factors for dyslipidemia subtype, and female, moderate and high SES, alcohol consumption, and family history of CVD were protective factors. Age 45 to 64 years, smoking, alcohol consumption, sleep snoring, fatigue and sleepiness, excessive BMI but normal WC, normal BMI but excessive WC, both BMI and WC and family history of diabetes were risk factors for heavy smoking subtype, and female and high SES were protective factors. Women, age ≥45 years, smoking, alcohol consumption, sleep snoring, fatigue and sleepiness, excessive BMI with normal WC, normal BMI with excessive WC, both BMI and WC with excessive BMI, and family history of hypertension, family history of diabetes, and family history of hypercholesterolemia were risk factors for WHO risk assessment subtype, and high SES was a protective factor.

Conclusions

In Shaanxi province, the detection rate of CVD in high-risk groups was high, and hypertension and diabetes were the main CVD high risk subtypes. Gender, age, SES, smoking status, alcohol consumption status, sleep snoring status, fatigue and sleepiness status, BMI and WC status, and family history of hypertension, diabetes, CVD, hypercholesterolemia, and cancer were the main influencing factors for the detection rate of CVD in high-risk groups in this area.

, authors=Kaiming GUO, Zhiping HU, Rong LIU, SARINA, Lin QIU, authorsList=Kaiming GUO, Zhiping HU, Rong LIU, SARINA, Lin QIU, authorCompany=null, correspAuthors=Lin QIU, authorNote=null, correspAuthorsNote=
QIU Lin, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321170099864711639, articleId=1321170098971324883, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=陕西省不同亚型心血管疾病高危人群检出情况及其影响因素分析, columnId=1320427696509793132, journalTitle=中国公共卫生, columnName=流行病学研究, runingTitle=null, highlight=null, articleAbstract=
目的

了解陕西省不同亚型心血管疾病(CVD)高危人群检出情况及其影响因素,为CVD的预防控制提供科学依据。

方法

于2015年12月—2022年12月采用便利抽样方法在陕西省宝鸡市(凤翔县、金台区、眉县),汉中市(城固县、汉台区),商洛市(商州区、镇安县),渭南市(澄城县、潼关县、蒲城县)和咸阳市(三原县、泾阳县)5个地市12个项目点招募168 742名≥35岁常住居民进行问卷调查、体格检查和实验室检测,计算陕西省不同亚型CVD高危人群的检出率,并应用多因素非条件logistic回归模型分析不同亚型CVD高危人群检出情况的影响因素。

结果

陕西省最终纳入分析的168 379名≥35岁常住居民中,检出CVD高危人群60197人,CVD高危人群检出率为35.75%;其中CVD史型、高血压型、糖尿病型、血脂异常型、重度吸烟型和世界卫生组织(WHO)评估风险型高危人群分别检出8 611、27 047、28 995、6 632、3 310和5 737人,高危人群检出率分别为5.11%、16.06%、17.22%、3.94%、1.97%和3.41%。多因素非条件logistic回归分析结果显示,年龄≥45岁、吸烟、饮酒、睡眠打鼾、疲劳和困倦、体质指数(BMI)超标但腰围(WC)正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、CVD家族史、高胆固醇血症家族史是CVD高危人群检出的危险因素,女性、中等和高社会经济地位(SES)是CVD高危人群检出的保护因素;年龄≥45岁、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、CVD家族史、癌症家族史是CVD史型高危人群检出的危险因素,女性、吸烟、饮酒和有高胆固醇血症家族史是CVD史型高危人群检出的保护因素;女性、年龄≥45岁、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压病家族史、高胆固醇血症家族史是高血压型高危人群检出的危险因素,高SES、吸烟和有糖尿病家族史是高血压型高危人群检出的保护因素;年龄≥45岁、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史是糖尿病型高危人群检出的危险因素,女性、中和高SES和吸烟是糖尿病型高危人群检出的保护因素;年龄≥55岁、吸烟、睡眠打鼾、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、高胆固醇血症家族史是血脂异常型高危人群检出的危险因素,女性、中等和高SES、饮酒和有CVD家族史是血脂异常型高危人群检出的保护因素;年龄45~64岁、吸烟、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有糖尿病家族史是重度吸烟型高危人群检出的危险因素,女性和高SES是重度吸烟型高危人群检出的保护因素;女性、年龄≥45岁、吸烟、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、高胆固醇血症家族史是WHO评估风险型高危人群检出的危险因素,高SES是WHO评估风险型高危人群检出的保护因素。

结论

陕西省CVD高危人群检出率较高,高血压型和糖尿病型是主要的亚型;性别、年龄、SES、吸烟情况、饮酒情况、睡眠打鼾情况、疲劳和困倦情况、BMI和WC状态以及有无高血压家族史、糖尿病家族史、CVD家族史、高胆固醇血症家族史、癌症家族史是该地区CVD高危人群检出的主要影响因素。

, authors=郭凯明, 胡志平, 刘蓉, 飒日娜, 邱琳*, *, authorsList=郭凯明, 胡志平, 刘蓉, 飒日娜, 邱琳, authorCompany=null, correspAuthors=邱琳, authorNote=

郭凯明(1996—),初级,硕士,研究方向:慢性病流行病学

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邱琳,E-mail:
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Comparison of the detection rates of high-risk groups for CVD among residents with different characteristics by sex, age, education level, marital status, occupation, Annual household income, rural/urban residence, medical insurance, SES、smoking, alcohol consumption, snoring, daytime fatigue or sleepiness, BMI and WC status , family history of hypertension, family history of diabetes, family history of CVD, family history of diabetes, family history of hypercholesterolemia, family history of cancer in Shaanxi province

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类调查人数高危人群检出人数高危人群检出率/% χ2值P值
性别男性68 94326 78738.85489.36<0.001
女性99 43633 41033.60
年龄/岁35~4420 648345916.757 002.59<0.001
45~5449 81114 45929.03
55~6457 15823 15240.51
≥6540 76219 12746.92
文化程度小学及以下60 67424 43340.271 159.54<0.001
初中67 96723 71034.88
高中/中专26 8248 51031.73
大专及以上12 7553 47327.23
不详1597144.65
婚姻状况非在婚11 2474 64841.33163.12<0.001
在婚157 13255 54935.35
职业技术工人129 34146 39535.87420.59<0.001
管理/专业人员10 9583 01027.47
退休人员17 8896 95838.90
失业/家务/不详10 1913 83437.62
家庭年均收入/元<10 00045 26418 21540.24738.18<0.001
10 000~50 00090 34731 16934.50
>50 00015 0204 39129.23
不详17 7486 42236.18
居住地农村121 41044 98137.05319.22<0.001
城市46 96915 21632.40
有无医疗保险无70522131.355.980.014
有167 67459 97635.77
SES低11 707489341.801 045.61<0.001
中等134 42449 37636.73
高22 2485 92826.65
吸烟情况不吸烟131 17445 51934.70284.76<0.001
吸烟37 20514 67839.45
饮酒情况不饮酒162 01757 38335.42207.02<0.001
饮酒6 3622 81444.23
睡眠打鼾否57 82919 01632.881 122.54<0.001
是47 80320 05041.94
不详62 74721 13133.68
疲劳和困倦否69 91623 97134.29869.26<0.001
是40 92317 09641.78
不详57 54019 13033.25
BMI和WC状态BMI和WC均正常68 33518 94327.724 503.09<0.001
BMI超标但WC正常37 87113 38635.35
BMI正常但WC超标9 7273 54336.42
BMI和WC均超标52 44624 32546.38
高血压家族史无161 45456 81735.19536.10<0.001
有6 9253 38048.81
糖尿病家族史无167 07359 51635.62153.99<0.001
有1 30668152.14
CVD家族史无165 48158 98435.6447.86<0.001
有2 8981 21341.86
高胆固醇血症家族史无168 23860 11535.7330.84<0.001
有1418258.16
癌症家族史无167 34959 81735.740.590.443
有1 03038036.89
), ArticleFig(id=1321170103719277057, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170098971324883, language=CN, label=表1, caption=

