某校大学生不同肥胖类型与心血管疾病代谢指标的关系

目的  获得大学生不同肥胖类型与心血管疾病代谢指标之间的关联性,为有效控制青少年肥胖、预防心血管疾病提供科学依据。 方法  本次研究以芜湖市某高校2018级3 450名新生为研究对象,采用整群抽样的方法对其进行问卷调查和体格检测。使用BMI及腰围身高比(waist height ratio, WHtR)作为判断肥胖的指标。 结果  符合条件的3 349名调查对象中复合型肥胖、中心型肥胖和外周型肥胖的患病率分别为6.51%、4.93%、0.53%。除了载脂蛋白A(apolipoprotein A, APOA)外,各心血管疾病代谢异常检出率在不同肥胖类型之间差异均有统计学意义(均有P＜0.05)。除APOA外,复合型肥胖发生心血管疾病代谢异常的风险较非肥胖人群均有增加(均有P＜0.05)。与非肥胖人群相比,复合型肥胖的青少年出现指标异常数≥2的可能性是6.86倍(OR=6.86, 95% CI: 4.54~10.39)。 结论  复合型肥胖青少年发生心血管疾病代谢异常的风险较高,联合使用BMI和WHtR可提高对青少年心血管疾病的预测效应。     

海珠区居民肥胖现状、危险因素及与慢性病的关系

目的探讨海珠区居民肥胖现状、危险因素及与相关慢性病的关系,为制定防控措施提供依据。方法用系统抽样法对海珠区40～88岁居民4 474人进行问卷调查、体格测量和实验室检测。结果超重和肥胖率分别为33.06%和9.37%。男女间超重率差异无统计学意义,女性肥胖率高于男性。饮酒、文化水平、吸烟暴露是肥胖的主要危险因素。体质量指数(BMI)与糖尿病、高血压和血脂异常的患病率有关,BMI越高,患病率越高。结论超重和肥胖率在海珠区中老年人居民已达到相当高的水平,今后应针对性地加强肥胖和慢性病的预防工作。     

超重、肥胖和腹型肥胖与心血管代谢性疾病的关联研究

目的 了解超重、肥胖和腹型肥胖对心血管代谢性疾病的影响。方法 采用整群抽样方法,选取河南省开封市通许县673名15岁以上居民为调查对象进行横断面调查,并对研究对象进行问卷调查和体格检查,留取空腹和餐后2h静脉血进行血糖检测。结果 开封地区居民标化超重患病率为35.52%;标化肥胖患病率为14.18%;标化腹型肥胖患病率为42.62%。单因素logistic回归分析显示,超重、肥胖和腹型肥胖是高血压、2型糖尿病、高血脂的危险因素;腹型肥胖是冠心病和脑卒中的危险因素(P<0.05)。腹型肥胖的人群归因危险度(PAR)在高血压、2型糖尿病、高血脂和心脑血管疾病中均高于70%。结论 在对高危人群进行筛查时,腰围比体质指数更为重要。减少腹型肥胖人群比例对预防心血管代谢性疾病的意义更为重大。     

Ecological analysis of the relationship between infant mortality and cardiovascular disease mortality at ages 45-69 in the Brazilian 1935 birth cohort

Background

International ecological studies have shown a positive association between infant mortality as a proxy for low birth weight and cardiovascular disease mortality in adult life.

Methods

Mortality rates due to Cardiovascular Diseases (CVDMR) standardised by age in adults between 45 and 69 years of age and by place of birth (pob) and residence (res) were related to Infant Mortality Rates (IMR) in the Brazilian 1935 birth cohort.

Results

Two relationship patterns were noted between IMR and CVDMR: for the Southeast, South and Centre-West group of regions (r_pob = 0.46; r_res = 0.29) and for the North and Northeast group of regions (r_pob = 0.21; r_res = 0.33). For the latter pattern, two states were identified (Rio Grande do Norte and Paraíba) as atypical areas, whose exclusion strengthened the association (r_pob = 0.73; r_res = 0.91).

