目的:探讨我国老年人健康行为对慢性病共病的影响并利用关联规则探索共病模式,为制定健康相关行为预防策略提供参考依据。方法:基于中国老年健康影响因素跟踪调查(CLHLS)中10,747名65岁老年人的相关数据,利用多因素logistic回归模型分析健康生活相关行为对慢性病共病的影响;通过关联规则分析慢性病共病组合。结果:研究对象 ≥ 65岁共计10,381名,慢性病共病患病率为36.04%。基于睡眠质量、睡眠时间、健康饮食、无吸烟史、无饮酒史、锻炼以及户外社交活动等7个健康生活相关行为变量的得分,分为健康行为组别人群3023人(29.12%)和不健康行为组别7358人(70.88%)。多因素logistic回归分析结果显示,年龄组别为65~74岁(OR = 1.16, 95%CI: 1.02~1.32)和75~84岁人群(OR = 1.56, 95%CI: 1.40~1.74)、户籍为城市(OR = 2.50, 95%CI: 2.26~2.75)人群是慢性病共病的危险因素。男性、学历组别为文盲和小学、正常BMI以及健康行为是慢性病共病的保护因素。不同健康行为组别的共病组合存在差异。健康生活方式与慢性病共病低风险相关,从健康行为上对老年人加以引导和宣传并加强常见共病模式慢性病的筛查与预防不失为有效降低慢性病共病的途径。Objective: To explore the influence of health behaviors on chronic disease comorbidities among elderly in China and the comorbidity patterns using association rules, to provide a reference for formulating health-related behavior prevention strategies. Methods: Based on the data of 10,747 65-year-old elderly people in the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a multivariate logistic regression model was used to analyze the influence of healthy life-related behaviors on chronic disease comorbidities. The combination of chronic diseases comorbidities was analyzed by association rules. Results: There were 10,381 subjects ≥ 65 years old, and the prevalence of chronic diseases was 36.04%. Based on the scores of 7 behavioral variables related to a healthy life, including sleep quality, sleep time, healthy diet, no smoking history, no drinking history, exercise, and outdoor social activities, the population was divided into 3023 people (29.12%) in the healthy behavior group and 7358 people (70.88%) in the unhealthy behavior group. Multivariate logistic regression analysis showed that the age group of 65~74 years old (OR = 1.16, 95%CI: 1.02~1.32) and 75~84 years old population (OR = 1.56, 95%CI: 1.40~1.74), and the household registration of urban (OR = 2.50, 95%CI: 2.26~2.75) were risk factors for chronic disease comorbidity. Male, educational group illiteracy and primary school, normal BMI, and healthy
背景:生命早期饥荒暴露会导致代谢综合征和脂肪肝病,但对最新定义的代谢功能障碍相关脂肪性肝病(MASLD)风险的影响暂不清楚。本研究的目的是通过因果定向无环图(DAG)分析生命早期饥荒暴露MASLD患病风险的影响。方法:分析了重庆市某体检中心15,791例含腹部超声检查体检对象的数据。将研究对象按出生年份分为(1953年1月1日至1955年12月31日出生)、童年晚期暴露组(1956年1月1日至1958年12月31日出生)、幼儿暴露组、胎儿暴露组(1959年1月1日至1961年12月31日出生)和非暴露组(1962年1月1日至1964年12月31出生)。通过DAG模型获得无偏调整集。使用二元logistic和线性回归模型对结果进行调整。结果:本研究人群中MASLD患病率为38.1%。但男性和女性受饥荒暴露人群的MASLD患病风险相反。相比于非暴露组,男性胎儿饥荒暴露组(OR = 0.688, 95% CI: [0.608, 0.779], P = 0.000)和幼儿饥荒暴露组(OR = 0.673, 95% CI: [0.593, 0.764], P = 0.000)和童年晚期暴露组(OR = 0.628, 95% CI: [0.537, 0.735], P = 0.000)患MASLD风险较低。而女性的童年晚期暴露组患MASLD的风险是非暴露组约1.2倍(OR = 1.236, 95% CI: [1.089, 1.404], P = 0.001)。早年经历饥荒男性的BMI、甘油三酯(TG)和高密度脂蛋白(HDL)指标的心血管代谢相关风险都较低,而经历饥荒女性的空腹血糖较高。结论:生命早期暴露于饥荒可能会降低男性老年时患MASLD的风险,但女性在童年晚期经历饥荒可能会增加老年时MASLD的风险,不同性别的风险差异可能是由于饥荒经历对男性和女性心血管代谢风险因素相关指标的影响不同所造成的。本研究与过往研究的差异可能是由于地区间受灾程度差异和研究对象的年龄阶段不同导致的,需要进一步的队列研究探索饥荒暴露对MASLD的长期影响。Background: Early life famine exposure leads to metabolic syndrome and fatty liver disease, but the effect on the risk of newly defined metabolic dysfunction-associated fatty liver disease (MASLD) is unclear. The aim of this study was to analyze the impact of early life famine exposure to MASLD risk by causally oriented acyclic graph (DAG). Methods: The data of 15,791 subjects with abdominal ultrasound examination in a physical examination center in Chongqing were analyzed. Participants were divided into (born between January 1, 1953 and December 31, 1955), late childhood exposure group (born between January 1, 1956 and December 31, 1958), infant exposure group, fetal exposure group (born between January 1, 1959 and December 31, 1961) and non-exposure group (born between January 1, 1962 and December 31, 1964). The unbiased adjustment set was obtained by the DAG model. The results were adjusted using binary logistic and linear regression models. Results: The prevalence of MASLD in this population was 38.1%. However, men and women have opposite risks of MASLD in people exposed to famine. Compared with the non-
暂无评论