陕西省不同特征居民CVD高危人群检出情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类调查人数高危人群检出人数高危人群检出率/% χ2值P值
性别男性68 94326 78738.85489.36<0.001
女性99 43633 41033.60
年龄/岁35~4420 648345916.757 002.59<0.001
45~5449 81114 45929.03
55~6457 15823 15240.51
≥6540 76219 12746.92
文化程度小学及以下60 67424 43340.271 159.54<0.001
初中67 96723 71034.88
高中/中专26 8248 51031.73
大专及以上12 7553 47327.23
不详1597144.65
婚姻状况非在婚11 2474 64841.33163.12<0.001
在婚157 13255 54935.35
职业技术工人129 34146 39535.87420.59<0.001
管理/专业人员10 9583 01027.47
退休人员17 8896 95838.90
失业/家务/不详10 1913 83437.62
家庭年均收入/元<10 00045 26418 21540.24738.18<0.001
10 000~50 00090 34731 16934.50
>50 00015 0204 39129.23
不详17 7486 42236.18
居住地农村121 41044 98137.05319.22<0.001
城市46 96915 21632.40
有无医疗保险无70522131.355.980.014
有167 67459 97635.77
SES低11 707489341.801 045.61<0.001
中等134 42449 37636.73
高22 2485 92826.65
吸烟情况不吸烟131 17445 51934.70284.76<0.001
吸烟37 20514 67839.45
饮酒情况不饮酒162 01757 38335.42207.02<0.001
饮酒6 3622 81444.23
睡眠打鼾否57 82919 01632.881 122.54<0.001
是47 80320 05041.94
不详62 74721 13133.68
疲劳和困倦否69 91623 97134.29869.26<0.001
是40 92317 09641.78
不详57 54019 13033.25
BMI和WC状态BMI和WC均正常68 33518 94327.724 503.09<0.001
BMI超标但WC正常37 87113 38635.35
BMI正常但WC超标9 7273 54336.42
BMI和WC均超标52 44624 32546.38
高血压家族史无161 45456 81735.19536.10<0.001
有6 9253 38048.81
糖尿病家族史无167 07359 51635.62153.99<0.001
有1 30668152.14
CVD家族史无165 48158 98435.6447.86<0.001
有2 8981 21341.86
高胆固醇血症家族史无168 23860 11535.7330.84<0.001
有1418258.16
癌症家族史无167 34959 81735.740.590.443
有1 03038036.89
), ArticleFig(id=1321170103819940354, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170098971324883, language=EN, label=Tab.2, caption=

Comparison of the detection rates of high-risk groups for various CVD subtypes among residents with different characteristics in Shaanxi province

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类调查人数CVD史型高危人群高血压型高危人群糖尿病型高危人群血脂异常型高危人群重度吸烟型高危人群WHO评估风险型高危人群
检出人数检出率/%检出人数检出率/%检出人数检出率/%检出人数检出率/%检出人数检出率/%检出人数检出率/%
性别男性68 94344296.4210 99515.9511 70816.983 1934.633 3054.792 6823.89
女性99 43641824.21 a16 05216.1417 28717.39 a34393.46 a50.01 a3 0553.07 a
年龄/岁35~4420 6482561.241 4527.031 3186.386823.302521.22490.24
45~5449 8111 2862.58608912.22690713.871 8223.661 2042.424640.93
55~6457 15834906.1110 19417.8311 46520.062 4184.231 3052.282 0503.59
≥6540 76235798.78 a931222.84 a930522.83 a1 7104.20 a5491.35 a3 1747.79 a
文化程度小学及以下60 67438346.3211 43018.8411 92619.662 4594.059631.592 7824.59
初中67 9673 1384.6210 42715.3411 54116.982 4973.671 5532.282 0162.97
高中/中专26 8241 1664.35366213.65401614.971 0914.075702.127382.75
大专及以上12 7554653.651 49811.741 47411.565824.562191.721961.54
不详15985.03 a3018.87 a3823.90 a31.89 a53.14 a53.14 a
婚姻状况非在婚11 2476675.932 27520.232 27420.224493.991741.556035.36
在婚157 13279445.06 a24 77215.77 a26 72117.01 a61833.933 1362.00 a51343.27 a
职业技术工人129 34164965.0220 70416.0122 46517.3750263.892 6962.0841293.19
管理/专业人员10 9583893.551 33212.161 25311.434614.212071.891411.29
退休人员17 8891 2436.953 12917.493 29518.427914.422981.679705.42
失业/家务/不详10 1914834.74 a1 88218.47 a1 98219.45 a3543.47 a1091.07 a4974.88 a
家庭年均收入/元<10 000452643 0966.84741116.37974221.521 8484.087791.721 7063.77
10 000~50 00090 34744214.8914 61516.1814 07515.5834533.821 8942.1030093.33
>50 00015 0205803.862 00213.331 98213.205803.862801.863562.37
不详17 7485142.90 a301917.01 a3 19618.01 a7514.23 a3572.01 a6663.75 a
居住地农村121 41068925.6819 76316.2822 14318.2447843.942 3811.9640063.30
城市46 9691 7193.66 a728415.51 a685214.59 a1 8483.939291.981 7313.69 a
有无医疗保险无705253.559213.0510414.75385.39131.84243.40
有167 67485865.1226 95516.08 a28 89117.2365943.93 a3 2971.9757133.41
SES低11 7076855.852 22519.012 53221.636035.151381.186155.25
中等134 42471505.3222 26916.5723 90617.7851393.822 7272.0347563.54
高22 2487763.49 a2 55311.48 a2 55711.49 a8904.00 a4452.00 a3661.65 a
吸烟情况不吸烟131 17465154.9721 35516.2823 11217.6247903.653520.2739242.99
吸烟37 20520965.63 a569215.30 a588315.81 a1 8424.95 a2 9587.95 a1 8134.87 a
饮酒情况不饮酒16201783425.1525 74415.8927 92817.2463863.942 5851.6053873.32
饮酒63622694.23 a1 30320.48 a1 06716.772463.8772511.40 a3505.50 a
睡眠打鼾否578292 5044.33813714.0710 01317.311 6362.838401.451 8103.13
是47 80330026.28914119.12996820.851 8213.811 4413.0120994.39
不详62 7473 1054.95 a976915.57 a901414.37 a3 1755.06 a1 0291.64 a1 8282.91 a
疲劳和困倦否69 9162 8434.0710 45014.9512 31617.622 2553.231 3861.982 2043.15
是40 9232 9967.32779719.05868721.231 3963.419772.391 9164.68
不详57 5402 7724.82 a880015.29 a799213.89 a2 9815.18 a9471.65 a1 6172.81 a
BMI和WC状态BMI和WC均正常68 3352 8964.24770911.28881212.901 9382.841 1071.621 6002.34
BMI超标但WC正常37 8711 8324.84614916.24616716.281 5564.117101.871 2583.32
BMI正常但WC超标97275015.151 45614.971 84919.014064.171661.713413.51
BMI和WC均超标52 4463 3826.45 a11 73322.37 a12 16723.20 a2 7325.21 a1 3272.53 a2 5384.84 a
高血压家族史无161 45480444.9825 09415.5427 76617.2061463.813 1771.9754113.35
有69255678.19 a1 95328.20 a1 22917.754867.02 a1331.923264.71 a
糖尿病家族史无167 07385045.0926 82416.0628 56117.0965163.903 2751.9656813.40
有1 3061078.19 a22317.0843433.23 a1168.88 a352.68564.29 a
CVD家族史无165 48182765.0026 49216.0128 53717.2464793.923 2411.9656383.41
有2 89833511.56 a55519.15 a45815.80 a1535.28 a692.38993.42 a
高胆固醇血症家族史无168 23886065.1227 00716.0528 96517.2265883.923 3061.9757283.40
有14153.554028.37 a3021.284431.21 a42.84 b96.38 b
癌症家族史无167 34985245.0926 87916.0628 84317.2465763.933 2891.9757003.41
有1 030878.45 a16816.3115214.76 a565.44 a212.04373.59
), ArticleFig(id=1321170103903826435, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170098971324883, language=CN, label=表2, caption=