Conclusions

The direction of the associations changed after the analysis by group of Brazilian regions (indirect control of socio-economic levels, coverage and quality of the information). There is a positive, although weak association between IMR and CVDMR. Attempts to control or minimise the interference of migratory movements, cohort effects and socio-economic levels represented methodological progress in ecological analyses of foetal programming in Brazil.     

Familial risk of premature cardiovascular mortality and the impact of intergenerational occupational class mobility

The negative impact of low social class on cardiovascular disease (CVD) and mortality has been consistently documented. However, less scientific consistency exists in terms of whether a unique health effect of social mobility from childhood to adulthood prevails. This study explored how childhood and adult social class and the transition between them (social mobility), are related to premature CVD mortality when familial aggregation of CVD among siblings is also considered. The study includes nearly 1.9 million Swedish residents born 1939-1959 distributed over 1,044,725 families, of whom 14,667 died prematurely from CVD in 1990-2003. Information on parental class (1960) and own mid-life occupational class (1990) was retrieved from the respective censuses. Odds ratios for premature CVD mortality according to trajectory-specific social mobility, along with pairwise mean odds ratios for sibling resemblance of premature CVD mortality, were calculated by means of alternating logistic regression. This model calculates the remaining dependency of CVD mortality within sibships after accounting for available risk factors (like parental and adult social class) in the population mean model. Results showed that premature CVD mortality was associated with both parental and own adult social class. A clear tendency for the downwardly mobile to have increased, and for the upwardly mobile to experience a decreased risk of premature CVD mortality was found, as well as a corresponding unique effect of social mobility per se among the manual and non-manual classes. This effect was verified for men, but not for women, when they were analysed separately. The pairwise mean odds ratios for premature CVD mortality among full siblings were 1.78 (95% CI: 1.52-2.08), and were independent of parental CVD mortality and parental or adult occupational class.     

Incident obesity and cardiovascular risk factors between young adulthood and middle age by religious involvement: the Coronary Artery Risk Development in Young Adults (CARDIA) study

Background

Religious involvement has been associated with improved health outcomes but greater obesity in older adults. No longitudinal study of young adults has examined the prospective association of religious involvement with incident cardiovascular risk factors (RFs) and subclinical disease (subCVD).

Methods

We included 2433 participants of the CARDIA study, aged 20 to 32 in 1987 when religiosity was assessed, who were followed for 18 years. Multivariable-adjusted regression models were fitted to assess prospective associations of frequency of religious participation at baseline with incidence of RFs and prevalence of subCVD after 18 years’ follow up.

Results

The high frequency of religious participation was associated with a significantly greater incidence of obesity in unadjusted models (RR 1.57, 95% CI 1.14-1.73) and demographic-adjusted models (RR 1.34, 95% CI 1.09-1.65) but not after additional adjustment for baseline RFs (RR 1.17, 95% CI .97-1.41). When religious participation was treated dichotomously, any religious participation, compared with none, was associated with significantly lower subCVD.

Conclusions

Frequent religious participants are more likely to become obese between young adulthood and middle age; this association is confounded by demographic and other factors. Nonetheless, young adults with frequent participation may represent an opportunity for obesity prevention.     

Excess cardiovascular mortality associated with cold spells in the Czech Republic

Background  

The association between cardiovascular mortality and winter cold spells was evaluated in the population of the Czech Republic over 21-yr period 1986–2006. No comprehensive study on cold-related mortality in central Europe has been carried out despite the fact that cold air invasions are more frequent and severe in this region than in western and southern Europe.     