陕西省不同特征居民各CVD亚型高危人群检出情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类调查人数CVD史型高危人群高血压型高危人群糖尿病型高危人群血脂异常型高危人群重度吸烟型高危人群WHO评估风险型高危人群
检出人数检出率/%检出人数检出率/%检出人数检出率/%检出人数检出率/%检出人数检出率/%检出人数检出率/%
性别男性68 94344296.4210 99515.9511 70816.983 1934.633 3054.792 6823.89
女性99 43641824.21 a16 05216.1417 28717.39 a34393.46 a50.01 a3 0553.07 a
年龄/岁35~4420 6482561.241 4527.031 3186.386823.302521.22490.24
45~5449 8111 2862.58608912.22690713.871 8223.661 2042.424640.93
55~6457 15834906.1110 19417.8311 46520.062 4184.231 3052.282 0503.59
≥6540 76235798.78 a931222.84 a930522.83 a1 7104.20 a5491.35 a3 1747.79 a
文化程度小学及以下60 67438346.3211 43018.8411 92619.662 4594.059631.592 7824.59
初中67 9673 1384.6210 42715.3411 54116.982 4973.671 5532.282 0162.97
高中/中专26 8241 1664.35366213.65401614.971 0914.075702.127382.75
大专及以上12 7554653.651 49811.741 47411.565824.562191.721961.54
不详15985.03 a3018.87 a3823.90 a31.89 a53.14 a53.14 a
婚姻状况非在婚11 2476675.932 27520.232 27420.224493.991741.556035.36
在婚157 13279445.06 a24 77215.77 a26 72117.01 a61833.933 1362.00 a51343.27 a
职业技术工人129 34164965.0220 70416.0122 46517.3750263.892 6962.0841293.19
管理/专业人员10 9583893.551 33212.161 25311.434614.212071.891411.29
退休人员17 8891 2436.953 12917.493 29518.427914.422981.679705.42
失业/家务/不详10 1914834.74 a1 88218.47 a1 98219.45 a3543.47 a1091.07 a4974.88 a
家庭年均收入/元<10 000452643 0966.84741116.37974221.521 8484.087791.721 7063.77
10 000~50 00090 34744214.8914 61516.1814 07515.5834533.821 8942.1030093.33
>50 00015 0205803.862 00213.331 98213.205803.862801.863562.37
不详17 7485142.90 a301917.01 a3 19618.01 a7514.23 a3572.01 a6663.75 a
居住地农村121 41068925.6819 76316.2822 14318.2447843.942 3811.9640063.30
城市46 9691 7193.66 a728415.51 a685214.59 a1 8483.939291.981 7313.69 a
有无医疗保险无705253.559213.0510414.75385.39131.84243.40
有167 67485865.1226 95516.08 a28 89117.2365943.93 a3 2971.9757133.41
SES低11 7076855.852 22519.012 53221.636035.151381.186155.25
中等134 42471505.3222 26916.5723 90617.7851393.822 7272.0347563.54
高22 2487763.49 a2 55311.48 a2 55711.49 a8904.00 a4452.00 a3661.65 a
吸烟情况不吸烟131 17465154.9721 35516.2823 11217.6247903.653520.2739242.99
吸烟37 20520965.63 a569215.30 a588315.81 a1 8424.95 a2 9587.95 a1 8134.87 a
饮酒情况不饮酒16201783425.1525 74415.8927 92817.2463863.942 5851.6053873.32
饮酒63622694.23 a1 30320.48 a1 06716.772463.8772511.40 a3505.50 a
睡眠打鼾否578292 5044.33813714.0710 01317.311 6362.838401.451 8103.13
是47 80330026.28914119.12996820.851 8213.811 4413.0120994.39
不详62 7473 1054.95 a976915.57 a901414.37 a3 1755.06 a1 0291.64 a1 8282.91 a
疲劳和困倦否69 9162 8434.0710 45014.9512 31617.622 2553.231 3861.982 2043.15
是40 9232 9967.32779719.05868721.231 3963.419772.391 9164.68
不详57 5402 7724.82 a880015.29 a799213.89 a2 9815.18 a9471.65 a1 6172.81 a
BMI和WC状态BMI和WC均正常68 3352 8964.24770911.28881212.901 9382.841 1071.621 6002.34
BMI超标但WC正常37 8711 8324.84614916.24616716.281 5564.117101.871 2583.32
BMI正常但WC超标97275015.151 45614.971 84919.014064.171661.713413.51
BMI和WC均超标52 4463 3826.45 a11 73322.37 a12 16723.20 a2 7325.21 a1 3272.53 a2 5384.84 a
高血压家族史无161 45480444.9825 09415.5427 76617.2061463.813 1771.9754113.35
有69255678.19 a1 95328.20 a1 22917.754867.02 a1331.923264.71 a
糖尿病家族史无167 07385045.0926 82416.0628 56117.0965163.903 2751.9656813.40
有1 3061078.19 a22317.0843433.23 a1168.88 a352.68564.29 a
CVD家族史无165 48182765.0026 49216.0128 53717.2464793.923 2411.9656383.41
有2 89833511.56 a55519.15 a45815.80 a1535.28 a692.38993.42 a
高胆固醇血症家族史无168 23886065.1227 00716.0528 96517.2265883.923 3061.9757283.40
有14153.554028.37 a3021.284431.21 a42.84 b96.38 b
癌症家族史无167 34985245.0926 87916.0628 84317.2465763.933 2891.9757003.41
有1 030878.45 a16816.3115214.76 a565.44 a212.04373.59
), ArticleFig(id=1321170103987712516, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170098971324883, language=EN, label=Tab.3, caption=

Multifactorial unconditional logistic regression analysis of factors influencing the detection rate of high-risk cardiovascular disease (CVD) individuals in Shaanxi province

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因素比较组参照组β $ S_{\overline{x}} $Waldχ2值P值OR值95%CI
性别女性男性–0.1480.014109.976<0.0010.8620.839~0.886
年龄/岁45~5435~440.6420.022883.481<0.0011.9011.822~1.983
55~641.1220.0212 781.629<0.0013.0712.946~3.202
≥651.3990.0223 965.586<0.0014.0503.877~4.230
SES中低–0.0740.02113.015<0.0010.9290.892~0.967
高–0.2870.026119.455<0.0010.7510.713~0.790
吸烟情况吸烟不吸烟0.1020.01638.728<0.0011.1071.072~1.143
饮酒情况饮酒不饮酒0.1960.02850.217<0.0011.2161.152~1.284
睡眠打鼾是否0.1770.014166.648<0.0011.1931.162~1.226
疲劳和困倦是否0.2450.014330.210<0.0011.2771.244~1.312
BMI和WC状态BMI超标但WC正常BMI和WC均正常0.3790.014711.706<0.0011.4611.421~1.503
BMI正常但WC超标0.3330.023202.849<0.0011.3961.333~1.461
BMI和WC均超标0.7520.0133 477.681<0.0012.1202.068~2.174
高血压家族史有无0.6770.028592.327<0.0011.9681.864~2.078
糖尿病家族史有无0.6170.060105.768<0.0011.8521.647~2.083
CVD家族史有无0.1380.04210.8680.0011.1481.058~1.246
高胆固醇血症家族史有无0.5510.1829.1650.0031.7351.214~2.478
), ArticleFig(id=1321170104075792901, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170098971324883, language=CN, label=表3, caption=

陕西省CVD高危人群检出情况影响因素多因素非条件logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素比较组参照组β $ S_{\overline{x}} $Waldχ2值P值OR值95%CI
性别女性男性–0.1480.014109.976<0.0010.8620.839~0.886
年龄/岁45~5435~440.6420.022883.481<0.0011.9011.822~1.983
55~641.1220.0212 781.629<0.0013.0712.946~3.202
≥651.3990.0223 965.586<0.0014.0503.877~4.230
SES中低–0.0740.02113.015<0.0010.9290.892~0.967
高–0.2870.026119.455<0.0010.7510.713~0.790
吸烟情况吸烟不吸烟0.1020.01638.728<0.0011.1071.072~1.143
饮酒情况饮酒不饮酒0.1960.02850.217<0.0011.2161.152~1.284
睡眠打鼾是否0.1770.014166.648<0.0011.1931.162~1.226
疲劳和困倦是否0.2450.014330.210<0.0011.2771.244~1.312
BMI和WC状态BMI超标但WC正常BMI和WC均正常0.3790.014711.706<0.0011.4611.421~1.503
BMI正常但WC超标0.3330.023202.849<0.0011.3961.333~1.461
BMI和WC均超标0.7520.0133 477.681<0.0012.1202.068~2.174
高血压家族史有无0.6770.028592.327<0.0011.9681.864~2.078
糖尿病家族史有无0.6170.060105.768<0.0011.8521.647~2.083
CVD家族史有无0.1380.04210.8680.0011.1481.058~1.246
高胆固醇血症家族史有无0.5510.1829.1650.0031.7351.214~2.478
), ArticleFig(id=1321170104155484678, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170098971324883, language=EN, label=Tab.4, caption=

Multivariable unconditional logistic regression analysis of factors influencing the detection of high-risk groups for various subtypes of CVD in Shaanxi province

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分类CVD史型高危人群高血压型高危人群糖尿病型高危人群血脂异常型高危人群重度吸烟型高危人群WHO评估风险型高危人群
OR值95%CIOR值95%CIOR值95%CIOR值95%CIOR值95%CIOR值95%CI
性别男性1.0001.0001.0001.0001.0001.000
女性0.5730.543~0.6051.0441.008~1.0810.9520.920~0.9850.8270.774~0.8830.0050.002~0.0111.3031.205~1.408
年龄/岁35~441.0001.0001.0001.0001.0001.000
45~542.0111.755~2.3041.7041.604~1.8102.2082.075~2.3491.0720.979~1.1741.9531.695~2.2503.6792.738~4.943
55~644.7694.188~5.4302.5862.438~2.7443.3243.128~3.5321.2141.110~1.3271.7381.508~2.00314.35610.796~19.090
≥656.9596.105~7.9323.6233.411~3.8493.9053.669~4.1571.1731.066~1.2901.0870.928~1.27334.63126.051~46.036
SES低1.0001.0001.0001.0001.0001.000
中等1.0690.984~1.1611.0100.961~1.0620.8850.844~0.9290.7630.698~0.8331.0540.880~1.2620.9180.840~1.004
高0.9880.884~1.1040.8730.817~0.9330.6940.650~0.7400.8240.737~0.9230.6860.559~0.8410.7950.692~0.914
吸烟情况不吸烟1.0001.0001.0001.0001.0001.000
吸烟0.8260.777~0.8790.9410.902~0.9810.8710.836~0.9071.2301.144~1.3227.0976.337~7.9482.1631.991~2.350
饮酒不饮酒1.0001.0001.0001.0001.0001.000
饮酒0.6300.554~0.7161.3561.269~1.4490.9570.892~1.0270.7700.674~0.8802.5022.285~2.7381.4021.246~1.579
睡眠打鼾否1.0001.0001.0001.0001.0001.000
是1.2181.151~1.2891.2171.176~1.2591.0821.047~1.1171.1671.088~1.2521.1961.091~1.3111.1591.084~1.240
疲劳和困倦否1.0001.0001.0001.0001.0001.000
是1.7291.638~1.8251.2191.179~1.2601.1711.135~1.2091.0240.956~1.0971.2921.184~1.4101.2941.214~1.381
BMI和WC状态BMI和WC均正常1.0001.0001.0001.0001.0001.000
BMI超标但WC正常1.1701.101~1.2441.5481.492~1.6071.3391.292~1.3881.4331.338~1.5351.1541.045~1.2751.6121.493~1.740
BMI正常但WC超标1.1121.007~1.2271.2611.186~1.3411.4901.408~1.5761.4271.279~1.5931.3321.122~1.5811.3061.158~1.474
BMI和WC均超标1.4091.337~1.4842.0872.021~2.1561.9251.866~1.9861.8141.708~1.9271.5671.437~1.7081.9821.856~2.116
高血压家族史无1.0001.0001.0001.0001.0001.000
有1.6831.518~1.8662.4942.344~2.6541.2371.152~1.3281.2921.161~1.4370.9530.779~1.1661.8591.629~2.122
糖尿病家族史无1.0001.0001.0001.0001.0001.000
有1.4811.199~1.8290.8090.694~0.9443.1822.810~3.6031.3961.134~1.7181.4971.033~2.1681.3711.030~1.825
CVD家族史无1.0001.0001.0001.0001.0001.000
有2.4762.175~2.8180.9620.869~1.0651.0040.900~1.1190.8180.686~0.9751.2620.963~1.6530.9850.792~1.225
高胆固醇血症家族史无1.0001.0001.0001.0001.0001.000
有0.3910.157~0.9771.5841.077~2.3291.0450.681~1.6046.5244.468~9.5241.1300.387~3.3032.0981.026~4.290
癌症家族史无1.0001.0001.0001.0001.0001.000
有1.5171.205~1.9100.9290.782~1.1030.9450.791~1.1290.9680.735~1.2741.0090.639~1.5941.1280.804~1.584
), ArticleFig(id=1321170104239370759, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170098971324883, language=CN, label=表4, caption=