天津市北辰区社区老年人腰围及向心性肥胖流行趋势分析

目的 分析2011-2013年天津市北辰区社区老年人腰围平均水平,超重、肥胖及向心性肥胖检出率的变化情况.方法 利用2011-2013年天津市北辰区果园新村街及双街镇≥60岁社区居民的体检资料进行统计分析.结果 该社区老年人3年间向心性肥胖的检出率最高,其次为超重及肥胖.超重的标化检出率呈逐年降低趋势(x2趋势=7.99,P =0.005);肥胖的标化检出率于2012年有所下降,于2013年呈大幅度提高(x2=186.39,P＜0.001);向心性肥胖的标化检出率呈逐年上升趋势(x2趋势=28.84,P＜0.001).2011-2013年男性腰围平均水平均高于女性,男性向心性肥胖的标化检出率均低于女性(均有P ＜0.05);3年间各年龄组人群的腰围平均水平均有所增长,60～岁年龄组增长幅度最大.各年龄组人群向心性肥胖的标化检出率随着年龄的增加呈现先升后降的趋势(均有P ＜0.05),于65～岁年龄组达到最大值.结论 3年间天津市北辰区社区老年人的腰围平均水平、肥胖以及向心性肥胖的检出率升高,因此应加强老年人群肥胖的防制工作,降低相关慢性疾病的发生率,提高老年人群的生活质量.     

Smoking-attributable mortality in the Czech Republic

Objectives The main objective of this work is to quantify the contribution of smoking to mortality in the Czech Republic (CR) in 2002. Methods The estimate of the proportion by which smoking contributed to mortality in the CR was computed using the method of smoking-attributable fractions (SAF). The SAF was computed from relative risks established in the American Cancer Prevention Study II and from estimates of the prevalence of smoking from a nationwide study conducted in 2002. Results In 2002, there were 20,550 (95% confidence interval: 18,851–22,262) deaths in the CR that could be attributed to smoking (14,525 men and 6,025 women). Deaths caused by smoking represent 19% of the total nationwide mortality for 2002. Earlier estimates were published by Peto and Lopez for 1995 (22,300 deaths caused by smoking) and 2000 (17,746 deaths). The estimate arrived at using the SAF method for 2002 coincides with that reported by Peto and Lopez for 2000. Conclusions The high mortality rate related to smoking is the result of the high prevalence of smoking and an insignificant change of smoking habits in the adult population in recent years. An efficient tobacco control policy could contribute to the reduction of smoking and save lives and costs expended to treat diseases caused by smoking.     

2009—2019年中国老年人心血管疾病死亡趋势及预测分析

目的 了解2009—2019年我国老年人心血管疾病总体死亡趋势并进行趋势预测的分析,为制定适合我国老年人心血管疾病整体防治策略提供相关理论基础。方法 利用2009—2019年《中国死因监测数据集》,采用joinpoint回归模型分析老年人心血管疾病死亡率的平均年度变化百分比(AAPC),应用GM(1,1)对我国2020—2030年老年人心血管疾病死亡粗率进行预测。结果 与2009年相比,2019年我国老年人心血管疾病平均死亡粗率降至2 039.99/10万,年龄标化死亡率则降至2 172.24/10万;我国总老年人群、老年男性和女性、城市和乡村老年人心血管疾病标化死亡率AAPC分别为-2.400%、-2.843%、-2.049%、-1.368%、-3.298%,均呈长期下降趋势,P<0.05;老年男性的死亡率下降速度快于老年女性,但2009—2019年老年男性心血管病标化死亡率始终较女性高;农村的下降速度快于城市,但2009—2019年农村老年人心血管病标化死亡率始终较城市高;随着年龄的增长,中国65岁以上老年人心血管疾病的死亡率逐渐上升,在≥85岁组死亡率达到最高,各年龄组AA...     