陕西省CVD各亚型高危人群检出情况影响因素多因素非条件logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分类CVD史型高危人群高血压型高危人群糖尿病型高危人群血脂异常型高危人群重度吸烟型高危人群WHO评估风险型高危人群
OR值95%CIOR值95%CIOR值95%CIOR值95%CIOR值95%CIOR值95%CI
性别男性1.0001.0001.0001.0001.0001.000
女性0.5730.543~0.6051.0441.008~1.0810.9520.920~0.9850.8270.774~0.8830.0050.002~0.0111.3031.205~1.408
年龄/岁35~441.0001.0001.0001.0001.0001.000
45~542.0111.755~2.3041.7041.604~1.8102.2082.075~2.3491.0720.979~1.1741.9531.695~2.2503.6792.738~4.943
55~644.7694.188~5.4302.5862.438~2.7443.3243.128~3.5321.2141.110~1.3271.7381.508~2.00314.35610.796~19.090
≥656.9596.105~7.9323.6233.411~3.8493.9053.669~4.1571.1731.066~1.2901.0870.928~1.27334.63126.051~46.036
SES低1.0001.0001.0001.0001.0001.000
中等1.0690.984~1.1611.0100.961~1.0620.8850.844~0.9290.7630.698~0.8331.0540.880~1.2620.9180.840~1.004
高0.9880.884~1.1040.8730.817~0.9330.6940.650~0.7400.8240.737~0.9230.6860.559~0.8410.7950.692~0.914
吸烟情况不吸烟1.0001.0001.0001.0001.0001.000
吸烟0.8260.777~0.8790.9410.902~0.9810.8710.836~0.9071.2301.144~1.3227.0976.337~7.9482.1631.991~2.350
饮酒不饮酒1.0001.0001.0001.0001.0001.000
饮酒0.6300.554~0.7161.3561.269~1.4490.9570.892~1.0270.7700.674~0.8802.5022.285~2.7381.4021.246~1.579
睡眠打鼾否1.0001.0001.0001.0001.0001.000
是1.2181.151~1.2891.2171.176~1.2591.0821.047~1.1171.1671.088~1.2521.1961.091~1.3111.1591.084~1.240
疲劳和困倦否1.0001.0001.0001.0001.0001.000
是1.7291.638~1.8251.2191.179~1.2601.1711.135~1.2091.0240.956~1.0971.2921.184~1.4101.2941.214~1.381
BMI和WC状态BMI和WC均正常1.0001.0001.0001.0001.0001.000
BMI超标但WC正常1.1701.101~1.2441.5481.492~1.6071.3391.292~1.3881.4331.338~1.5351.1541.045~1.2751.6121.493~1.740
BMI正常但WC超标1.1121.007~1.2271.2611.186~1.3411.4901.408~1.5761.4271.279~1.5931.3321.122~1.5811.3061.158~1.474
BMI和WC均超标1.4091.337~1.4842.0872.021~2.1561.9251.866~1.9861.8141.708~1.9271.5671.437~1.7081.9821.856~2.116
高血压家族史无1.0001.0001.0001.0001.0001.000
有1.6831.518~1.8662.4942.344~2.6541.2371.152~1.3281.2921.161~1.4370.9530.779~1.1661.8591.629~2.122
糖尿病家族史无1.0001.0001.0001.0001.0001.000
有1.4811.199~1.8290.8090.694~0.9443.1822.810~3.6031.3961.134~1.7181.4971.033~2.1681.3711.030~1.825
CVD家族史无1.0001.0001.0001.0001.0001.000
有2.4762.175~2.8180.9620.869~1.0651.0040.900~1.1190.8180.686~0.9751.2620.963~1.6530.9850.792~1.225
高胆固醇血症家族史无1.0001.0001.0001.0001.0001.000
有0.3910.157~0.9771.5841.077~2.3291.0450.681~1.6046.5244.468~9.5241.1300.387~3.3032.0981.026~4.290
癌症家族史无1.0001.0001.0001.0001.0001.000
有1.5171.205~1.9100.9290.782~1.1030.9450.791~1.1290.9680.735~1.2741.0090.639~1.5941.1280.804~1.584
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陕西省不同亚型心血管疾病高危人群检出情况及其影响因素分析
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郭凯明 , 胡志平 , 刘蓉 , 飒日娜 , 邱琳 *, *
中国公共卫生 | 流行病学研究 2025,41(1): 32-41
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中国公共卫生 |流行病学研究 2025 , 41 (1) : 32 -41
陕西省不同亚型心血管疾病高危人群检出情况及其影响因素分析
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郭凯明, 胡志平, 刘蓉, 飒日娜, 邱琳*, *
作者信息
  • 陕西省疾病预防控制中心慢性非传染性疾病预防控制所,西安 710054
通讯作者:
邱琳,E-mail:
作者简介:

郭凯明(1996—),初级,硕士,研究方向:慢性病流行病学

The detection rate of high-risk groups for different subtypes of cardiovascular diseases and its influencing factors in Shaanxi province
Kaiming GUO, Zhiping HU, Rong LIU, SARINA, Lin QIU
Affiliations
  • Institute for Chronic and Noncommunicable Disease Control and Prevention, Shanxi Center for Disease Control and Prevention, Xi’an, 710054, China
  • Corresponding Author:
    QIU Lin, E-mail:
出版时间: 2025-01-10 doi: 10.11847/zgggws1144622
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目的

了解陕西省不同亚型心血管疾病(CVD)高危人群检出情况及其影响因素,为CVD的预防控制提供科学依据。

方法

于2015年12月—2022年12月采用便利抽样方法在陕西省宝鸡市(凤翔县、金台区、眉县),汉中市(城固县、汉台区),商洛市(商州区、镇安县),渭南市(澄城县、潼关县、蒲城县)和咸阳市(三原县、泾阳县)5个地市12个项目点招募168 742名≥35岁常住居民进行问卷调查、体格检查和实验室检测,计算陕西省不同亚型CVD高危人群的检出率,并应用多因素非条件logistic回归模型分析不同亚型CVD高危人群检出情况的影响因素。

结果

陕西省最终纳入分析的168 379名≥35岁常住居民中,检出CVD高危人群60197人,CVD高危人群检出率为35.75%;其中CVD史型、高血压型、糖尿病型、血脂异常型、重度吸烟型和世界卫生组织(WHO)评估风险型高危人群分别检出8 611、27 047、28 995、6 632、3 310和5 737人,高危人群检出率分别为5.11%、16.06%、17.22%、3.94%、1.97%和3.41%。多因素非条件logistic回归分析结果显示,年龄≥45岁、吸烟、饮酒、睡眠打鼾、疲劳和困倦、体质指数(BMI)超标但腰围(WC)正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、CVD家族史、高胆固醇血症家族史是CVD高危人群检出的危险因素,女性、中等和高社会经济地位(SES)是CVD高危人群检出的保护因素;年龄≥45岁、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、CVD家族史、癌症家族史是CVD史型高危人群检出的危险因素,女性、吸烟、饮酒和有高胆固醇血症家族史是CVD史型高危人群检出的保护因素;女性、年龄≥45岁、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压病家族史、高胆固醇血症家族史是高血压型高危人群检出的危险因素,高SES、吸烟和有糖尿病家族史是高血压型高危人群检出的保护因素;年龄≥45岁、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史是糖尿病型高危人群检出的危险因素,女性、中和高SES和吸烟是糖尿病型高危人群检出的保护因素;年龄≥55岁、吸烟、睡眠打鼾、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、高胆固醇血症家族史是血脂异常型高危人群检出的危险因素,女性、中等和高SES、饮酒和有CVD家族史是血脂异常型高危人群检出的保护因素;年龄45~64岁、吸烟、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有糖尿病家族史是重度吸烟型高危人群检出的危险因素,女性和高SES是重度吸烟型高危人群检出的保护因素;女性、年龄≥45岁、吸烟、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、高胆固醇血症家族史是WHO评估风险型高危人群检出的危险因素,高SES是WHO评估风险型高危人群检出的保护因素。

结论

陕西省CVD高危人群检出率较高,高血压型和糖尿病型是主要的亚型;性别、年龄、SES、吸烟情况、饮酒情况、睡眠打鼾情况、疲劳和困倦情况、BMI和WC状态以及有无高血压家族史、糖尿病家族史、CVD家族史、高胆固醇血症家族史、癌症家族史是该地区CVD高危人群检出的主要影响因素。

心血管疾病(CVD)  /  亚型  /  高危人群  /  检出情况  /  影响因素  /  陕西省
Objective

To investigate the detection rate of different subtypes of cardiovascular disease (CVD) high-risk populations in Shaanxi province and their influencing factors, so as to provide a scientific basis for the prevention and control of CVD.

Methods

From December 2015 to December 2022, a convenience sampling method was used to recruit 168 742 permanent residents aged ≥35 years from 12 project sites in 5 cities of Shaanxi province: Baoji city (Fengxiang county, Jintai district, Mei county), Hanzhong city (Chenggu county, Hantai district), Shangluo city (Shangzhou district, Zhen'an county), Weinan city (Chengcheng county, Tongguan county, Pucheng county), and Xianyang city (Sanyuan county, Jingyang county). Questionnaires, physical examinations, and laboratory tests were conducted. The detection rates of different subtypes of CVD high-risk populations in Shaanxi province were calculated, and a multifactorial unconditional logistic regression model was used to analyze the influencing factors of the detection of different subtypes of CVD high-risk populations.

Results

Among the 168 379 permanent residents aged ≥35 years finally included in the analysis in Shaanxi province, 60 197 were identified as high-risk for CVD, with a detection rate of 35.75%. Among them, 8 611, 27 047, 28 995, 6 632, 3 310, and 5 737 individuals were identified as having a history of CVD, hypertension, diabetes, dyslipidemia, heavy smoking, and World Health Organization (WHO) assessed risk, respectively, with detection rates of 5.11%, 16.06%, 17.22%, 3.94%, 1.97%, and 3.41%, respectively. Multifactorial unconditional logistic regression analysis showed that age ≥45 years, smoking, alcohol consumption, snoring, daytime fatigue or sleepiness, overweight with normal waist circumference (WC), normal body mass index (BMI) with high WC, both high BMI and WC, and a family history of hypertension, diabetes, CVD, and hypercholesterolemia were risk factors for the detection of high-risk CVD populations, while female sex and middle and high socioeconomic status (SES) were protective factors. Age ≥45 years, snoring, fatigue and sleepiness, overweight with normal WC, normal BMI with high WC, both high BMI and WC, and a family history of hypertension, diabetes, CVD, and cancer were risk factors for the detection of high-risk CVD history populations, while female sex, smoking, alcohol consumption, and a family history of hypercholesterolemia were protective factors. Female sex, age ≥45 years, alcohol consumption, snoring, fatigue and sleepiness, overweight with normal WC, normal BMI with high WC, both high BMI and WC, and a family history of hypertension and hypercholesterolemia were risk factors for the detection of high-risk hypertension populations, while high SES, smoking, and a family history of diabetes were protective factors. Age ≥45 years, sleep snoring, fatigue and drowsiness, excessive BMI with normal WC, normal BMI with excessive WC, both excessive BMI and WC, family history of hypertension, family history of diabetes were risk factors for the diabetes subtype, and female, moderate and high SES and smoking were protective factors. Age ≥55 years, smoking, sleep snoring, excessive BMI with normal WC, normal BMI with excessive WC, both BMI and WC, family history of hypertension, family history of diabetes, and family history of hypercholesterolemia were risk factors for dyslipidemia subtype, and female, moderate and high SES, alcohol consumption, and family history of CVD were protective factors. Age 45 to 64 years, smoking, alcohol consumption, sleep snoring, fatigue and sleepiness, excessive BMI but normal WC, normal BMI but excessive WC, both BMI and WC and family history of diabetes were risk factors for heavy smoking subtype, and female and high SES were protective factors. Women, age ≥45 years, smoking, alcohol consumption, sleep snoring, fatigue and sleepiness, excessive BMI with normal WC, normal BMI with excessive WC, both BMI and WC with excessive BMI, and family history of hypertension, family history of diabetes, and family history of hypercholesterolemia were risk factors for WHO risk assessment subtype, and high SES was a protective factor.

Conclusions

In Shaanxi province, the detection rate of CVD in high-risk groups was high, and hypertension and diabetes were the main CVD high risk subtypes. Gender, age, SES, smoking status, alcohol consumption status, sleep snoring status, fatigue and sleepiness status, BMI and WC status, and family history of hypertension, diabetes, CVD, hypercholesterolemia, and cancer were the main influencing factors for the detection rate of CVD in high-risk groups in this area.