银川市大气颗粒物对人群循环系统疾病死亡影响的时间序列分析

目的探讨银川市大气颗粒物污染水平及其对居民循环系统疾病死亡的暴露-反应关系。方法通过收集银川市2013—2015年空气质量监测数据、气象监测数据和居民死亡监测资料,采用广义相加模型,分析银川市大气颗粒物物对与居民循环系统疾病死亡的暴露-反应关系。结果大气PM_(10)和PM_(2.5)年均浓度均超过GB 3095—2012《环境空气质量标准》二级标准。大气PM_(10)和PM_(2.5)浓度每升高10μg/m~3对人群循环系统疾病死亡的超额危险度分别为0.56%(95%CI:0.15%~0.97%),1.33%(95%CI:0.46%~2.21%);大气PM_(10)和PM_(2.5)浓度对小于65岁组的循环系统疾病死亡的影响无统计学意义(P0.05),对65岁以上年龄组人群循环系统疾病死亡的超额危险度分别在滞后7、5 d时达到最大效应,分别为1.24%(95%CI:0.21%~2.28%)和0.57%(95%CI:0.08%~1.06%);大气PM_(10)、PM_(2.5)浓度对女性循环系统疾病死亡的超额危险度高于男性。结论研究期间银川市大气颗粒物浓度较高,且对人群循环系统疾病死亡存在一定的暴露-反应关系。     

老年肥胖与心血管病主要危险因素聚集的关系

目的 探讨老年人肥胖与发生心血管疾病主要危险因素聚集之间的相关关系.方法 采用横断面调查546名60～90岁的老年人,用描述性统计方法、logistic回归和ROC工作曲线法进行相关分析. 结果 (1)四种危险因素及危险因素聚集的检出率随着BMI、腰围(WC)水平的上升而增加,危险因素聚集检出率为59.5%,其中男性组为52.5%,女性组为65.7%.(2)随着BMI和(或)WC水平的上升,老年男性发生危险因素聚集风险的增长速度要高于女性,其中男性最高水平组OR值为13.579,女性组为2.876.(3)男性BMI和WC均与危险因素聚集存在独立的相关性(P<0.05),logistic回归系数分别为bBMI=0.196,bWC=0.074;女性只有WC与危险因素聚集存在独立的相关性(P<0.05),logistic回归系数为bWC=0.060,而BMI与危险因素聚集不存在独立的相关性(P=0.537).(4)男性的BMI和WC组合公式(CE)为CEBMI+WC=0.726×BMI+0.274×WC,最佳截断值为41.59,其灵敏度和特异度分别为0.785和0.598. 结论 四种主要的心血管病危险因素经常伴随着肥胖出现,BMI和WC对于心血管疾病的一级预防具有重要意义,两者的组合公式可用于预测个体的心血管疾病危险因素聚集风险.     

汉族和朝鲜族居民不同类型肥胖与心血管代谢危险因素的关系

目的 分析延边地区朝鲜族和汉族居民不同类型肥胖与心血管代谢危险因素的关系.方法 于2006年8月～2008年8月在吉林省延边农村地区随机抽取30～70岁朝鲜族和汉族人群5842人,测其身高、体重、腰围( waist circumference,WC)等指标,同时采集清晨空腹(禁食12h)静脉血,并准确测定生化指标.结果 1)30～70岁人群肥胖粗患率汉族和朝鲜族分别为12.2％和8.7％,年龄调整患病率分别为11.2％和9.8％,汉族均高于朝鲜族(x2=18.09,P＜0.001; U=39.43,P＜0.001);汉族和朝鲜族腹型肥胖粗患病率分别为46.4％和44.8％,年龄调整患病率分别为41.8％和40.9％,调整患病率汉族高于朝鲜族(U=17.64,P＜0.001).2)不同性别及民族心血管代谢危险因素及其聚集性与体质指数(body mass index,BMI)水平、WC关联与否及其程度有所不同.3)Logistic分析结果表明,高血压、高血糖(朝鲜族)、高胆同醇(total cholesterol,TC)(汉族)、低高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)(汉族)、非HDL-C、高甘油三酯(triglyceride,TG)和代谢综合征(metabolic syndrome,MS)在BMI和WC均异常组的aRR值最大;单纯BMI异常组的aRR值大于单纯WC异常组的心血管代谢危险因素为高血压(朝鲜族)、低HDL-C(汉族)和非HDL-C(朝鲜族);而单纯WC异常组的aRR值大于单纯BMI异常组的心血管代谢危险因素则为高血压(汉族)、高血糖、高TC(朝鲜族)、高TG和MS.结论 吉林省延边地区一般人群肥胖患病水平较高,而且不同民族人群不同类型肥胖患病率存在明显的差异.BMI、WC及其合并组表现出不同的心血管代谢风险.     