cardiovascular disease (CVD)  /  subtype  /  high-risk population  /  detection  /  influencing factors  /  Shaanxi province
郭凯明, 胡志平, 刘蓉, 飒日娜, 邱琳. 陕西省不同亚型心血管疾病高危人群检出情况及其影响因素分析. 中国公共卫生, 2025 , 41 (1) : 32 -41 . DOI: 10.11847/zgggws1144622
Kaiming GUO, Zhiping HU, Rong LIU, SARINA, Lin QIU. The detection rate of high-risk groups for different subtypes of cardiovascular diseases and its influencing factors in Shaanxi province[J]. Chinese Journal of Public Health, 2025 , 41 (1) : 32 -41 . DOI: 10.11847/zgggws1144622
据报道,2020年中国城乡居民近一半人死于心血管疾病(cardiovascular disease,CVD),由其引起的疾病负担日趋严重,仍是我国居民的首要死因[1];2021年全球疾病负担预测分析,到2050年导致伤残调整寿命年的前2位原因为缺血性心脏病和脑卒中[2]。既往研究表明,我国西部地区部分CVD危险因素控制水平低于东部经济发达地区[3],西北地区CVD高危风险概率约1/17,但CVD高危人群的用药比例却<4%[4]。针对CVD高危人群进行可改变危险因素的早期有效干预是CVD防治的重要措施,但目前关于CVD高危人群危险因素的研究中却较少考虑不同亚型CVD高危人群危险因素的差异。因此,本研究于2015年12月—2022年12月采用便利抽样方法在陕西省宝鸡市(凤翔县、金台区、眉县),汉中市(城固县、汉台区),商洛市(商州区、镇安县),渭南市(澄城县、潼关县、蒲城县)和咸阳市(三原县、泾阳县)5个地市12个项目点招募168742名≥35岁常住居民进行问卷调查、体格检查和实验室检测,计算陕西省不同亚型CVD高危人群的检出率,并应用多因素非条件logistic回归模型分析不同亚型CVD高危人群检出情况的影响因素,旨在了解陕西省不同亚型CVD高危人群的检出情况及其影响因素,为CVD的预防控制提供科学依据。结果报告如下。
于2015年12月—2022年12月采用便利抽样方法在陕西省宝鸡市(凤翔县、金台区、眉县),汉中市(城固县、汉台区),商洛市(商州区、镇安县),渭南市(澄城县、潼关县、蒲城县)和咸阳市(三原县、泾阳县)5个地市12个项目点招募168 742名≥35岁且过去1年在当地居住≥6个月的常住居民作为调查对象进行问卷调查、体格检查和实验室检测。本研究经中国医学科学院阜外医院伦理委员会审查批准(批号:2014–574),且所有调查对象均签署了知情同意书。最终本研究纳入其中168 379名数据无缺失的调查对象进行分析。
采用国家心血管中心统一设计的调查问卷,由经过统一培训且考核合格的调查员进行面访调查。内容包括性别、年龄、文化程度、婚姻状况、职业、家庭年均收入、居住地、有无医疗保险、吸烟情况、饮酒情况、是否睡眠打鼾、是否疲劳和困倦、CVD病史、有无高血压家族史、有无糖尿病家族史、有无CVD家族史、有无高胆固醇血症家族史和有无癌症家族史等。其中,吸烟指目前吸烟且过去1年内平均吸烟数≥1支/天[5];饮酒指目前饮酒且在过去1年内饮酒≥2次/周[5]。根据文化程度、婚姻状况、职业、家庭年均收入、居住地、有无医疗保险构建复合指标社会经济地位(socioeconomic status,SES),参考相关文献[6–7],将文化程度小学及以下/不详、初中、高中/中专和大专及以上分别计0、1、2和3分,婚姻状况非在婚和在婚分别计0和1分,职业为失业/家务/不详、退休、技术工人和管理/专业人员分别计0、1、2和3分,家庭年均收入不详、<10 000、10 000~50 000和>50 000元分别计0、1、2和3分,居住在农村和城市分别计0和1分,无和有医疗保险分别计0和1分,将以上6个指标得分相加,总分为0~12分,SES低、中等、高水平分别为0~4、5~8和9~12分。
由经过统一培训的体检人员进行身高、体重、腰围(Waist Circumference,WC)和血压,并计算体质量指数(Body Mass Index,BMI)=体重(kg)/[身高(m)]2。其中,血压测量采用HEM–7430型欧姆龙电子血压计(日本欧姆龙公司),要求调查对象者静坐休息5 min后测量右上臂血压2次,每次间隔1 min,若2次收缩压差值>10 mmHg(1 mmHg=0.133 3 kPa)则测量第3次,取后2次血压平均值作为最终血压。BMI≥24.0代表超重肥胖,定义为BMI超标;WC男性≥90 cm、女性≥85 cm代表中心性肥胖,定义为WC超标[8]。
采集调查对象空腹≥8 h指尖血,采用百捷PD–G001血糖仪(中国百捷公司)现场进行空腹血糖检测,并采用Cardiocheck PA仪器(美国卡迪克公司)现场进行低密度脂蛋白胆固醇和高密度脂蛋白胆固醇检测。
CVD高危人群指符合以下6项中任意1项者[9–12]:(1)CVD史型:有心肌梗死病史、接受经皮冠状动脉介入治疗、接受冠状动脉搭桥手术、脑卒中(缺血性脑卒中或出血性脑卒中)中任一疾病史;(2)高血压型:收缩压≥160 mmHg或舒张压≥100 mmHg;(3)糖尿病型:年龄≥40岁且空腹血糖≥7.0 mmol/L或自报服用降血糖药物或有糖尿病病史;(4)血脂异常型:低密度脂蛋白胆固醇≥4.14 mmol/L(160 mg/dL)或高密度脂蛋白胆固醇<0.78 mmol/L(30 mg/dL);(5)重度吸烟型:吸烟≥30支/天;(6)世界卫生组织(World Health Organization,WHO)评估风险型:根据2008年WHO《心血管风险评估和管理指南》[13]的风险评估预测图进行评估,10年CVD患病风险≥20%。
应用SPSS 25.0统计软件进行一般描述分析、χ2检验、Fisher确切概率法检验和多因素非条件logistic回归分析,以P<0.05为差异有统计学意义。
陕西省最终纳入分析的168 379名≥35岁常住居民中,男性68 943人(40.95%),女性99 436人(59.05%);年龄35~76岁,平均年龄(56.65±9.67)岁,其中35~44岁20 648人(12.26%),45~54岁49 811人(29.58%),55~64岁57 158人(33.95%),≥65岁40 762人(24.21%);文化程度小学及以下60 674人(36.03%),初中67 967人(40.37%),高中/中专26 824人(15.93%),大专及以上12 755人(7.58%),不详159人(0.09%);婚姻状况非在婚11 247人(6.68%),在婚157 132人(93.32%);职业为技术工人129 341人(76.82%),管理/专业人员10 958人(6.51%),退休人员17 889人(10.62%),失业/家务/不详10 191人(6.05%);家庭年均收入<10 000元45264人(26.88%),10 000~50 000元90 347人(53.66%),>50 000元15 020人(8.92%),不详17 748人(10.54%);居住在农村121 410人(72.11%),城市46 969人(27.89%);无医疗保险705人(0.42%),有医疗保险167 674人(99.58%);低SES者11 707人(6.95%),中等SES者134 424人(9.83%),高SES者22 248人(13.21%);不吸烟131 174人(77.90%),吸烟37 205人(22.10%);不饮酒162017人(96.22%),饮酒6362人(3.78%);不睡眠打鼾57829人(34.34%),睡眠打鼾47 803人(28.39%),不详62 747人(37.27%);不疲劳和困倦69 916人(41.52%),疲劳和困倦40 923人(24.30%),不详57 540人(34.17%);BMI和WC均正常68 335人(40.58%),BMI超标但WC正常37 871人(22.49%),BMI正常但WC超标9 727人(5.78%),BMI和WC均超标52 446人(31.15%);无高血压家族史161 454人(95.89%),有高血压家族史6 925人(4.11%);无糖尿病家族史167 073人(99.22%),有糖尿病家族史1 306人(0.78%);无CVD家族史165 481人(98.28%),有CVD家族史2 898人(1.72%);无高胆固醇血症家族史168 238人(99.92%),有高胆固醇血症家族史141人(0.08%);无癌症史167 349人(99.39%),有癌症家族史1 030人(0.61%)。
陕西省最终纳入分析的168 379名≥35岁常住居民中,检出CVD高危人群60 197人,CVD高危人群检出率为35.75%;其中CVD史型、高血压型、糖尿病型、血脂异常型、重度吸烟型和WHO评估风险型高危人群分别检出8 611、27 047、28 995、6 632、3 310和5 737人,高危人群检出率分别为5.11%、16.06%、17.22%、3.94%、1.97%和3.41%。陕西省不同特征≥35岁常住居民比较,不同性别、年龄、文化程度、婚姻状况、职业、家庭年均收入、居住地、SES、吸烟情况、饮酒情况、BMI和WC状态及有无医疗保险、是否睡眠打鼾、是否疲劳和困倦、有无高血压家族史、有无糖尿病家族史、有无CVD家族史、有无高胆固醇血症家族史居民CVD高危人群检出率不同;不同性别、年龄、文化程度、婚姻状况、职业、家庭年均收入、居住地、SES、吸烟情况、饮酒情况、BMI和WC状态及是否睡眠打鼾、是否疲劳和困倦、有无高血压家族史、有无糖尿病家族史、有无CVD家族史、有无癌症家族史居民CVD史型高危人群检出率不同,不同年龄、文化程度、婚姻状况、职业、家庭年均收入、居住地、SES、吸烟情况、饮酒情况、BMI和WC状态及有无医疗保险、是否睡眠打鼾、是否疲劳和困倦、有无高血压家族史、有无CVD家族史、有无高胆固醇血症家族史居民高血压型CVD高危人群检出率不同;不同性别、年龄、文化程度、婚姻状况、职业、家庭年均收入、居住地、SES、吸烟情况、BMI和WC状态及是否睡眠打鼾、是否疲劳和困倦、有无糖尿病家族史、有无CVD家族史、有无癌症家族史居民糖尿病型CVD高危人群检出率不同;不同性别、年龄、文化程度、职业、家庭年均收入、SES、吸烟情况、BMI和WC状态及有无医疗保险、是否睡眠打鼾、是否疲劳和困倦、有无高血压家族史、有无糖尿病家族史、有无CVD家族史、有无高胆固醇血症家族史、癌症家族史居民血脂异常型CVD高危人群检出率不同;不同性别、年龄、文化程度、婚姻状况、职业、家庭年均收入、SES、吸烟情况、饮酒情况、BMI和WC状态及是否睡眠打鼾、是否疲劳和困倦居民重度吸烟型CVD高危人群检出率不同;不同性别、年龄、文化程度、婚姻状况、职业、家庭年均收入、居住地、SES、吸烟情况、饮酒情况、BMI和WC状态及是否睡眠打鼾、是否疲劳和困倦、有无高血压家族史、有无糖尿病家族史、有无CVD家族史居民CVD高危人群检出率不同,差异均有统计学意义(均P<0.05)。
分别以陕西省是否检出CVD高危人群、CVD史型高危人群、高血压型高危人群、糖尿病型高危人群、血脂异常型高危人群、重度吸烟型高危人群、WHO评估风险型高危人群为因变量(0=否,1=是),以性别、年龄、SES、吸烟情况、饮酒情况、是否睡眠打鼾、是否疲劳和困倦、BMI和WC状态、有无高血压家族史、有无糖尿病家族史、有无CVD家族史、有无高胆固醇血症家族史和有无癌症家族史共13个因素为自变量进行多因素非条件logistic回归分析。结果显示,年龄≥45岁、吸烟、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、CVD家族史、高胆固醇血症家族史是CVD高危人群检出的危险因素,女性、中等和高SES是CVD高危人群检出的保护因素;年龄≥45岁、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、CVD家族史、癌症家族史是CVD史型高危人群检出的危险因素,女性、吸烟、饮酒和有高胆固醇血症家族史是CVD史型高危人群检出的保护因素;女性、年龄≥45岁、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压病家族史、高胆固醇血症家族史是高血压型高危人群检出的危险因素,高SES、吸烟和有糖尿病家族史是高血压型高危人群检出的保护因素;年龄≥45岁、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史是糖尿病型高危人群检出的危险因素,女性、中等和高SES和吸烟是糖尿病型高危人群检出的保护因素;年龄≥55岁、吸烟、睡眠打鼾、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、高胆固醇血症家族史是血脂异常型高危人群检出的危险因素,女性、中等和高SES、饮酒和有CVD家族史是血脂异常型高危人群检出的保护因素;年龄45~64岁、吸烟、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有糖尿病家族史是重度吸烟型高危人群检出的危险因素,女性和高SES是重度吸烟型高危人群检出的保护因素;女性、年龄≥45岁、吸烟、饮酒、睡眠打鼾、疲劳和困倦、BMI超标但WC正常、BMI正常但WC超标、BMI和WC均超标以及有高血压家族史、糖尿病家族史、高胆固醇血症家族史是WHO评估风险型高危人群检出的危险因素,高SES是WHO评估风险型高危人群检出的保护因素。
本次调查结果显示,陕西省CVD高危人群的检出率为35.75%,高于北京市的20.82%[10]、江苏省的25.03%[11]和辽宁省的25.03%[14],这可能与本研究综合考虑了多种亚型CVD高危人群有关。在不同亚型CVD高危类型中,高血压型(16.06%)和糖尿病型(17.22%)的检出率较高;其中高血压型高危人群检出率低于江苏省的19.01%[11]、河北省的17.88%[15]和西藏自治区的18.62%[16],高于安徽省的14.46%[9]和四川省的14.87%[17];糖尿病型高危人群检出率略低于西北地区的18.20%[4],高于北京市的12.99%[10]和东北地区的9.70%[18],这可能与不同地区高血压和糖尿病的患病率和控制率本身存在差异有关。高血压和糖尿病是CVD的重要危险因素[1,19],有研究表明,高血压相关CVD的人群归因分值为32.5%[20],2型糖尿病可能造成2.5~12.9年的寿命损失[21]。因此,为进一步提高当地居民CVD的防控能力、降低CVD疾病负担和经济负担,陕西省可优先将高血压和糖尿病作为重点关注疾病。
本次调查中,WHO评估风险型CVD高危人群的检出率仅为3.41%,在既往基于10年CVD患病风险>10%或20%判定CVD高危人群的研究中,其检出率均较低[4, 9, 11],这可能严重低估了人群中CVD高危的比例。而目前CVD仍是威胁中国居民健康的首位疾病[1],陕西省去CVD死因后全人群的预期寿命可提高约11.90岁[22],因此CVD高危人群的早期干预至关重要。而筛查作为早期发现癌症、慢性阻塞性肺疾病和CVD等慢性病的重要手段之一,可能会促进疾病早期诊断,从而有利于改善患者预后[23]。因此,为降低CVD漏筛率并提高筛查效益,今后可采取多指标联合方式识别CVD高危人群,并根据不同个体高危特征有针对性地开展多维度的干预措施。
本次调查结果还显示,年龄较高、SES较低、睡眠打鼾、疲劳和困倦、BMI和WC均超标和有高血压家族史为CVD史型、高血压型、糖尿病型、血脂异常型、重度吸烟型和WHO评估风险型高危人群检出的危险因素。既往研究表明,SES较低的人群CVD发病风险和全因死亡风险可分别增加43%和65%[24],本次调查中高SES多偏向于居住在城市、文化程度较高、职业为专业技术和管理人员、家庭年均收入较高和有医疗保险的人群,而此类人群更可能具备健康知识且易获得医疗资源,因此CVD患病率较低。本研究中睡眠打鼾与CVD及其亚型高危人群检出率均呈正相关,与既往相关研究结果一致[25–27],这可能是因为打鼾时的高水平振动可能引起局部炎症反应[28],从而容易导致血管损伤和斑块破裂,且打鼾者睡眠时常伴有呼吸暂停或低通气量,会导致低氧血症、高碳酸血症、胸腔内压变化甚至反复睡眠觉醒[29],影响睡眠质量,从而增加了CVD的患病风险。此外,肥胖与不同亚型CVD患病风险均呈正相关[30],超重肥胖和腰围超标均为CVD高危的危险因素[11]。提示未来可进一步通过加强体重管理来降低人群的肥胖率,从而减少CVD的发病。
此外,吸烟和饮酒虽增加了总体CVD高危人群的检出风险,但在不同亚型CVD高危人群的风险中却存在差异,其中吸烟者较非吸烟者CVD史型、高血压型和糖尿病型CVD高危人群检出的可能性低。既往研究表明,中国成年男性吸烟者的BMI和WC均较非吸烟者低[31],而肥胖者发生高血压、糖尿病和CVD的风险更高[32–34],因此肥胖可能是两者关联的一个中介因素。饮酒者较非饮酒者CVD史型、糖尿病型和血脂异常型CVD高危人群检出的可能性低。既往研究表明,少量饮酒可能降低≥40岁人群脑卒中、缺血性心脏病和糖尿病的发病风险[35],且在男性中,不论少量还是过量饮酒,患低高密度脂蛋白胆固醇血症的风险均较低[36],而本研究将少量饮酒者纳入饮酒者中,因此这3种亚型CVD高危人群的检出风险可能较低。
综上所述,陕西省CVD干预对象的选择上可将高龄、低SES、睡眠打鼾、疲劳和困倦、BMI和WC均超标以及有高血压、糖尿病、CVD和高胆固醇血症等家族史的人群作为重点关注对象,针对吸烟和饮酒者,可依据其CVD高危风险亚型采取有针对性的干预措施,从而降低整个人群的CVD疾病负担。但本研究仍存在一定的局限性:由于本研究对象不是通过随机抽样获得,因此代表性不足,结果外推需谨慎,但在大型筛查项目中采用随机抽样方法抽取筛查对象并不现实,因此今后可收集更多数据进行分析对本研究结果加以验证。此外,本研究为横断面研究,可能无法进行因果推断,在今后的研究中可开展队列研究进一步进行分析。

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2025年第41卷第1期
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doi: 10.11847/zgggws1144622
  • 接收时间:2024-04-04
  • 首发时间:2026-10-25
  • 出版时间:2025-01-10
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  • 收稿日期:2024-04-04
  • 修回日期:2024-08-31
  • 录用日期:2024-11-21
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    陕西省疾病预防控制中心慢性非传染性疾病预防控制所,西安 710054

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邱琳,E-mail:
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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