湖南省洪涝灾害事件对居民心血管疾病死亡的影响

目的研究洪涝灾害对湖南省居民心脑血管疾病日死亡人数的影响。方法首先采用描述性分析比较洪涝暴露年(2010年)和非暴露年(2009、2011年)心血管类疾病死亡人数的差别,然后选择差异有统计学意义的病种,采用1∶2双向病例交叉研究进一步进行验证。病例交叉分析结合分层Cox模型判断洪涝灾害对心血管类疾病死亡人数效应的滞后期及其风险比(HR),同时将最高气温、平均气压、平均相对湿度作为控制变量和待研究变量一起选入Cox模型,控制混杂因素的影响。结果描述性分析发现缺血性心脏病2010年死亡人数高于2009年和2011年;病例交叉分析中,心血管疾病总死亡在滞后17 d时HR到达最大值[1.584(95%CI:1.389~1.807)],缺血性心脏病死亡在滞后20 d时HR到达最大值[1.409(95%CI:1.122~1.769)]。结论洪涝灾害事件可能导致心血管疾病尤其是缺血性心脏病死亡风险增大,值得关注。     

城区成人超重、肥胖与心血管病危险因素关系的调查分析

目的了解武汉市矫口区社区成年居民超重、肥胖的患病现状及其相关危险因素，为社区采取有效的干预措施提供科学依据。方法采用多阶段整群随机抽样的方法，按照《2002年中国居民营养与健康状况调查工作手册》，对其进行调查和分析。结果研口社区成年居民超重率、肥胖率和腹型肥胖率分别为31．64％、12．61％和36．95％，人群超重、肥胖和腹型肥胖均随年龄增长而呈上升趋势，随体质指数的增加，高血压、糖尿病、心血管疾病、血脂异常等慢性病发生的危险因素显著增高，差别有统计学意义（P〈0．005）。人群超重、肥胖和腹型肥胖是高血压、糖尿病、心血管疾病、血脂异常等危险因素异常发生的相关因素。结论武汉市斫口区社区成年居民超重率、肥胖率和腹型肥胖率均高于2002年中国居民营养调查结果中全国人群超重、肥胖和腹型肥胖的水平，应采取积极的预防干预措施。     

Diverging trends in cardiovascular morbidity and mortality in a low risk population

Cardiovascular (CVD) disease morbidity and mortality are changing over the years, following changes in socioeconomic conditions and underlying risk factors. However, the trends of these changes differ among various populations. There is little data regarding these trends in low CVD risk populations. Tables of deaths by cause and age for the period 1956–2007 and tables of hospitalizations for the period 1979–2003 published by the National Statistical Service of Greece were used. Trends over time were determined using log-linear regression models. Age-adjusted all-cause mortality has declined steadily since 1964 in both sexes. CVD mortality initially increased until the late 1980s and subsequently decreased. An increase in mortality from stroke was seen until 1978, especially in men, followed by a decline. Mortality from coronary heart disease (CHD) increased initially, continued to increase for one decade more than stroke and started to decrease in 1989. However, only in women has CHD mortality returned below 1956 levels. As a result, deaths from CHD have surpassed those from stroke. Although the in-hospital fatality of acute myocardial infarction (AMI) has decreased by half between 1979 and 2003, deaths from AMI have decreased only slightly, as hospitalization and morbidity rates have increased during the same period. Although the various types of CVD share common risk factors, the trends of their respective mortality rates have differed significantly over the past five decades in the Greek population. This could partly be explained by the fact that risk factors do not equally contribute to CHD and stroke, and they might have not all been equally well controlled.     

Social costs of obesity in the Czech Republic

The European Journal of Health Economics - Increasing prevalence of obesity (BMI &gt; 30) is a pressing public health issue in the Czech Republic as well as world-wide, affecting up to 2.1...